Assessment of radiation dose in X-Ray fluoroscopically guided interventional procedures in Kenyan Hispitals

Abstract

Radiation dose measurements were done in four hospitals III Kenya that perform interventional procedures on a total of 52 procedures. Dose-Area Product (DAP) and Maximum Skin Dose (MSD) were measured for the patients using Dose-Area Product meter and slow radiographic films respectively. Occupational doses were measured using thermoluminescent dosimeters (TLDs) placed near the thyroid. The organ was chosen owing to its high radiosensitivity and due to the inadequate availability and use of the thyroid collars among the radiology staff during the procedures.

Maximum and minimum values were found to be 137.1 Gy.cm/ and 4.2 Gy.cnr', respectively for DAP and 740 mGy and 52 mGy for MSD. Fluoroscopic time range between 3.3-164.0 minutes. The maximum and minimum occupational (staff) dose values are: 1.41 mGy and 0.05 mGy respectively for doctors; 1.16 and 0.03 mGy for nurses; 0.78 and 0.04 mGy for radiographers; and 0.88 and 0.04 mGy for patient assistants.

Even though these values are within the dose reference levels for patients (25mGy/minute for low dose-rate mode and 100mGy/minute for high dose-rate fluoroscopic mode) and occupational dose limits for the staff (20mGy per annum), there is a lot that can be done to reduce these values through optimization of the procedures and justification of the patient dose in line with the ALARA (As Low As Reasonably Achievable) principle.