Operator Intracranial Dose Protection During Fluoroscopic-Guided Interventions

Cardiovasc Intervent Radiol. 2023 Jul;46(7):943-952. doi: 10.1007/s00270-023-03458-2. Epub 2023 Jun 6.

Abstract

Purpose: We utilized an anthropomorphic model made with a human skull to determine how different personal protective equipment influence operator intracranial radiation absorbed dose.

Materials and methods: A custom anthropomorphic phantom made with a human skull coated with polyurethane rubber, mimicking superficial tissues, and was mounted onto a plastic thorax. To simulate scatter, an acrylic plastic scatter phantom was placed onto the fluoroscopic table with a 1.5 mm lead apron on top. Two Radcal radiation detectors were utilized; one inside of the skull and a second outside. Fluoroscopic exposures were performed with and without radiation protective equipment in AP, 45-degree RAO, and 45-degree LAO projections.

Results: The skull and soft tissues reduce intracranial radiation by 76% when compared to radiation outside the skull. LAO (308.95 μSv/min) and RAO projections (96.47μSv/min) result in significantly higher radiation exposure to the primary operator when compared to an AP projection (54 μSv/min). All tested radiation protection equipment demonstrated various reduction in intracranial radiation when compared to no protection. The hood (68% reduction in AP, 91% LAO, and 43% in RAO), full cover (53% reduction in AP, 76% in LAO, and 54% in RAO), and open top with ear coverage (43% reduction in AP, 77% reduction in LAO, and 22% in RAO) demonstrated the most reduction in intracranial radiation when compared to the control.

Conclusion: All tested equipment provided various degrees of additional intracranial protection. The skull and soft tissues attenuate a portion of intracranial radiation.

Keywords: Intracranial radiation protection; Lead cap; Lead glasses; Personal protective equipment; Radiation protective equipment; Thyroid collar.

MeSH terms

  • Fluoroscopy
  • Humans
  • Occupational Exposure* / prevention & control
  • Phantoms, Imaging
  • Radiation Dosage
  • Radiation Exposure* / prevention & control
  • Radiation Protection*