Monitoring of surgical staff x-ray exposure in the operating room with DosiBadge.

Surgical procedures involving the use of x-rays in the operating room (OR) have increased in recent years, thereby increasing the exposure of OR staff to ionizing radiation. An individual dosimeter makes it possible to record the radiation exposure to which these personnel are exposed, but there is a lack of compliance in the wearing of these dosimeters for several practical reasons. This makes the dose results obtained unreliable. To try to improve the rate of dosimeter wearing in the OR, the Dosibadge project studied the association of the individual dosimeter with the hospital access badge, forming the Dosibadge. Through a study performed at the Tours University Hospital in eight different ORs for two consecutive periods of 3 months. The results show a significant increase in the systematic use of the dosimeter thanks to the Dosibadge, which improves the reliability of the doses obtained on the dosimeters and the monitoring of personnel. The increase is especially marked with clinicians. Following these results and the very positive feedback to this first single-centre study, we are then planning a second multicentre study to validate our proof of concept on different sites, with the three brands of individual dosimeters used in France i.e. dosimeters supplied by Dosilab; Landauer and IRSN.

Multi-selective catheter for MR-guided endovascular interventions.

Selective catheters have predefined distal shapes and need to be exchanged to change tip geometry to facilitate selective catheterization of vascular side branches. These repeated insertions increase the risk of endovascular injury and radiation dose in conventional catheterization laboratories. The aim of this study is to develop a multi-selective catheter that can replace three conventional selective catheters that are commonly used sequentially in a single procedure. By integrating the different shapes in one instrument, it is possible to avoid the required time-consuming exchange. This new instrument is also made compatible with magnetic resonance imaging (MRI) guidance, which, unlike X-ray, presents variable soft tissue contrast without the use of ionizing radiation. A 1.2 m long and 2.15 mm diameter deflectable polymer-based catheter was assembled and three widely used selective catheters could be mimicked. The instrument was visible on the images without producing unwanted artifacts in an abdominal model and in an animal under real-time MRI guidance. Simple navigation tasks were performed together with a 0.035 in. MRI-safe guidewire. In these tasks, the iliac, renal, brachiocephalic, and left subclavian arteries were cannulated only by using the shape setting and without exchange of the instruments.