Top

CardioVascular and Interventional Radiology

Published in:

01-04-2015 | Technical Note

Radiation Protection Methods for the Interventionalist’s Hands: Use of an Extension Tube

Authors: Shaheen Dixon, Daniel Schick, John Harper

Published in: CardioVascular and Interventional Radiology | Issue 2/2015

Abstract

Purpose

Cumulative radiation exposure to the hands during certain interventional procedures may be high. It is important to decrease the amount of radiation to the operator due to the possibility of deterministic effects. We performed a pilot study to demonstrate a significant decrease in operator dose when using extension tubing (ET) in combination with shielding and collimation during a simulated percutaneous transhepatic cholangiogram (PTC) procedure.

Methods

A whole body, anthropomorphic phantom was used to simulate the patient. A Unfors-Xi Survey detector (to measure scatter) supported by a retort stand and trolley was placed in various positions to simulate the position of hands and eyes/thyroid of an interventionalist. Radiation dose was measured simulating left and right-sided PTC punctures with and without a lead shield, and with and without ET.

Results

Regarding the radiation dose to the hands; the use of an ET reduces dose by 54 % in right-sided PTC punctures without a shield and by 91 % if used in combination with a shield. For left-sided PTC punctures, ET reduces hand dose by 75 %. The use of collimation decreases hand dose by approximately 60 %. The use of shielding reduces dose to the eyes/thyroid by 98 %.

Conclusions

The dose to the hands can be significantly reduced with the appropriate use of a shield, ET, and tight collimation. The use of a shield is paramount to reduce dose to the eyes/thyroid. It is important for interventionalists to adhere to radiation protective practice considering the potential deterministic effects during a lifelong career.

Efstathopoulos EP, Pantos I, Andreou M et al (2011) Occupational radiation doses to the extremities and the eyes in interventional radiology and cardiology procedures. Br J Radiol 84:70–77CrossRefPubMedCentralPubMed

Miller DL, Vano E, Bartal G et al (2010) Occupational radiation protection in interventional radiology: a joint guideline of the cardiovascular and interventional society of Europe and the society of interventional radiology. CardioVasc Interv Radiol 33:230–239CrossRef

Hidajat N, Wust P, Felix R, Schröder RJ (2006) Radiation exposure to patient and staff in hepatic chemoembolization: risk estimation of cancer and deterministic effects. Cardiovasc Interv Radiol 29:297–796

International Commission on Radiological Protection 2011. Statement on tissue reactions ICRP ref. 4825-3093-1464, April 21, 2011

Bouffler S, Ainsbury E, Gilvin P, Harrison J (2012) Radiation-induced cataracts: the Health Protection Agency’s response to the ICRP statement on tissue reactions and recommendations on the dose limit for the eye lens. J Radiol Prot 32:479–488CrossRefPubMed

Vano E, Gonzalez L, Beneytez F, Moreno F (1998) Lens injury induced by occupational exposure in non-optimizes interventional radiology laboratories. Br J Radiol 71:728–733CrossRefPubMed

Jacob S, Boveda S, Bar O et al (2013) Interventional cardiologists and risk of radiation-induced cataract: results of a French multicenter observational study. Int J Cardiol 167:1843–1847CrossRefPubMed

Hammer GP, Scheidemann-Wesp U, Samkange-Zeeb F, Wicke H, Neriishi K, Blettner M (2013) Occupational exposure to low doses of ionizing radiation and cataract development: a systematic literature review and perspectives on future studies. Radiat Environ Biophys 52:303–319CrossRefPubMed

Whitby M, Martin CJ (2005) A study of the distribution of dose across the hands of interventional radiologists and cardiologists. Br J Radiol 78:219–229CrossRefPubMed

10.

Marque N, Jegou A, Varenne O et al (2009) Impact of an extension tube on operator radiation exposure during coronary procedures performed though the radial approach. Arch Cardiovasc Dis 102:749–754CrossRefPubMed

11.

Abatzoglou I, Koukourakis M, Konstantinides S (2013) Reduction of the radiation dose received by interventional cardiologists following training in radiation protection. Radiat Prot Dosimetry 155:119–121CrossRefPubMed

12.

Jacob S, Donadille L, Maccia C et al (2013) Eye lens radiation exposure to interventional cardiologists: a retrospective assessment of cumulative doses. Radiat Prot Dosimetry 153:282–293CrossRef

13.

Maeder M, Brunner-La Rocca HP, Wolber T et al (2006) Impact of a lead glass shield on scatter radiation to the eyes and hands in interventional cardiologists. Catheter Cardiol Interv 67:18–24CrossRef

14.

Brambilla M, Occhetta E, Ronconi M, Plebani L, Carriero A, Marino P (2010) Reducing operator radiation exposure during cardiac resynchronization therapy. Clin Res 12:1769–1773

15.

Murphy JC, Darragh K, Walsh SJ, Hanratty CG (2011) Efficacy of the RADPAD protective drape during real world complex percutaneous coronary intervention procedures. Am J Cardiol 108:1408–1410CrossRefPubMed

16.

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

17.

McCaffrey JP, Tessier F, Shen H (2012) Radiation shielding materials and radiation scatter effects to interventional radiology (IR) physicians. Med Phys 39:4537–4546CrossRefPubMed

Title: Radiation Protection Methods for the Interventionalist’s Hands: Use of an Extension Tube
Authors: Shaheen Dixon
Daniel Schick
John Harper
Publication date: 01-04-2015
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 2/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-0893-2

At a glance: The STEP trials

Springer Medicine

Radiation Protection Methods for the Interventionalist’s Hands: Use of an Extension Tube

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2015

Successful Control of Liver Metastases From Pancreatic Solid-Pseudopapillary Neoplasm (SPN) Using Hepatic Arterial Embolization

Fusion Guidance in Endovascular Peripheral Artery Interventions: A Feasibility Study

Chemoembolization of Extrahepatic Collateral Arteries for Treatment of Hepatocellular Carcinoma in the Caudate Lobe of the Liver

Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

Sphere-Enhanced Microwave Ablation (sMWA) Versus Bland Microwave Ablation (bMWA): Technical Parameters, Specific CT 3D Rendering and Histopathology

Sac Angiography and Glue Embolization in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysm