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European Radiology

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01-08-2014 | Interventional

A novel removable shield attached to C-arm units against scattered X-rays from a patient’s side

Authors: Hiroshige Mori, Kichiro Koshida, Osamu Ishigamori, Kosuke Matsubara

Published in: European Radiology | Issue 8/2014

Abstract

Objectives

We invented a drape-like shield against scattered X-rays that can safely come into contact with medical equipment or people during fluoroscopically guided procedures. The shield can be easily removed from a C-arm unit using one hand. We evaluated the use of the novel removable shield during the endoscopic retrograde cholangiopancreatography (ERCP) procedure.

Methods

We measured the dose rate of scattered X-rays around endoscopists with and without this removable shield and surveyed the occupational doses to the ERCP staff. We also examined the endurance of the shield.

Results

The removable shield reduced the dose rate of scattered X-rays to one-tenth and reduced the monthly dose to an endoscopist by at least two-fifths. For 2.5 years, there was no damage to the shield and no loosening of the seam. The bonding of the hook-and-loop fasteners did not weaken, although the powerful double-sided tapes made especially for plastic did.

Conclusions

The removable shield can reduce radiation exposure to the ERCP staff and may contribute to reducing the exposure to the eye lenses of operators. It would also be possible to expand its use to other fluoroscopically guided procedures besides ERCP because it is a light, simple, and useful device.

Key Points

• We invented a shield that can be removed from C-arm units with one hand.

• The removable shield reduces the dose rate of X-rays to one-tenth.

• The removable shield reduces operator exposure by two-fifths.

• The removable shield is durable, lasting for several years.

• The drape-like removable shield is light, simple, and useful.

Ramos M, Montoro A, Almonacid M (2010) Radiation effects analysis in a group of interventional radiologists using biological and physical dosimetry methods. Eur J Radiol 75:259–264PubMedCrossRef

Buls N, Pages J, Mana F, Osteaux M (2002) Patient and staff exposure during endoscopic retrograde cholangiopancreatography. Br J Radiol 75:435–443PubMedCrossRef

Ito H, Hosoya T, Eguchi Y, Adachi M, Watanabe Y, Yamaguchi K (1999) Analysis of radiation scatter during angiographic procedures: evaluation of a phantom model and a modified radiation protection system. J Vasc Interv Radiol 10:1343–1350PubMedCrossRef

Dumonceau JM, Garcia-Fernandez FJ, Verdun FR et al (2012) Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy 44:408–421PubMedCrossRef

Uradomo L, Cohen H, Fried M, Petrini J, Rehani M (2009) Radiation protection in the endoscopy suite—Minimizing radiation exposure for patients and staff in endoscopy: a joint ASGE/IAEA/WGO guideline. World Gastroenterology Organisation, Milwaukee, WI. Available via http://www.worldgastroenterology.org/radiation_protection_in_the_endoscopy_suite.html. Accessed 31 Dec 2013

Tsapaki V, Paraskeva KD, Mathou N et al (2011) Patient and endoscopist radiation doses during ERCP procedures. Radiat Prot Dosim 147:111–113CrossRef

Chen MY, Van Swearingen FL, Mitchell R, Ott DJ (1996) Radiation exposure during ERCP: effect of a protective shield. Gastrointest Endosc 43:1–5PubMedCrossRef

Kim YJ, Cho KB, Kim ES et al (2011) Efficacy of a self-designed protective lead shield in reduction of radiation exposure dose during endoscopic retrograde cholangiopancreatography. Korean J Gastroenterol 57:28–33PubMedCrossRef

King JN, Champlin AM, Kelsey CA, Tripp DA (2002) Using a sterile disposable protective surgical drape for reduction of radiation exposure to interventionalists. AJR Am J Roentgenol 178:153–157PubMedCrossRef

10.

Dromi S, Wood BJ, Oberoi J, Neeman Z (2006) Heavy metal pad shielding during fluoroscopic interventions. J Vasc Interv Radiol 17:1201–1206PubMedCentralPubMedCrossRef

11.

Shortt CP, Al-Hashimi H, Malone L, Lee MJ (2007) Staff radiation doses to the lower extremities in interventional radiology. Cardiovasc Intervent Radiol 30:1206–1209PubMedCrossRef

12.

International Commission on Radiation Units and Measurements (1993) Quantities and units in radiation protection dosimetry. ICRU Report 51, ICRU, Bethesda, Maryland

13.

Kurihara T, Itoi T, Sofuni A et al (2012) Novel protective lead shield and pulse fluoroscopy can reduce radiation exposure during the ERCP procedure. Hepatogastroenterology 59:709–712PubMed

14.

Heyd RL, Kopecky KK, Sherman S, Lehman GA, Stockberger SM (1996) Radiation exposure to patients and personnel during interventional ERCP at a teaching institution. Gastrointest Endosc 44:287–292PubMedCrossRef

15.

International Commission on Radiological Protection (2012) ICRP Statement on tissue reactions/early and late effects of radiation in normal tissues and organs—Threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Annals of the ICRP 41 (1/2), ICRP, Ottawa, Ontario

16.

Naidu LS, Singhal S, Preece DE, Vohrah A, Loft DE (2005) Radiation exposure to personnel performing endoscopic retrograde cholangiopancreatography. Postgrad Med J 81:660–662PubMedCentralPubMedCrossRef

17.

O’Connor U, Gallagher A, Malone L, O’Reilly G (2013) Occupational radiation dose to eyes from endoscopic retrograde cholangiopancreatography procedures in light of the revised eye lens dose limit from the international commission on radiological protection. Br J Radiol. doi:10.1259/bjr.20120289 PubMedCentral

Title: A novel removable shield attached to C-arm units against scattered X-rays from a patient’s side
Authors: Hiroshige Mori
Kichiro Koshida
Osamu Ishigamori
Kosuke Matsubara
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3186-x

At a glance: The STEP trials

Springer Medicine

A novel removable shield attached to C-arm units against scattered X-rays from a patient’s side

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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