Matt Vanderhoek is the Imaging Physicist at Henry Ford Health System in Michigan.
Radiation: Finding the right balance.
Achieving a healthy balance is key to many things in life. Whether it’s a healthy work-life balance or a balanced diet, there is usually a fine line necessary to achieve proper balance. The same is true in radiology where balance is necessary in order to maximize the benefits and minimize the risks of imaging with radiation. Too much or too little radiation can create problems for the health of the patient and the clinical team. Fundamentally, the clinical team attempts to find just the right balance by optimizing the amount of radiation used to make an image.
But, there are drawbacks to imaging with too much or too little radiation. Underexposure results in images of inferior quality. In fact, the quality can be so poor as to render the images diagnostically useless. In such cases, the patient has been exposed to the risks of radiation with no real benefit since the inferior images cannot be used for diagnosis or intervention.
Imaging with too much radiation unnecessarily elevates the risks to the patient. These risks can include deterministic effects like skin injury and hair loss and/or stochastic effects such as possible cancer induction. Furthermore, patient overexposure can result in elevated radiation exposure to clinical staff. For example, in interventional procedures involving fluoroscopic imaging, clinical staff is exposed to scatter radiation from the patient. Overexposing the patient increases the scatter radiation dose to the clinical staff and its associated risks, such as the development of cataracts. A number of studies have demonstrated substantially increased cataract rates among interventional radiologists and cardiologists.
Radiation: Seeing is believing.
Physicians are generally aware of both the benefits and risks of radiation. The benefits are very tangible as radiographic images are essential for diagnostic and interventional procedures. Physicians use these images in their daily practice. Radiation risks are more abstract as it can take years before the negative effects of radiation (e.g. cataracts) are realized. This is further exacerbated by the fact that radiation itself is rather abstract – it can’t be seen, heard, felt, tasted, or smelled. Consequently, physicians are often unaware of their daily radiation dose due to its abstract nature.
So what is the solution? The RaySafe i2 Dosimetry System – a product that makes radiation more tangible and “visible”. This system has been recently deployed in a state-of-the-art interventional radiology lab at Henry Ford Hospital. Wearing a small radiation dosimetry badge on their lead aprons, clinical staff are able to “see” their individual radiation doses in real-time as the dose amount is displayed on a monitor (color coded for easy viewing) during each interventional procedure. The RaySafe i2 system was selected for its clear display, straightforward interface, simple installation and implementation, intuitive dose management software and flexibility. Staff members have remarked that their radiation dose is much more “real” to them now that they can “see” it in real-time. We are currently investigating whether the ability to “see” the real-time dose data results in modified staff behavior in the interventional lab and a corresponding reduction in staff dose and possibly patient dose as well.
The i2 system has already proven its value for staff education and training. We have developed a hands-on fluoroscopy class in the interventional lab where clinical staff explore how staff and patient dose are affected by different parameters like x-ray beam technique, system geometry, shielding, distance, and beam-on time. The i2 is an integral part of this class; it enables the staff to directly see and learn how to optimize their use of the fluoroscopy system to minimize their dose and their patients’ dose. The real-time dose visualization helps clinical staff buy into and internalize the dose reduction techniques demonstrated during the class.
Achieving radiation balance with real time dosimetry.
The real-time dosimetry system may very well be a valuable tool in helping to achieve the right balance with radiation. In the interventional setting, the benefits of radiation are always front and center as the clinical staff views the radiographic images in real time and uses these images to perform potentially life-saving interventions. The other side of the balance equation, namely the radiation risk, is usually hidden in the background due to its abstract nature. The RaySafe i2 dosimetry system brings the risks of radiation to the foreground by displaying the staff dose in real-time, thereby making these risks more tangible and visible. With both the benefits and risks of radiation in their field of view, physicians may be better equipped to find the right balance as they optimize their use of radiation in diagnosing and treating patients. Ultimately, this innovative technology should lead to improved patient care and healthier clinical staff by maximizing the benefits and minimizing the risks of radiation in medical imaging.
Product page: RaySafe i2 Dosimetry System…