Radiation exposure during C-arm-guided (fluoroscopy) small animal orthopaedic surgery

The purpose of the current study was to investigate the radiation exposure level of surgeons performing C-arm guided small animal orthopaedic surgery using thermoluminescent dosimeters located inside and outside personnel shielding devices at major body parts. A prospective study was conducted to measure the radiation exposure dose of individuals in three positions (first assistant, operating surgeon and anaesthesiologist) using thermoluminescent dosimeters placed inside and outside protective devices. The lead equivalent protective devices included panorama mask, thyroid shield, apron and arm shield placed at five anatomic sites (eye, thyroid, breast, gonad and hand). Radiation exposure was measured during 12 surgical procedures with mean kVp of 51 and mean mAs of 1.6. The equivalent doses for thyroid, breast and gonad (outside/inside in mSv) were 1.75/0.58, 2.01/0.13 and 3.03/0.11, respectively, for the first assistant and 1.69/1.46, 4.82/0.35 and 5.25/0.22 for the operating surgeon. The dose of eye, thyroid, breast, gonad and arm for the anaesthesiologist were 0.61/0.51, 0.35/0.3, 0.67/0.34, 0.72/0.29 and 0.62/0.35, respectively. The exposure dose to gonads outside the lead protection showed the highest values in all participants. With lead protection, there was a significant reduction in the exposure dose to the gonads (first assistant, 96%; operating surgeon, 96%; anaesthesiologist, 60%). These results suggest that a radiation shield is essential in veterinary surgery with C-arms, particularly for gonad protection. In addition, these results demonstrate that exposure dose decreases with increasing distance from the C-arm machine.