Nils Rathmann MD, Presenter: Nothing to Disclose

Michael Kostrzewa MD, Abstract Co-Author: Nothing to Disclose

Uwe Haeusler, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Institutional research agreement, Siemens AG

Steffen J. Diehl MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to investigate absolute radiation exposure values for interventional radiologists during 3D laser guided soft tissue interventions using a multi-axis interventional C-arm CT system with 3D laser guidance (Artis Zeego, Siemens Healthcare Sector, Germany).

3D, laser supported, fluoroscopic guidance (syngo iGuide) of the Siemens Artis Zeego intervention system was used to puncture sixteen lesions at different angles with a 20G biopsy-needle. The lesions were identified in a triple modality 3D abdominal phantom (model 057A, CIRS, Norfolk, VA, USA). Two 20l water containers were placed adjacent to the phantom to increase its volume. One C-arm CT (syngo DynaCT) was performed for planning of the intervention and one DynaCT was performed for post procedural evaluation to properly identify the needlepoint within the lesion. Laser supported fluoroscopy was used for needle guidance. For each intervention three thermoluminiscent dosimeters (TLDs) placed on an i.v. pole at the level of the eyes, the umbilicus and the ankles were used to collect representative radiation exposure values of the interventionalist. The i.v. pole was placed next to the phantom analogue to the position of the interventionalist without lead shielding for the entire duration of the intervention.

Sixteen interventions were analyzed. For proper positioning of the needle within each target lesion mean fluoroscopy time was 4.1s and mean overall procedural duration was 904s. Mean radiation value of all TLDs was 189µSv (±59, range 100 – 423). Mean radiation value of the TLDs at the level of the eye lens was 177µSv (±44, range 118 – 290), of the umbilicus 231µSv (±29, range 100 – 189) and of the ankle 150µSv (±29, range 100 – 189).

Our results suggest that proper lead shielding during the interventions and leaving the intervention suite during DynaCT is of critical importance to minimize radiation exposure for the medical staff. Furthermore these results have to be systematically compared to CT-guided interventions for which lower values of radiation exposure have been reported for medical staff.

These results indicate that even with modern navigation tools without lead shielding relative high radiation doses for medical staff can occur during biopsy with a clinical robot-arm assisted intervention system.

Rathmann, N, Kostrzewa, M, Haeusler, U, Schoenberg, S, Diehl, S, Radiation Exposure of Medical Staff during Percutaneous Soft Tissue Interventions on a Phantom Using a Multi-axis Interventional C-arm CT System with 3D Laser Guidance.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014165.html