Lightweight Bilayer Barium Sulfate–Bismuth Oxide Composite Thyroid Collars for Superior Radiation Protection in Fluoroscopy-guided Interventions: A Prospective Randomized Controlled Trial

Abstract

Purpose:To test whether newer bilayer barium sulfate-bismuth oxide composite (XPF) thyroid collars (TCs) provide superior radiation protection and comfort during fluoroscopy-guided inter ventions compared with standard 0.5-mm lead-equivalent TCs. Materials and Methods:Institutional review board approval and written informed consent were obtained for this HIPAA-compliant study, and 144 fluoroscopy-guided vascular interventions were included at one center between October 2011 and July 2012, with up to two operators randomly assigned to wear XPF (n = 135) or standard 0.5-mm lead-equivalent (n = 121) TCs. Radiation doses were measured by using dosimeters placed outside and underneath the TCs. Wearing comfort was assessed at the end of each procedure on a visual analog scale (0-100, with 100 indicating optimal comfort). Adjusted differences in comfort and radiation dose reductions were calculated by using a mixed logistic regression model and the common method of inverse variance weighting, respectively. Results:Patient (height, weight, and body mass index) and procedure (type and duration of intervention, operator, fluoroscopy time, dose-area product, and air kerma) data did not differ between the XPF and standard groups. Comfort was assessed in all 256 measurements. On average, the XPF TCs were 47.6% lighter than the standard TCs (mean weight 6 standard deviation, 133 g 6 14 vs 254 g 6 44; P , .001) and had a significantly higher likelihood of a high level of comfort (visual analog scale .90; odds ratio, 7.6; 95% confidence interval: 3.0, 19.2; P , .001). Radiation dose reduction provided by the TCs was analyzed in 117 data sets (60 in the XPF group, 57 in the standard group). The mean radiation dose reductions (ie, radiation protection) provided by XPF and standard TCs were 90.7% and 72.4%, with an adjusted mean difference of 17.9% (95% confidence interval: 7.7%, 28.1%; P , .001) favoring XPF. Conclusion:XPF TCs are a lightweight alternative to standard 0.5-mm lead-equivalent TCs and provide superior radiation protection during fluoroscopy-guided interventions.q RSNA, 2013

A Transformable Mucoadhesive Microgel Network for Noninvasive Multimodal Imaging And Radioprotection of a Large Area of the Gastrointestinal Tract

“…[ 50 ] The Ba@Bi‐GLUE is made from heavy metal materials, for example, Ba and Bi, which can sharply attenuate radiation and have been widely used in radiation shielding. [ 51 ] We envision that when the GI tract is coated with Ba@Bi‐GLUE as an intracorporal radiation shield, [ 52 ] it may protect the neighboring GI tract and other healthy tissue from the high radiation exposure (Figure 8a; Figure S31, Supporting Information).…”

“…In addition to a large area of GI-tract imaging, Bi-GLUE can also be used to construct an intracorporal radiation shield by covering the GI tract with a uniform layer of radiation-attenuating material. [51,52] In the whole-abdomen irradiation model of rats, Ba@Bi-GLUE protected the GI tract from radiation damage, leading to greatly decreased GI radiotoxicity.…”

Integrity of personal radiation protective equipment (PRPE): a 4-year longitudinal follow-up study

“…PRPE layers can consist of a single attenuating layer, while others consist of a bilayer structure, the latter designed to account for fluorescent X-rays [ 21 , 27 , 28 ]. The brands mentioned in Table 2 are all composed of lead-free materials except Brand C (lead-composite).…”

Shielding effect of radiation dose reduction fiber during the use of C-arm fluoroscopy: a phantom study

“…Previous studies demonstrated the effect of barium sulfate composite thyroid collars and apron on radiation protection for operators during the use of fluoroscopy and X-ray [ 15 , 16 ]. However, there has been no study investigating the effect of patient organ shield during C-arm fluoroscopic examination.…”