Evaluation of Occupational and Patient Dose in Challenging Hemodialysis Catheter Placement

Catheter hemodialysis is the last choice for end stage kidney disease patients. Unfortunately, long-term catheterization can lead to problems that make re-catheterization challenging. Sometimes the physician has to try catheterization through several veins and stays close to the patient during the procedure that may lead to a high radiation dose exposure to the radiologist, so that some radiologists refuse to admit such patients.
The objective of this study was an assessment of the radiation dose of radiologists and patients during the placement of double lumen catheter in difficult cases.
Patients and The thermoluminescent dosimeter (TLD) was used to measure the delivered radiation dose to physicians. During the procedure, a package of dosimeter was placed on the thyroid shield and another on the chest, under the apron in order to calculate the occupational effective dose. Moreover, patient information and parameters of the procedure were recorded in order to estimate the patient dose during the procedure.
The mean effective dose provided by TLDs, dose/procedure, and the annual dose of physicians resulted from this procedure were 30.38 µSv, 0.02 µSv/procedure, and 350.20 µSv/y, respectively. The mean dose area product, dose, and calculated peak skin dose obtained in this study were 151.44 cGy.cm2, 851.71 mGy, and 384.97 mGy, respectively.
The mean effective dose of physician per case is about 0.02 μSv/procedure which is much less than the radiation dose per other procedures. Briefly, it can conclude that double lumen replacement does not deliver an unacceptable radiation dose to the physician and even the radiation dose resulted from these cases are much less than the other procedures.