Help - Need your recommendation for real-time dose monitoring instrumentationor methods to calculate dignostic level doses of ionizing rad. in pregnant patients

[Mark Steinbuchel <markst@ONC.hhsys.org>]

Dear Listserver Colleagues,
I would sincerely appreciate direct e-mail replies on your suggestion to 
assist us to procure a name brand instrument you can recommend by either 
actual use or knowledge of.  Want vendor/cost ballpark info to below addr.
We have just this morning had our third case (in as many years) of a 
pregnant patient who requires Cardiology procedures that we would like to 
closely monitor both her and the fetal dose in real time versus 
external dosimetry which requires processing and delay.
We shielded the patients abdomen and placed portable waist belt digital 
dosimeters and Landauer dosimetry at the surface under the lead/vinyl 
shielding but we are aware that the highly columnated beam will scatter 
slight doses from the chest's irregular bony surfaces thru the diaphragm to 
give a slight, non-teragenic dose to the fetus.
This is not a therapy use but rather fluoroscopy dose that is dependent 
upon clinician use time and contrast media use.
Our preference is to find a good diode or other transducer with a real time 
meter that can read this diagnostic dose out on a digital display.
Our plan is to place this device in our Cardiac Cath unit for use as needed 
in other departments (ER, Diagnostic Radiology, Pain Mgmt)
Do you recommend a specific device?
Would the dosimetrists recommend a better method.  Our in-house cancer 
therapy dosimetrist says it is not his area but rather a diagnostic 
radiology therapy dose which he is not sure how to calculate versus his 
bread and butter work with a tumor and adjacent structures involving 
significantly higher doses.
How do you calculate and document diagnostic doses?
Again, please reply to markst@onc.hhsys.org.
Thank you in advance,
Mark Steinbuchel, CHCM
Chairman, Radiation Safety Committee (HHS/RSC)
Alternate Radiation Safety Officer
Huntsville Hospital System
markst@ONC.hhsys.org

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