Reduction of radiation exposure to operating physician and assistant using a real-time auditory feedback dosimeter during femoral artery puncturing: a study on swine model

BACKGROUND: Real-time dosimeters may create a relatively safer environment not only for the patient but also for the physician and the assistant as well. We propose the use of a real-time radiation measurement dosimeter having auditory feedback to reduce radiation exposure. METHODS: Radiation dose rates were measured for 30 fluoroscopy-guided puncturing procedures of femoral arteries in swine. Fifteen puncturing procedures were performed with real-time radiation measurement dosimeter having auditory feedback and other 15 were performed without auditory feedback dosimeter by an interventional cardiologist with 10 years of experience. RESULTS: The left body side of the operating physician (38%, p < 0.001) and assistant (25%, p < 0.001) was more exposed as compared to the right body side. Radiation dose rate to the left hand, left arm and left leg were reduced from 0.96 ± 0.10 to 0.79 ± 0.12 mSv/h (17% reduction, p < 0.001), from 0.11 ± 0.02 to 0.07 ± 0.01 mSv/h (36% reduction, p < 0.001) and from 0.22 ± 0.06 to 0.15 ± 0.02 mSv/h (31% reduction, p < 0.001) with the use of auditory feedback dosimeter, respectively. The mean fluoroscopic time was reduced from 4.8 ± 0.43 min to 4.2 ± 0.53 min (p < 0.001). The success rate of performing arterial puncturing was 100%. CONCLUSIONS: The use of auditory feedback dosimeter resulted in reduction in effective dose. The sound beep alerted the physician from the danger of exposure, and this approach induced awareness and protective mindset to the operating physician and assistant.