Radiation exposure to interventional radiologists during manual-injection digital subtraction angiography

Purpose: We investigated the relationship between the amount of radiation exposure to the operator during table-side manual-injection angiographic procedures including digital subtraction angiography (DSA) and the operator's position, as well as a simple means to decrease radiation exposure. Methods: Measurement of radiation exposure was carried out with thermoluminescent dosimeters (TLDs) in nine abdominal angiographies. In the first study, radiation exposure during DSA or during fluoroscopy was measured using TLDs placed near the angiographic table. In the second study, radiation exposure to the interventional radiologist was measured during manual-injection DA at a near and a far operator position. Results: Radiation exposure to the operator received during manual-injection DSA accounted for more than 90% of the total procedural exposure. The exposure to the operator markedly decreased at: the far position compared with that at the near position when performing DSA. Conclusion: Manual-injection DSA is the largest contributor to radiation exposure received by the interventional radiologist, therefore, the use of a power injector is always recommended when performing DSA. When manual-injection DSA is necessary, radiologists should position themselves as far away from the patient as possible.