Introduction – Procedures related to cardiac catheterization are increasing, resulting in increased radiation exposure for medical staff and the associated health risks. To limit the amount of radiation exposure measures are used. In many cases those measures are not properly used due to the lack of awareness from the medical staff. The primary goal of this research is to integrate a radiation model with a tool, the Azure Kinect, to locate the medical staff and calculate the radiation exposure. The secondary goal is to track the lead shield resulting in the possibility to adjust to the optimal position for the staff while executing the surgery. This study may contribute to real-time dosimetry, the optimal position of both the medical staff and the lead shield, better awareness of radiation exposure, and generally a minimization of the exposure of the medical staff during procedures in the cath lab.
Method – The Azure Kinect DK is used to track the position of the medical staff and, with help of the Aruco markers the lead shield. By using an existing radiation model, the exposure of radiation can be calculated. Firstly, the accuracy of the tracking was ensured. Subsequently, the Azure Kinect’s ability was tested to capture difficult situations. Then, the applicability of the radiation model to the Azure Kinect measurements was tested. Finally, the ability to visualize changes and demonstrate their effect on radiation exposure was examined.
Results – The inaccuracy was higher than the Azure Kinect developers reported due to non-optimal conditions; the accuracy deviation had an absolute value of 6,25%. It was found that the deviation of the coordinates between the different measurement points are moderate, with a few outliers and the y-coordinates decreasing deviation as the cardiologist moves farther away from the phantom. By combining medical staff tracking software with the radiation model, radiation exposure can be calculated. The results show that the software detected a decrease in radiation exposure as the distance towards the source increased and the lead shield is placed closer to the cardiologist.
Discussion and Conclusion – This research aims to improve the awareness of radiation exposure in real-time during a procedure. This software represents a significant improvement over the equipment currently used, such as the Phillips Dose Aware badges and the Dosimetry badges.
Despite the error sensitivity of the Azure Kinect, the combination of the device and software can measure the radiation exposure of the medical staff in simulated procedural scenarios in the cath lab. However, there are some limitations resulting in not yet being applicable during a procedure.
Future research directions should enhance the system to increase the applicability during procedures. Optimization can be achieved by positioning of the Azure Kinect to reduce the change of possible occlusion during a procedure and tracking of the lead shield with the help of AI object detection.
By accomplishing these objectives, the gap can be narrowed between the use of this software in a test environment and its application during a procedure. Ultimately, this will lead to an increased awareness of unnecessary radiation exposure among medical staff during procedures.