Clinical evaluation of a novel head protection system for interventional radiologists

Bärenfänger, Felix; Walbersloh, Jörg; Rachid, El Mouden; Goerg, F; Block, A.; Rohde, Stefan

doi:10.1016/j.ejrad.2021.110114

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…A clinical study by Bärenfänger et al evaluating the head protector used in this study found a super cial mean dose reduction of 75% and 90% for general radiology and neuro radiology procedures respectively (20). Meanwhile, the clinical evaluation in the present study showed that the head protector reduced the radiation dose to the dosimeters placed on the inside of the protector by about 40%.…”

Section: Discussionsupporting

confidence: 57%

Evaluation of novel radiation protection devices during radiologically guided interventions

Larsson,

Jonasson,

Apell

et al. 2023

Preprint

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Background: In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. Method: An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head: and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. Results: The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. Conclusions: A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck.

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Section: Discussionsupporting

confidence: 57%

Evaluation of novel radiation protection devices during radiologically guided interventions

Larsson,

Jonasson,

Apell

et al. 2023

Preprint

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show abstract

“…A clinical study by Bärenfänger et al evaluating the head protector used in this study found a superficial mean dose reduction of 75% and 90% for general radiology and neuro radiology procedures respectively [ 20 ]. Meanwhile, the clinical evaluation in the present study showed that the head protector reduced the radiation dose to the dosimeters placed on the inside of the protector by about 40%.…”

Section: Discussionmentioning

confidence: 97%

“…In accordance with the present data, Marshall et al showed the effect of shielding against obliquely arising scattered radiation from below using a lead acrylic face mask that provided an 80% reduction in brain dose, while also protecting eye and thyroid [ 24 ]. Although the present study did not include a clinical study with the extended thyroid protector, this was tested clinically by Bärenfänger et al demonstrating an attenuation effect of the extended thyroid protector resulting in a dose reduction by up to 97% after the barrier [ 20 ]. This is consistent with the results in the present phantom study with the extended thyroid protector prototype, reducing the radiation dose by up to 90% in the middle sections of the head.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of novel radiation protection devices during radiologically guided interventions

Larsson,

Jonasson,

Apell

et al. 2024

CVIR Endovasc

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Background In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. Method An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. Results The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. Conclusions A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck. Graphical Abstract

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“…As therapeutic techniques advance, interventional cardiologists utilise catheter-based diagnostics and treatments more frequently using fluoroscopy, a real-time X-ray imaging modality, resulting in an exponential increase in their exposure to radiation, (1) predominantly to the head and neck regions not protected by lead aprons or leaded glasses. (1)(2)(3)(4) The growing concern over radiation-induced diseases among physicians performing interventional procedures, especially in interventional cardiology, highlights the need for stringent protective measures. (5,6) Experienced interventional cardiologists working in high-volume catheterisation laboratories close to the X-ray source have some of the highest occupational exposure rates to ionising radiation, with an annual exposure equivalent to 200 -250 chest X-rays.…”

Section: Introductionmentioning

confidence: 99%

The incidence of head and neck cancer in interventional cardiologists

Pretorius,

Ntutuka,

Hattingh

et al. 2024

SAHJ

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The occupational risk to interventional cardiologists related to using X-rays in the catheterisation laboratory (cath lab) includes a range of radiation-induced effects. The primary concern is the possibility of developing head and neck malignancies. A literature review of reports on developing head and neck malignancies among interventional cardiologists was conducted. Several individual cases of head and neck malignancies have been reported, predominantly on the left side. However, these studies do not have a sufficient sample size to generalise the results. Based on the available reports, it is concluded that head and neck malignancies are unlikely to constitute an occupational risk for interventional cardiologists. More research is required to establish whether head and neck malignancies are more prevalent among interventional cardiologists.

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Clinical evaluation of a novel head protection system for interventional radiologists

Cited by 5 publications

References 14 publications

Evaluation of novel radiation protection devices during radiologically guided interventions

Evaluation of novel radiation protection devices during radiologically guided interventions

Evaluation of novel radiation protection devices during radiologically guided interventions

The incidence of head and neck cancer in interventional cardiologists

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