SU-E-I-56: Diagnostic Lead Apron Radiation Exposure Comparison Between Manufacture-Stated and Measurements

Abstract Physicians and nurses stand with their back towards the C-arm fluoroscope when using the computer, taking things out of closets and preparing drugs for injection or instruments for intervention. This study was conducted to investigate the relationship between the type of lead apron and radiation exposure to the backs of physicians and nurses while using C-arm fluoroscopy. We compared radiation exposure to the back in the three groups: no lead apron (group C), front coverage type (group F) and wrap-around type (group W). The other wrap-around type apron was put on the bed instead of on a patient. We ran C-arm fluoroscopy 40 times for each measurement. We collected the air kerma (AK), exposure time (ET) and effective dose (ED) of the bedside table, upper part and lower part of apron. We measured these variables 30 times for each location. In group F, ED of the upper part was the highest (p < 0.001). ED of the lower part in group C and F was higher than that in group W (p = 0.012). The radiation exposure with a front coverage type apron is higher than that of the wrap-around type and even no apron at the neck or thyroid. For reducing radiation exposure to the back of physician or nurse, the wrap-around type apron is recommended. This type of apron can reduce radiation to the back when the physician turns away from the patient or C-arm fluoroscopy.

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A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-012038 ◽

2015 ◽

Vol 8 (10) ◽

pp. 1052-1055 ◽

Cited By ~ 7

Author(s):

Diogo C Haussen ◽

Imramsjah Martijn John Van Der Bom ◽

Raul G Nogueira

Keyword(s):

Radiation Exposure ◽

Radiation Protection ◽

Protection System ◽

Skin Dose ◽

Lead Apron ◽

Dose Area Product ◽

Primary Operator ◽

The Mean ◽

Area Product ◽

Peak Skin Dose

Background and purposeWe aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures.Materials and methodsRadiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot.ResultsThe two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators’ cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator.ConclusionsThe ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection.

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Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures

Asian Spine Journal ◽

10.4184/asj.2017.11.1.75 ◽

2017 ◽

Vol 11 (1) ◽

pp. 75-81 ◽

Cited By ~ 4

Author(s):

Kazuta Yamashita ◽

Hisanori Ikuma ◽

Takuya Tokashiki ◽

Takashi Maehara ◽

Akihiro Nagamachi ◽

...

Keyword(s):

Radiation Dose ◽

Prospective Study ◽

Radiation Exposure ◽

Radiological Protection ◽

Dominant Hand ◽

Annual Dose ◽

Lead Apron ◽

Left Chest ◽

Glass Dosimeter ◽

The Right

<sec><title>Study Design</title>Prospective study.</sec><sec><title>Purpose</title>During fluoroscopically guided spinal procedure, the hands of spinal surgeons are placed close to the field of radiation and may be exposed to ionizing radiation. This study directly measured the radiation exposure to the hand of a spinal interventionalist during fluoroscopically guided procedures.</sec><sec><title>Overview of Literature</title>Fluoroscopically guided spinal procedures have been reported to be a cause for concern due to the radiation exposure to which their operators are exposed.</sec><sec><title>Methods</title>This prospective study evaluated the radiation exposure of the hand of one spinal interventionalist during 52 consecutive fluoroscopic spinal procedures over a 3-month period. The interventionalist wore three real-time dosimeters secured to the right forearm, under the lead apron over the chest, and outside the lead apron over the chest. Additionally, one radiophotoluminescence glass dosimeter was placed under the lead apron over the left chest and one ring radiophotoluminescence glass dosimeter was worn on the right thumb. The duration of exposure and radiation dose were measured for each procedure.</sec><sec><title>Results</title>The average radiation exposure dose per procedure was 14.9 µSv, 125.6 µSv, and 200.1 µSv, inside the lead apron over the chest, outside the lead apron over the chest, and on the right forearm, respectively. Over the 3-month period, the protected radiophotoluminescence glass dosimeter over the left chest recorded less than the minimum reportable dose, whereas the radiophotoluminescence glass ring dosimeter recorded 368 mSv for the thumb.</sec><sec><title>Conclusions</title>Our findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure.</sec>

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Knowledge And Awareness of Radiation Safety Among Orthopaedic Surgeon: A Survey Analysis

10.21203/rs.3.rs-412015/v1 ◽

2021 ◽

Author(s):

Bushu Harna ◽

Shivali Arya ◽

Jaikaran Singh ◽

Palash Gupta ◽

Ajay Gupta

Keyword(s):

Radiation Exposure ◽

Potential Risk ◽

Radiation Safety ◽

Training Programme ◽

Minimal Invasive ◽

Survey Analysis ◽

Lead Apron ◽

Orthopaedic Surgeons ◽

Protective Gear ◽

Level Of Knowledge

Abstract Purpose: Orthopaedic surgeons are at potential risk to suffer from radiation exposure. The radiation exposure has increased due to minimal invasive and complex orthopaedic procedures. This study evaluates the level of knowledge of orthopaedic surgeons regarding radiation safety and prevention.Methods: A survey consisting of 17 questions was conducted among the 519 orthopaedic surgeons. The orthopaedic surgeons were contacted via mobile or email and the data was analysed.Results: Total of 542 responses were received and 23 were excluded due to incomplete responses. The result depicted, only 5% of the orthopaedic surgeons were aware of the ALARA/ALARP principles. Only 45% of the surgeons were right about the collimated image acquisition. None of the surgeon used dosimeter in the study. Most of the surgeons (40%) were not aware of the influence of C-Arm orientation on the scattered radiation. The protective gears were used by 75% of the orthopaedic surgeons and 5% used it occasionally. A lead apron is used by all the orthopaedic surgeons using the protective gear whereas only 15% used thyroid shield additionally. Only 5% of orthopaedic surgeons had some training in radiation safety and protection.Conclusion: The study demonstrates the level of knowledge regarding radiation safety and consequences among orthopaedic surgeons. The study depicts the need for proper and appropriate training required by the orthopaedic surgeons. Further extensive and elaborate studies are required to ascertain the radiation safety as a part of the training programme of the orthopaedic surgeons.

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Comparison of a Suspended Radiation Protection System versus Standard Lead Apron for Radiation Exposure of a Simulated Interventionalist

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2010.12.016 ◽

2011 ◽

Vol 22 (4) ◽

pp. 437-442 ◽

Cited By ~ 28

Author(s):

Daniel A. Marichal ◽

Temoor Anwar ◽

David Kirsch ◽

Jessica Clements ◽

Luke Carlson ◽

...

Keyword(s):

Radiation Exposure ◽

Radiation Protection ◽

Protection System ◽

Lead Apron ◽

System Versus ◽

Standard Lead

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Collimation Reduces Radiation Exposure to the Surgeon in Endoscopic Spine Surgery: A Prospective Study

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0041-1726111 ◽

2021 ◽

Author(s):

H. Yener Erken ◽

Onur Yilmaz

Keyword(s):

Radiation Dose ◽

Gamma Radiation ◽

Prospective Study ◽

Radiation Exposure ◽

Spine Surgery ◽

Lead Apron ◽

Endoscopic Spine Surgery ◽

A Prospective Study ◽

Operating Surgeon

Abstract Background and Study Aims There are no previous studies in the literature comparing the radiation dose to which surgeons are exposed while using a standard fluoroscopy versus collimation during transforaminal percutaneous endoscopic lumbar diskectomy (PELD). The aim of this study is to compare this and to evaluate the effectiveness of collimation in reducing radiation exposure. Methods In this study, the operating surgeon (single surgeon) placed a gamma radiation dosimeter on his chest outside of the lead apron during transforaminal PELD surgeries and measured the radiation exposure immediately after each surgery. As foraminoplasty using free-hand reamers is a longer procedure and requires more fluoroscopy shots, we divided the patients into two groups. The first group consisted of 24 patients (nonforaminoplasty group). The second group consisted of 13 patients (foraminoplasty group). We compared the radiation exposure to the operating surgeon using a standard fluoroscopy versus collimation for each group individually and overall. We randomized the patients within each group based on the order in which they had their respective procedures. Results We analyzed 39 patients who underwent transforaminal PELD between May and December 2019. In both groups, as well as overall, the recorded radiation exposure to the surgeon was significantly lower in surgeries in which collimation was used. In the first group, the radiation dose was 0.083 versus 0.039 mSv per surgery (p = 0.019), whereas in the second group, it was 0.153 versus 0.041 mSv per surgery (p = 0.001), and overall it was 0.108 versus 0.039 mSv per surgery (p < 0.001). Conclusion The use of collimation during transforaminal PELD significantly reduces spine the surgeon's exposure to radiation. Therefore, spine surgeons should consider using collimation during transforaminal PELD.

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Fetal radiation exposure risk in the pregnant neurointerventionalist

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015727 ◽

2020 ◽

Vol 12 (10) ◽

pp. 1014-1017 ◽

Cited By ~ 1

Author(s):

Stephanie H Chen ◽

Marie-Christine Brunet

Keyword(s):

Radiation Exposure ◽

Radiation Safety ◽

Women Physicians ◽

Fluoroscopy Time ◽

Exposure Risk ◽

Safety Practices ◽

Lead Apron ◽

Significant Difference ◽

Fetal Dose ◽

Exposure Measurements

BackgroundThe prevalence of women physicians is steadily rising, but the field of neurointervention remains one of the most male-dominated subspecialties in medicine. A fear of radiation exposure, particularly during pregnancy and childbearing years, may be responsible for deterring some of the best and brightest. This is the first study to examine the amount of maternal and fetal radiation exposure during a pregnant neurointerventional fellow’s training.MethodsWe retrospectively analyzed the radiation exposure of a neurointerventional fellow prior to and during pregnancy from February 2018 to May 2019 in 758 neurointerventional cases. The collar dosimeter was used to measure overall maternal exposure and an additional fetal dosimeter was worn under two lead apron skirts to estimate fetal radiation exposure.ResultsThere was not a significant difference between pre- and post-pregnancy overall maternal radiation exposure as measured by the collar dosimeter (151 mrem pre-pregnancy and 105 mrem during pregnancy, p=0.129). Mean fluoroscopy time and fluoroscopy emission per procedure also did not differ prior to and during pregnancy. Fetal radiation exposure measurements from both the Mirion Genesis Ultra TLD dosimeter as well as the Mirion Instadose dosimeters worn under double lead apron skirts were 0 mrem for all 6 months.ConclusionThese findings suggest that, when optimal radiation safety practices are implemented, the fetal dose of a pregnant neurointerventionalist is negligible. Further studies and education are necessary to encourage women to choose neurointervention and allow practicing women neurointerventionalists to maintain their productivity during their reproductive years.

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Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

Diagnostics ◽

10.3390/diagnostics11061099 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1099

Author(s):

Peter Dankerl ◽

Matthias Stefan May ◽

Christian Canstein ◽

Michael Uder ◽

Marc Saake

Keyword(s):

Remote Control ◽

Radiation Exposure ◽

Radiation Protection ◽

Full Potential ◽

Control Room ◽

Lead Apron ◽

Significant Difference ◽

Tube Output ◽

Examination Room ◽

Personal Dosimeter

This study aimed to evaluate the radiation exposure to the radiologist and the procedure time of prospectively matched CT interventions implementing three different workflows—the radiologist—(I) leaving the CT room during scanning; (II) wearing a lead apron and staying in the CT room; (III) staying in the CT room in a prototype radiation protection cabin without lead apron while utilizing a wireless remote control and a tablet. We prospectively evaluated the radiologist’s radiation exposure utilizing an electronic personal dosimeter, the intervention time, and success in CT interventions matched to the three different workflows. We compared the interventional success, the patient’s dose of the interventional scans in each workflow (total mAs and total DLP), the radiologist’s personal dose (in µSV), and interventional time. To perform workflow III, a prototype of a radiation protection cabin, with 3 mm lead equivalent walls and a foot switch to operate the doors, was built in the CT examination room. Radiation exposure during the maximum tube output at 120 kV was measured by the local admission officials inside the cabin at the same level as in the technician’s control room (below 0.5 μSv/h and 1 mSv/y). Further, to utilize the full potential of this novel workflow, a sterile packed remote control (to move the CT table and to trigger the radiation) and a sterile packed tablet anchored on the CT table (to plan and navigate during the CT intervention) were operated by the radiologist. There were 18 interventions performed in workflow I, 16 in workflow II, and 27 in workflow III. There were no significant differences in the intervention time (workflow I: 23 min ± 12, workflow II: 20 min ± 8, and workflow III: 21 min ± 10, p = 0.71) and the patient’s dose (total DLP, p = 0.14). However, the personal dosimeter registered 0.17 ± 0.22 µSv for workflow II, while I and III both documented 0 µSv, displaying significant difference (p < 0.001). All workflows were performed completely and successfully in all cases. The new workflow has the potential to reduce interventional CT radiologists’ radiation dose to zero while relieving them from working in a lead apron all day.

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AWARENESS OF RADIATION HAZARD IN ORTHOPAEDIC RESIDENTS SURGEON IN A CENTRAL INDIA

International Journal of Advanced Research ◽

10.21474/ijar01/13273 ◽

2021 ◽

Vol 9 (08) ◽

pp. 352-356

Author(s):

Rajeev Shukla ◽

◽

Mayank Gulve ◽

Bikramdeep Singh ◽

Aayush Soni ◽

...

Keyword(s):

Radiation Exposure ◽

Biological Effects ◽

Central India ◽

Image Intensifier ◽

Daily Practice ◽

Radiation Hazard ◽

Radiation Toxicity ◽

Total Radiation ◽

College Hospital ◽

Lead Apron

One of the effective techniques which has evolved in contemporary orthopaedic practice is C-arm ï¬‚uoroscopy in intra-operative orthopaedic procedures. Such techniques improve the competence of the surgeon while reducing the jejuneness and duration of the patients stay at hospital. Although having awareness about reported benefits of the device, there is increasing worry over the surgical teams elevated radiation exposure. The current research was undertaken on orthopaedic surgeons working in the region of Central India to assess the amount of radiation exposure if they follow the normal precautionary steps as well as to raise awareness and encouraging them to use the image intensifier safety in daily practice. In addition, to raise concerns of radiation safety and the befitting use of radiation in the operating room.Materials and Method: This is an observational review of data gathered by residents performing common orthopedic surgical operations in emergency and routine OT during one-year residency at a medical college hospital. We calculated the mean radiation exposure on each resident (orthopedic resident postgraduate-3yr) with and without lead apron protection, and compared it with the ICRP limit for radiation to body per year between 1st January 2020 and 31st December 2021.Result: Total radiation levels accumulated by one resident without lead apron over 1 year was calculated (35.88 milliSv). which was greater to ICRP limit for radiation to body per year (20milliSv).Total radiation levels accumulated by one resident with lead apron over 1 year was calculated (2.04 mSv).which was less than ICRP limit for radiation to body per year (20mSv).Conclusion: Orthopedic resident surgeons are not listed as Radiation personnel. Radiation toxicity, in addition to the risks of other surgical industries, is therefore an additional occupational danger. As a result, orthopedic resident surgeons should be concerned. During surgeries, junior orthopaedic residents vastly underestimate their level of radiation. They should adhere to the guidelines outlined above. The conventional assertion that radiation exposures during c arm use are negligible and should be disregarded, as the long-term adverse biological effects of continuous low-dose radiation exposure are uncertain at this time. Theres a chance of cancer, as well as genetic variations and fertility complications.

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Radiation Exposure

Rheumatology News ◽

10.1016/s1541-9800(07)70634-8 ◽

2007 ◽

Vol 6 (11) ◽

pp. 35

Author(s):

WILLIAM E. GOLDEN ◽

ROBERT H. HOPKINS

Keyword(s):

Radiation Exposure

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