Staff Radiation Doses to the Lower Extremities in Interventional Radiology

Abstract

The purpose of this study was to investigate the radiation doses to the lower extremities in interventional radiology suites and evaluate the benefit of installation of protective lead shielding. After an alarmingly increased dose to the lower extremity in a preliminary study, nine interventional radiologists wore thermoluminescent dosimeters (TLDs) just above the ankle, over a 4-week period. Two different interventional suites were used with Siemens undercouch fluoroscopy systems. A range of procedures was carried out including angiography, embolization, venous access, drainages, and biopsies. A second identical 4-week study was then performed after the installation of a 0.25-mm lead curtain on the working side of each interventional table. Equivalent doses for all nine radiologists were calculated. One radiologist exceeded the monthly dose limit for a Category B worker (12.5 mSv) for both lower extremities before lead shield placement but not afterward. The averages of both lower extremities showed a statistically significant dose reduction of 64% (p < 0.004) after shield placement. The left lower extremity received a higher dose than the right, 6.49 vs. 4.57 mSv, an increase by a factor of 1.42. Interventional radiology is here to stay but the benefits of interventional radiology should never distract us from the important issue of radiation protection. All possible measures should be taken to optimize working conditions for staff. This study showed a significant lower limb extremity dose reduction with the use of a protective lead curtain. This curtain should be used routinely on all C-arm interventional radiologic equipment.

Occupational radiation doses to the extremities and the eyes in interventional radiology and cardiology procedures

“…Moreover, the interventionist may have a false impression of the level of protection they provide [15]. The current study did not investigate the effect of shielding on occupational dose; however, other studies have shown that the use of a table curtain can reduce doses to the lower extremities by 64% [21], whereas a similar dose reduction at the upper body is achievable by ceiling-mounted screens [14]. Regarding the nurses, recorded doses were low (maximum dose to the extremities 41 mSv and maximum dose to the eyes 16 mSv), indicating that the position of these individuals and the protective shields used during intervention effectively reduce their irradiation.…”

Radiation exposure of medical staff from interventional x-ray procedures: a multicentre study

“…This applies particularly to the feet: because protective shoes are not available, the installation of hanging lead blades under the patient couch is strongly recommended. A lead curtain is proven to reduce the radiation exposure of the lower extremities substantially [10]. Lead gloves for the hands are available, but they are not used in common practice because a high degree of touch is needed by the operator.…”

“…Several investigations [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] revealed that the doses to medical staff in interventional radiology and cardiology may be of concern from a radiation hygiene point of view. Partial-body doses reported ranged from a few microsieverts up to a few millisieverts per procedure, with higher values occurring mainly for the hands.…”

Effective Use of Radiation Shields to Minimize Operator Dose During Invasive Cardiology Procedures

“…As shown in Figure 1, shields investigated included a ceilingmounted upper body shield with a patient contour cutout, a detachable lower body shield that mounts to the side rail of the patient table, an accessory shield that extends vertically from the lower body shield, and a radiation-absorbing disposable pad (6,(11)(12)(13)(14)(15). The influence of precise placement of the upper body shield was specifically investigated.…”