Computational assessment of occupational exposure during hepatic chemoembolization

Abstract

One of the treatment alternatives for hepatocellular carcinoma (HCC) is transarterial chemoembolization (TACE). During this procedure, occupationally exposed individuals (OEIs) remain in the room and, therefore, are exposed to radiation. The objective of this work was to evaluate the equivalent and effective doses that OEIs received from TACE procedure of HCC. The evaluation was carried out by means of conversion coefficients for equivalent (CC[H_T]) and effective (CC[E]) doses. The study was conducted based on computer simulation, using the Monte Carlo N-Particle code, version 6.2. An interventional radiology (IR) room was built containing 3 male virtual phantoms (MASH3) to represent the main physician, the assistant, and the patient. The scenarios varied according to the posteroanterior (PA), cranial, 12° (CRA12), caudal, 12° (CAU12) and left anterior oblique, 26° (LAO26) projections and different tube voltage values (70 and 80 kV) with the field size fixed at 35 × 35 cm². Furthermore, personal protective equipment (PPE) and collective protective equipment (CPE) were incorporated into the scenarios to evaluate the dose reduction on the OIEs. It was observed that the highest dose values received by the OEIs were for the LAO26 projection when an 80 kV tube voltage was applied. The CC[E] values were reduced by up to 95%, while the CC[H_T] values saw a reduction of up to 99% with the use of PPEs, for the main physician. Considering the scenario without the use of PPEs, the absolute effective dose received by the main physician was 266.71 μSv and by the assistant 30.29 μSv. When all PPEs and CPEs were used, the effective doses for these professionals were reduced to 24.12 μSv (main physician) and 1.16 μSv (assistant). The significant dose reduction achieved with protective equipment underscores the critical importance of consistently using these devices.