Eye Lens Exposure to Radiation in Interventional Suites: Caution Is Warranted

TLDR

The study reports estimated eye‑lens radiation doses to interventionalists from procedures performed with and without radiation protection measures. Using patient‑simulating phantoms, the authors measured scattered radiation from seven fluoroscopic systems across low, medium, and high‑dose modes, accounting for beam angulation, equipment, distance, procedure complexity, collimation, and protective eyewear or screens to estimate lens doses. Measured lens doses ranged from 6.0 to 34.5 µSv/min during fluoroscopy, 0.77–3.33 µSv per DSA image, and 0.25–3.72 mSv per procedure for various interventions, with neuroembolization exceeding 10 mSv, indicating that cumulative exposure can surpass cataract thresholds without protection.

Abstract

To report estimated radiation doses to the eye lens of the interventionalist from procedures performed with and without use of radiation protection measures.Scattered radiation doses for seven interventional radiology fluoroscopic systems were measured by using phantoms simulating patients 16-28 cm in thickness undergoing low-, medium-, and high-mode fluoroscopy, cine cardiac imaging, and digital subtraction angiography (DSA). The radiation doses to the eye lens in low- and high-dose scenarios were estimated. Beam angulation, biplanar equipment, working distance, procedure complexity, imaging collimation, and use of eyeglasses and/or protective suspended screens were taken into account. The doses to the lens in several procedures were assessed.Mean scattered radiation doses to the lens during fluoroscopy were 6.0 and 34.5 microSv/min in the low- and high-dose scenarios, respectively. For DSA, typical doses to the lens ranged from 0.77 to 3.33 microSv per image. Operation modes involving increasing or decreasing radiation doses were quantified. For hepatic chemoembolization, iliac angioplasty, pelvic embolization, and transjugular intrahepatic portosystemic shunt creation, lens doses ranged from 0.25 to 3.72 mSv per procedure when protection was not used. Lens doses in the neuroembolization procedures could exceed 10 mSv per procedure.With typical reported workloads, radiation doses to eye lenses may exceed the threshold for deterministic effects (ie, lens opacities or cataracts) after several years of work if radiation protection tools are not used.