Literature DB >> 28821928

Is lead shielding of patients necessary during fluoroscopic procedures? A study based on kyphoplasty.

Joshua R Smith1, Rebecca M Marsh2, Michael S Silosky1.   

Abstract

OBJECTIVE: To determine the benefits, risks, and limitations associated with wrapping a patient with lead shielding during fluoroscopy-guided kyphoplasty procedures as a way to reduce operator radiation exposure.
MATERIALS AND METHODS: An anthropomorphic phantom was used to mimic a patient undergoing a kyphoplasty procedure under fluoroscopic guidance. Radiation measurements of the air kerma rate (AKR) were made at several locations and under various experimental conditions. First, AKR was measured at various angles along the horizontal plane of the phantom and at varying distances from the phantom, both with and without a lead apron wrapped around the lower portion of the phantom (referred to here as phantom shielding). Second, the effect of an operator's apron was simulated by suspending a lead apron between the phantom and the measurement device. AKR was measured for the four shielding conditions-phantom shielding only, operator apron only, both phantom shielding and operator apron, and no shielding. Third, AKR measurements were made at various heights and with varying C-arm angle.
RESULTS: At all locations, the phantom shielding provided no substantial protection beyond that provided by an operator's own lead apron. Phantom shielding did not reduce AKR at a height comparable to that of an operator's head.
CONCLUSIONS: Previous reports of using patient shielding to reduce operator exposure fail to consider the role of an operator's own lead apron in radiation protection. For an operator wearing appropriate personal lead apparel, patient shielding provides no substantial reduction in operator dose.

Entities:  

Keywords:  Fluoroscopy; Interventional; Kyphoplasty; Operator dose; Radiation exposure; Radiation safety

Mesh:

Year:  2017        PMID: 28821928     DOI: 10.1007/s00256-017-2756-9

Source DB:  PubMed          Journal:  Skeletal Radiol        ISSN: 0364-2348            Impact factor:   2.199


  23 in total

1.  Operator shielding: how and why.

Authors:  Beth A Schueler
Journal:  Tech Vasc Interv Radiol       Date:  2010-09

2.  Radiation exposure to the surgeon during fluoroscopically assisted percutaneous vertebroplasty: a prospective study.

Authors:  Roger Harstall; Paul F Heini; Roberto L Mini; Rene Orler
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3.  Radiation safety during spine interventions.

Authors:  Jonathan S Luchs; Alex Rosioreanu; David Gregorius; Natarajan Venkataramanan; Volkmar Koehler; A Orlando Ortiz
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4.  Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty.

Authors:  Hyun-Chul Choi
Journal:  J Korean Neurosurg Soc       Date:  2011-01-31

5.  Reduction of operator radiation dose by a pelvic lead shield during cardiac catheterization by radial access: comparison with femoral access.

Authors:  Helmut W Lange; Heiner von Boetticher
Journal:  JACC Cardiovasc Interv       Date:  2012-04       Impact factor: 11.195

6.  Patient and staff dosimetry in vertebroplasty.

Authors:  Niki T Fitousi; Efstathios P Efstathopoulos; Harry B Delis; Sofia Kottou; Alexis D Kelekis; George S Panayiotakis
Journal:  Spine (Phila Pa 1976)       Date:  2006-11-01       Impact factor: 3.468

7.  Is brain cancer an occupational disease of cardiologists?

Authors:  M M Finkelstein
Journal:  Can J Cardiol       Date:  1998-11       Impact factor: 5.223

8.  Fluoroscopically guided percutaneous vertebroplasty: assessment of radiation doses and implementation of procedural routines to reduce operator exposure.

Authors:  A von Wrangel; A Cederblad; M Rodriguez-Catarino
Journal:  Acta Radiol       Date:  2009-06       Impact factor: 1.990

9.  Radiation exposure to the surgeon and the patient during kyphoplasty.

Authors:  Thomas E Mroz; Takayuki Yamashita; William J Davros; Isador H Lieberman
Journal:  J Spinal Disord Tech       Date:  2008-04

10.  Time to take the gloves off: the use of radiation reduction gloves can greatly increase patient dose.

Authors:  Alexander S Pasciak; A Kyle Jones
Journal:  J Appl Clin Med Phys       Date:  2014-11-08       Impact factor: 2.102

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