Effectiveness of additional lead shielding to protect staff from scattering radiation during endoscopic retrograde cholangiopancreatography procedures

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is often complex and involves long fluoroscopic times, with significant radiation exposure to medical staff. We investigated protective effects of an additional attached lead shielding device. The lead shielding device covered with the X-ray tube table (0.125 mm lead equivalent) during ERCP procedures. Fluoroscopy scatter radiation, with or without the lead shielding device, was measured using an acrylic phantom and a radiation survey meter. Measurements (25 points) were made at 50 cm intervals, at both 90 and 150 cm above the floor. We created radiation maps, with and without the additional lead shielding device. Moreover, we monitored annual staff exposure to radiation, before and after inclusion of the shielding device. Without additional shielding, exposure doses at the physician’s position, 90 and 150 cm above the floor, were 1940 and 4040 (μSv/h) respectively. In contrast, with the shielding device, corresponding exposures were 270 and 450 (μSv/h) at 90 and 150 cm, respectively. Scattered radiation was decreased by 86.1% at 90 cm or 88.9% at 150 cm. However, with additional lead shielding in the middle, rather than hung over the operating table, scattered radiation was decreased by only ~10%. The staff’s annual dose equivalents (DEs) were 12.2–29.8 mSv/year without and 3.8–8.4 mSv/year with lead shielding. With lead shielding, dose equivalent values for the staff were decreased by 41.0–76.5%. Thus, with additional lead shielding, properly used, scattered radiation would be decreased by ~90%, thus decreasing exposure doses to medical staff during ERCPs.

Usefulness of an additional lead shielding device in reducing occupational radiation exposure during interventional endoscopic procedures

“…Additionally, Morishima et al reported that among endoscopists, the mean radiation doses per procedure with and without the additional lead shielding device were 31.9 μSv and 87.8 μSv, respectively (dose reduction of 63.7%). [ 2 ] The mean radiation dose per procedure at the endoscopist's location was lower in our study (28.8 μSv) than in previous studies. Additionally, our phantom study revealed the usefulness of the additional lead shielding device.…”

“…Although there have been reports on the use of additional lead shielding devices during cardiac catheterization procedures, [ 12 – 15 ] few studies have examined scattered radiation doses received by medical staff during endoscopic procedures, including ERCP. [ 2 – 4 , 16 ] Therefore, the present study aimed to compare radiation doses during endoscopic procedures before and after the installation of an additional lead shielding device, attached to the operating room table, and to determine whether this additional lead shielding device can further protect endoscopists and other medical staff, especially nurses, from radiation.…”

Evaluation of novel X-ray protective eyewear in reducing the eye dose to interventional radiology physicians

“…Although reports have been published on the basic effects of radiation protection products [ 33–43 ], few studies have evaluated the shielding effects of Pb glasses in a clinical setting, such as IVR [ 29–31 ]. Prevention of occupational eye radiation dose is important, particularly for IVR physicians; thus, Pb glasses that provide better shielding are required.…”

Radiation protection effect of mobile shield barrier for the medical personnel during endoscopic retrograde cholangiopancreatography: a quasi-experimental prospective study

“…More recently, in 2011, Kim et al 11 used a curtain-shaped protective shield composed of seven movable lead plates to reduce radiation. Several other studies have attempted to attach lead shields directly to X-ray tubes12–14 or image intensifiers 15. The above-mentioned studies commonly used a method of hanging a radiation protective shield from above, similar to a curtain.…”