Radiation doses accepted by operators in different positions during percutaneous coronary intervention: analysis of radiation distribution characteristics

Objective: To discuss the characteristics of radiation distribution for operators in different positions with different radiation shields during percutaneous coronary intervention (PCI). Methods: Seven operator's positions and radial artery approach often used in PCI were adopted in this study. The standard simulation human body was exposed to X-ray. Under the conditions of different operator's positions with no bedside protection, with only hanging protective shield or with only bedside fixed lead skirt, the body surface incident doses on the first and second operators in different positions were separately measured, and the measurements were repeated 20 times. Using t test the differences of body surface incident dose under different conditions were compared. The radiation-shielding rates of different protective shields in different positions were separately calculated. Results: The body surface incident doses on the first and second operators when only a fixed bedside lead skirt was used were higher than those when only a hanging protective shield was used (t values for first operator = 926.0, 376.5, 75.8, 1329.0, 668.0, 1148.0 and 419.5 respectively; t values for second operator = 102.6, 41.1, 82.8, 539.4, 541.8, 204.0 and 43.1 respectively), the differences were statistically significant (P < 0.05). The radiation-shielding rates of ceiling-suspended screen for body surface incident dose for first operator in different positions were 98.31%, 93.67%, 67.74%, 98.63%, 99.52%, 89.28% and 96.10% respectively;while the radiation-shielding rates of fixed bedside lead skirt for body surface incident dose for first operator in different positions were 10.39%, 4.53%, 57.67%, 0.68%, 4.66%, 54.38% and 9.68% respectively. Conclusion: During PCI, the radiation dose received by the operators mainly comes from the scattered radiation above the catheter-bed, which is more obvious in left foot position, left anterior oblique position, foot position, right foot position and right anterior oblique position. In left head position and head position, the radiation dose received by the operators not only comes from the scattered radiation above the catheter-bed but also partly comes from the scattered radiation below the catheter-bed. Full understanding of radiation doses distribution in different positions can help make a good job of daily radiation protection in a targeted manner. (authors)