Radiation dose to patients and personnel during intraoperative digital subtraction angiography

BACKGROUND AND PURPOSE: The use of intraoperative angiography to assess the results of neurovascular surgery is increasing, The purpose of this study was to measure the radiation dose to patients and personnel during intraoperative angiography and to determine the effect of experience. METHODS: Fifty consecutive intraoperative angiographic studies were performed during aneurysmal clipping or arteriovenous malformation resection from June 1993 to December 1993 and another 50 from December 1994 to June 1995, Data collected prospectively included fluoroscopy time, digital angiography time, number of views, and amount of time the radiologist spent in the room. Student's t-test was used to assess statistical significance. Effective doses were calculated from radiation exposure measurements using adult thoracic and head phantoms, RESULTS: The overall median examination required 5.2 minutes of fluoroscopy, 55 minutes of operating room use, 40 seconds of digital angiographic series time, and four views and runs. The mean room time and the number of views and runs increased in the second group of patients. A trend toward reduced fluoroscopy time was noted. Calculated effective doses for median values were as follows: patient, 76.7 millirems (mrems); radiologist, 0.028 mrems; radiology technologist, 0.044 mrems; and anesthesiologist, 0.016 mrems. CONCLUSION: Intraoperative angiography is performed with a reasonable radiation dose to the patient and personnel, The number of angiographic views and the radiologist's time in the room increase with experience.