Radiation safety assessment of patient and staff during intracranial aneurysm treatment: A phantom study
Authors:   Radiology Medical Services, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Punikhom Puengjai , Kirisattyakul Woranan ,   Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Prabsattroo Thawatchai ,   Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Munkong Waranon ,   Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Pattum Panuwat ,   Radiology Medical Services, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Karawek Rattapong ,   Radiology Medical Services, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Awikunprasert Panatsada ,   Department of Radiological Technology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Pungkun Vithit ,   Office of Atoms for Peace, Ministry of Higher Education, Science, Research and Innovation, Bangkok, Thailand.
Published: February 2025

Background: Endovascular treatment using coiling embolization for intracranial aneurysms is common in interventional neuroradiology (INR). However, it is associated with high radiation exposure to both patients and medical staff. The assessment and management of radiation risk have been a concern.

Objective: To evaluate patient and scatter radiation doses at INR staff working position during the coiling embolization procedure in a phantom study.

Materials and methods: An anthropometric phantom from head to pelvis was placed on an angiographic table. To determine the phantom’s entrance skin dose (ESD), 19 NanoDot optically stimulated luminescence dosimeters (OSLDs) were placed on the surface of the head phantom. Moreover, 6 NanoDot OSLDs were also placed on the surface of the phantom at 3 critical organs (eyes, thyroid, ovaries). To determine the scatter radiation dose at staff working position, polyvinyl chloride pipes (150 cm height) were placed at the position of all staff, including interventional radiologist (IR), radiology resident (RR), scrubbed nurse (SN), radiologic technologist (RT), circulating nurse (CN), and nurse anesthetists (AN). The InLight® OSLDs were placed on each PVC pipe at 50, 100, and 150 cm height from the floor level. Coiling embolization was simulated following the standard procedure using a bi-plane digital subtraction angiography unit with standard radiation protective equipment. The patient doses from the radiation dose structured report (RDSR) were also recorded.

Results: The highest ESDs were observed in the occipital part (1,631.56±36.97 mGy). These ESD peaks were also observed within the safety limit and produced no skin reaction. The radiation dose at the left eye was observed to be the highest value among critical organs. The highest scatter radiation dose was observed at the position of IR at 100 cm level. Among CN, AN, and RT positions, the highest dose was recorded at the RT position at the level of 150 cm. The RDSR showed that most of the patient radiation dose was received from the 2-dimension angiography.

Conclusion: The distribution of radiation dose varied across different staff positions. As the key person conducting the coiling embolization procedure, the IR position received the highest radiation dose. Thus, close monitoring and development of additional radiation protection methods for this position are essential. Although the radiation dose at the back of the head was elevated, it remained within safety limits. Nevertheless, the monitoring of potential radiation effects should not be neglected.