Integration of Active Personal Dosimeters, Videos from In-Room Monitors, and Videos from the Surgeon’s Main Panel Reveal Pitfalls in Radiation Protection

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

In this manuscript, synchronizing APD data, in-room video, and exposure-related parameters from the operator’s main monitor identified previously unrecognized misuses of radiation protective devices and enabled clear corrective strategies. They used the proposed method to identify operator’s incorrect use of radiation protection equipment and enabled clear feedback to operators on areas for improvements in radiation protection practices. It is an interesting method in the field of radiation protection. It is shown that appropriate use of a ceiling-suspended radiation protective shield (CSRPS) was associated with approximately 70% exposure reduction. It is useful for practical applications. The manuscript can meet the standards of Applied Sciences. I think it can be acceptable for publication after minor revision.

1. In the introduction part, authors should provide more sufficient backgrounds about radiological protection and discuss the novelty and academic values of this paper more clearly.
2. Authors should compare their results with others well-known techniques in section 3 or in section 4 to prove the advantages of the proposed method. 
3. The authors should check the formatting of the entire file. For example, some figures are not well-presented such as Figs.1-3 and Figs.6-7.
4. The manuscript presents the method of the integration of active personal dosimeters and videos. will these large amounts of data affect the speed of data processing?

Minor revision is there. Please carefully address above concerns in the revised manuscript. Then the paper may be accepted.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Editor-In-Chief

Applied Science, MDPI,

Subject: Review of the article applsci-3926428

 

Entitled “Integration of active personal dosimeters, videos from in-room monitors, and videos from the surgeon's main panel reveals pit-falls in radiation protection”

 

The study addresses misuse of radiation protection devices, and enables corrective strategies. The misuse was evident after synchronizing APD data, in-room video and operator’s exposure related parameters. The work is interesting, relevant and informative. The work can be further enhanced to become an effective educational tool. Enclosed below are some specific comments for the authors to consider.

 

Specific comments:

1. keywords should be reduced following journal formats.
2. introduction: how is APD, and in-room monitors being associated with lens dose? Further, how is the inappropriate use of CSRPS resulting in higher operator lens dose? While this is the findings reported in reference 4, the rational behind it should be clearly introduced since it is the base of building the current study.
3. Fig 3: identify the in-room camera footage location. If it’s C1 and C2, then clearly mention that.
4. Example is needed to help understand how unprotected dose was calculated based on the operator position.
5. an added section to describe the non-therapeutic intervention procedure is preferable. This is to better understand section 2.7.
6. table 1. The readings between the two physicians per procedure is significant, why?
7. Table 2: when data is not provided, what does it mean?
8. Table 3: the placement of CSRPS didn’t significantly affect the chest active meter readings, however the dose remains high as if no attenuation effect. Why?
9. a table that summarize the appropriate placement of CSRPS and CMRPC is beneficial. The summary will be based on all the different scenes.
10. all dose measured are not lens specific, if yes a formula to estimate the lens dose using cervical or chest active meters should be included.

 

 

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The provided file contains comments and suggestions. Please check the document to see feedback.

Comments for author File: Comments.pdf

Author Response

Thank you for your helpful comments. We have updated the IRB statement accordingly:

This study is a retrospective observational analysis of existing individual radiation exposure doses of healthcare workers. Since measuring individual doses is a statutory requirement, an ethical review was not necessary. However, because individual doses are private information, written consent was obtained from the participants after approval from the Ethics Committee for this paper. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the University of Occupational and Environmental Health. Reference number: ID24-015, with the original version (1.0) approved by the IRB on March 25, 2025, and a revised version (2.0) approved on August 12, 2025.

 

We appreciate your detailed advice on statistical methods. As you pointed out, much of our data, including our own, does not follow a standard normal distribution. We believe there is still much for us to learn about statistical approaches for such cases, possibly because we are all clinicians or radiologic technologists. When writing our next paper, we plan to include a statistics expert as a co-author, and we will greatly benefit from your insights.

Reviewer 4 Report

Comments and Suggestions for Authors

The study on the use of CSRPS/CSRPC to reduce radiation exposure for operating personnel takes an interesting approach to improving radiation protection with the integration of video analysis. The text is written in a clear and understandable manner and can be published as is, with the exception of one formal point—the set of formulas (1) and (2) in lines 123 and 139. The use of scientific formula typesetting makes it easier for me, at least, to read the formula without having to guess what is in the numerator or denominator.  It is also not entirely clear to me whether p = P (153) and what the meaning of the variable alpha (144) is.

I am unable to assess whether the measures proposed from line 314 onwards can be implemented and whether, for example, they restrict the freedom of movement of the operators. However, this is a good point for discussion, which has nothing to do with the quality of the study and may need to be demonstrated in practice.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf