Radiation Protection Devices Research Articles

Knowledge and practices of interventional radiology staff regarding radiation protection

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.

The influence of revised ordinance on radiation protection management in Japanese hospitals: device deployment and involvement of radiology technologists.

This study evaluates the impact of the 2021 revision of Japan's Ordinance on the Prevention of Ionizing Radiation Hazards on radiation protection practices, focusing on the deployment of radiation protection devices and the involvement of radiology technologists in Japanese hospitals. A two-phase web-based questionnaire survey was conducted among hospitals registered as training facilities with the Japanese Radiological Society. The survey included 53 questions covering facility information, radiation worker management, training, and working environment. The use of lens-specific dosimeters significantly increased post-revision (p = 0.005). Protective eyewear availability showed minor improvements, particularly in angiographic rooms (p = 0.019). The involvement of radiology technologists remained high in angiographic rooms but showed no significant changes in endoscopy and fluoroscopy rooms. Larger hospitals exhibited better compliance with protective measures, though gaps in resource allocation persisted. The ordinance revision led to significant improvements in dosimeter usage but only minor changes in protective eyewear deployment and technologist involvement.

Evaluation of radiation protection effectivity in a cardiac angiography room using visualized scattered radiation distribution

In this study, we devised a radiation protection tool specifically designed for healthcare professionals and students engaged in cardiac catheterization to easily monitor and evaluate scattered radiation distribution across diverse C-arm angles and arbitrary physician associated staff positions—scrub nurse and technologist positions. In this study, scattered radiation distributions in an angiography room were calculated using the Monte Carlo simulation of particle and heavy ion transport code system (PHITS) code. Four visualizations were performed under different C-arm angles with and without radiation protection: (1) a dose profile, (2) a 2D cross-section, (3) a 3D scattered radiation distribution, and (4) a 4D scattered radiation distribution. The simulation results detailing the scattered radiation distribution in PHITS were exported in Visualization Toolkit format and visualized through the open-source visualization application ParaView for analysis. Visualization of the scattered dose showed that dose distribution depends on the C-arm angle and the x-ray machine output parameters (kV, mAs s−1, beam filtration) which depend upon beam angulation to the patient body. When irradiating in the posterior–anterior direction, the protective curtain decreased the dose by 62% at a point 80 cm from the floor, where the physician’s gonads are positioned. Placing the protection board close to the x-ray tube reduced the dose by 24% at a location 160 cm from the floor, where the lens of the eye is situated. Notably, positioning the protection board adjacent to the physician resulted in a 95.4% reduction in incident air kerma. These visualization displays can be combined to understand the spread and direction of the scattered radiation distribution and to determine where and how to operate and place radiation protection devices, accounting for the different beam angulations encountered in interventional cases. This study showed that scatter visualization could be a radiation protection teaching aid for students and medical staff in angiography rooms.

Evaluation of a Curtain-Type Radiation Protection Device for Veterinary Interventional Procedures

Evaluation of a Curtain-Type Radiation Protection Device for Veterinary Interventional Procedures

Assessing the Adherence to Safety Protocol Among Personnel Working in the Dental Radiology Department: A Qualitative Cross-Sectional Study.

Implementing recommended radiation safety protocols in the radiology departments is crucial for the safety of the working personnel, patients, and environment. Similarly, adherence and continuous monitoring are essential, and few studies have been conducted in dental radiology settings regarding the occupational safety of employees. Hence, the present study was carried out to assess the knowledge and adherence of personnel to safety protocol in the dental radiology department. The questionnaire-based study was conducted in a dental institute involving the relevant staff and students, consisting of 25 participants including radiographers (a technician, faculty, and postgraduates) and auxiliary staff. The 14-elementquestionnaire with questions on radiation exposure, hazards, safety protocols, protective devices, and infrastructure was given to study participants, and data was obtained. Overall, the responses to the questionnaire were favorable in terms of awareness or knowledge of participants about radiation protection and protection devices. Notably, 71.4 % (15) of the participants agreed that they consistently wear PPDs, and 86.5% (18) agreed that the radiology operatory is well-equipped concerning radiation safety measures. On the whole, the responses to the questionnaire were encouraging from the auxiliary staff in terms of radiation protection awareness. The perception of study participants provides valuable insight to enhance the adherence to radiation safety protocol in the institutes. The study demonstrated that most participants revealed adequate knowledge of radiation exposure hazards, the need for personnel protection, and adherence to radiation safety protocol. This study would serve as the pilot project and may provide a platform for further multicenter studies to be carried out.

Radiation protection in a cohort of healthcare workers: knowledge, attitude, practices, feelings and IR-exposure in French hospitals

The number of healthcare workers occupationally exposed to ionizing radiation (IR) is increasing every year. As health effects from exposure to low doses IR have been reported, radiation protection (RP) in the context of occupational activities is a major concern. This study aims to assess the compliance of healthcare workers with RP policies, according to their registered cumulative dose, profession, and perception of radiation self-exposure and associated risk. Every healthcare worker from one of the participating hospitals in France with at least one dosimetric record for each year 2009, 2014, and 2019 in the SISERI registry was included and invited to complete an online questionnaire including information on the worker’s occupational exposure, perception of IR-exposure risk and RP general knowledge. Hp(10) doses were provided by the SISERI system. Multivariate logistic regressions were used. Dosimeter wearing and RP practices compliance were strongly associated with ‘feeling of being IR-exposed’ (OR = 3.69, CI95% 2.04–6.66; OR = 4.60, CI95% 2.28–9.30, respectively). However, none of these factors was associated with RP training courses attendance. The main reason given for non-compliance is unsuitability or insufficient numbers of RP devices. This study provided useful information for RP policies. Making exposed workers aware of their own IR-exposure seems to be a key element to address in RP training courses. This type of questionnaire should be introduced into larger epidemiological studies. Dosimeter wearing and RP practices compliance are associated to feeling being IR-exposed. RP training courses should reinforce workers’ awareness of their exposure to IR.

Regulatory Needs for Radiation Protection Devices based upon Artificial Intelligence

Artificial intelligence (AI) is increasingly employed in radiation protection, encompassing both medical devices and software. These technologies are integrated with AI throughout their manufacturing and application processes. This article underscores the imperative for comprehensive regulation in the utilization of AI. Decisions regarding AI application should not solely rest with manufacturers, medical professionals, or patients. Instead, an overarching "neutral" authority must be engaged to regulate, review, and enforce adherence to established protocols. The authors contend that relying on "self-regulation" within the free market, absent clear guidelines, proves to be inadequately effective and leads to patient's radiation protection safety issues.

Evaluation of novel radiation protection devices during radiologically guided interventions

BackgroundIn radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure.MethodAn anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons.Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions.ResultsThe extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points.ConclusionsA ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck.Graphical

Assessment of Radiation Protection Devices Practice in Fluoroscopy

Fluoroscopy experts who are exposed to radiation over a prolonged period face a higher likelihood of developing cancer caused by radiation. Therefore, the personnel are being more frequently exposed to X ray radiation during their everyday work. This brings up uncertainties about the risks they encounter and the radiation protection measures required to minimize them. The objective of the study was to assess the safety measures implemented by theater personnel for radiation protection. The survey for the study was conducted on patients and medical professionals involved in fluoroscopic procedures. For the gathering of data, we observed individuals such as patients, radiation technologists, radiologists, surgeons, and students who wore radiation protection clothing while undergoing radiological procedures at the Gastroenterology. The total observed individuals were 30 patients and 17 medical professionals.

Radiation dose in radiologist from cerebral angiography using optically stimulated luminescence dosimeter

Background: The number of cerebral angiography procedures is increasing, resulting in higher X-ray radiation doses received by radiologists. Consequently, understanding the radiation doses received by radiologists and the accumulation of radiation in control rooms is crucial for guiding prevention strategies against radiation hazards. Objectives: This study aimed to measure and evaluate radiation doses to the hands, lenses of the eyes, and thyroids of radiologists performing cerebral angiography procedures, as well as to measure the accumulated radiation dose in the control room. Materials and methods: OSL dosimeters were placed on the eyeglass frames, thyroids, hands, and legs of radiologists performing 20 cerebral angiography procedures, as well as on the wall and window of the control room. Results: Radiologists’ average radiation doses were measured at specific body parts as follows: left eye (49 µSv), right eye (15 µSv), left hands (34 µSv), right hands (16 µSv), left legs (27 µSv), right legs (7 µSv), and thyroid glands (14 µSv). Notably, the received doses remained well within the maximum radiation dose limit established by the International Commission on Radiological Protection (ICRP). When calculating the maximum number of procedures that can be performed annually, we based it on the limit of the radiation dose that the eyes’ lenses should not exceed. Our findings revealed that the permissible number of procedures determined by the lens radiation dose limit, should not surpass 405 cases annually (equivalent to 34 cases per month). The radiation dose from therapeutic angiography procedures was discovered to be up to 5 times higher than that from diagnostic angiography procedures. The maximum accumulated radiation dose in the control room was 1.18 µSv/hr, which remained below the limit of the Department of Medical Sciences (< 3 µSv/hr). Conclusion: Radiologists receive less radiation from cerebral diagnostic angiography than therapeutic angiography. Organs on the left side were exposed to greater radiation levels than those on the right side. Wearing radiation protection devices during each procedure can reduce radiation exposure and mitigate long-term effects on radiologists. It is recommended to monitor and calculate the accumulated radiation dose of workers to ensure their exposure remains within safety limits.

Radiation Doses to the Entire Catheterization Laboratory Team With a Novel Radiation Protection Device

BackgroundA novel radiation protection system has recently been shown to shield the primary operator from scatter radiation, but whether it shields other members of the catheterization laboratory team remains unknown. MethodsRadiation exposure data were collected prospectively in 50 coronary angiography cases, in which 25 were completed using standard radiation protection and 25 with a novel system consisting of a series of rigid shields and flexible radiation-resistant drapes. Radiation doses, measured with real-time dosimeters, were compared between the 2 groups. ResultsThere were no significant differences between groups with respect to patient or procedural characteristics, including air kerma (P = .97) and dose area product (P = .17). The primary operator received a median head-level radiation dose of 0.0 [0.0, 0.0] μSv with the novel radiation protection system and 2.1 [0.7, 3.3] μSv with standard radiation protection (P < .001). Scrub technologists had a median head-level radiation dose of 0.0 [0.0, 0.0] μSv with the novel radiation protection system and 0.3 [0.1, 0.4] μSv with standard radiation protection (P < .001). The median head-level radiation dose among circulating nurses was 0.0 [0.0, 0.0] μSv with the novel radiation protection system and was 0.1 [0.0, 0.2] μSv with standard radiation protection (P < .001). ConclusionsCompared to standard radiation protection with lead aprons, use of a novel radiation protection system during coronary angiography was associated with significantly lower head-level radiation doses among all members of the catheterization laboratory team.

Doping impacts of La2O3 on physical, structural, optical and radiation shielding properties of (30-x)BaCO3–30TiO2–40SiO2-xLa2O3 (0 ≤ x ≤ 6) glasses for optoelectronic applications

Herein, synthesis of novel barium silicate glasses doped with La2O3 in the system (30-x)BaCO3–30TiO2–40SiO2-xLa2O3, BTSL (0 ≤ x ≤ 6) via fast melt-quenching technique was carried out. Further, to confirm the amorphous behaviour of prepared glass samples, x-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM) were carried out. The density of all prepared glasses was determined using Archimedes’ principle and found to be in an increasing manner. To investigate the doping influence of La2O3 on the glasses, few more physical properties like molar volume (Vm), polaron radius (rp), and field strength (Fs) were also studied and found to be increased due to incorporation of La2O3 into BTSL glassy system. Moreover, to explore the structural, functional, and bonding mechanism of the glasses, FTIR, Raman and 29Si-MAS-ssNMR spectroscopies were performed. Further, to investigate the numerous optical parameters, UV–visible spectroscopy was executed, and energy band gaps were found in the decreasing manner as increasing the La2O3 concentrations. Additionally, to study the optoelectronic properties, refractive indices (η) and optical dielectric constant (ε) were determined and revealed the increasing behaviour and found suitable material for optoelectronic devices. Furthermore, the radiation shielding parameters, mass attenuation coefficient (MAC), linear attenuation coefficient (LAC), etc were determined using Phy-X/PSD software and these parameters are increased owing to the doping of La2O3. Among all fabricated glasses, (30-x)BaCO3–30TiO2−40SiO2−6La2O3, BTS6L glass exhibited outstanding optical and radiation attenuation properties; can be tailored for the fabrication of optoelectronic and radiation protection devices.

Enhancing Radiation Safety Culture: Investigating the Mediating Role of Awareness Among Orthopedic Doctors and Operation Theatre Assistants.

The increasing use of minimally invasive orthopedic procedures has led to a greater reliance on fluoroscopy, resulting in elevated radiation exposure for surgeons. This study aimed to evaluate the knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in an academic hospital. Understanding radiation safety is crucial to minimize patient exposure and prevent adverse effects on surgeons. This cross-sectional study was conducted at the Department of Orthopedics of different tertiary care hospitals in Rawalpindi, Pakistan. Data were collected prospectively for two years, and a total of 505 participants, including residents, consultants, and operation theatre assistants, completed a questionnaire. The questionnaire was validated by experts and covered information on fluoroscopy usage, frequency of surgeries, awareness of radiation safety, and protective measures. Ethical approval was obtained, and data were analyzed using SPSS version 26.0. The majority of participants were male (74.1%), and the sample included various ranks of orthopedic surgeons. Only 56.2% of participants were aware of the usage of fluoroscopy, and 40.2% had read some research on the topic. While 44.6% used lead aprons for radiation protection, the usage of other protective measures and dosimeters was limited. The mediation analysis showed an insignificant indirect association between the rank of orthopedic surgeons, number of surgeries performed, and fluoroscopy usage as a mediator. Awareness and reading research on fluoroscopy were significantly associated with radiation protection. The knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in fluoroscopy use need improvement. The findings emphasize the importance of implementing training programs, providing radiation protection devices, and ensuring compliance with safety guidelines.

Effectiveness of a radiation protective device of interventional echocardiographers during structural heart disease interventions

Interventional echocardiographers (IE) have a crucial role in growing structural heart interventional procedures. Previous studies showed a 5 times higher exposure of IE than that of the invasive cardiologist. No dedicated and adapted radiation protection device currently exists for IE. It is from this observation that the interventional cardiology team of the Nantes University Hospital, together with the company “LemerPax”, have designed a radiation protection cabin (EchoSafe) dedicated to the protection of the IE in the operative room. The objective of this study is to evaluate the radioprotective performances of this cabin in real life. We included during 6 months all procedures that required transesophageal echocardiography. These procedures were divided into two groups (the first on which the usual protection device were used, i.e. a leaded glass door – the second on which the “Echosafe” device was used). We matched the procedures to obtain a total amount of irradiation estimated by the DAP (dose area product) close between the two groups. Irradiation measurements of the IE were performed with 10 TLD (thermoluminescent detectors) distributed over the whole body. We included a total of 64 procedures: 24 procedures in the control group, and 40 in the “echosafe” group. The cumulative DAP for each group was 75,206.9 Cgy/cm2 in the control group, and 70,042 mGy.cm2 in the echosafe group. Patient characteristics were identical between the two groups. The results show that in the “echosafe” group, irradiation was below the dose limit for the left lens, shoulders, thorax, and neck, a 49% reduction in irradiation of the right lens, 76% of the right wrist, 12% of the left wrist, 49% of the pubis, and 36% of the right ankle. The “echosafe” device offers a clear reduction in the irradiation of the IE during structural heart intervention. Irradiation measurment of the sonographer (Fig. 1).

Effectiveness of staff radiation protection devices for interventional cardiology procedures

PurposeTo evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and brain. MethodsThe performances of five RP devices (masks, caps, patient drapes, staff lead and lead-free aprons and Zero-Gravity (ZG) suspended radiation protection system) were assessed by means of Monte Carlo (MC) simulations. A geometry representative of an interventional cardiology setup was modelled and several configurations, including beam projections and staff distance from the source, were investigated. In addition, measurements on phantoms were performed for masks and drapes. ResultsAn average dose reduction of 65% and 25% to the eyes and the brain respectively was obtained for the masks by MC simulations but a strong influence of the design was observed. The cap effectiveness for the brain ranges on average between 13% and 37%. Nevertheless, it was shown that only some upper parts of the brain were protected. There was no significant difference between the effectiveness of lead and lead-free aprons. Of all the devices, the ZG system offered the highest protection to the brain and eye lens and a protection level comparable to the apron for the organs normally covered. ConclusionAll investigated devices showed potential for dose reduction to specific organs. However, for masks, caps and drapes, it strongly depends on the design, exposure conditions and staff position. Therefore, for a clinical use, it is recommended to evaluate their effectiveness in the planned conditions of use.

Evaluating operator’s organ dose and effective dose according to the lead equivalent of radiation protection devices in performing angiography and interventional procedures

Evaluating operator’s organ dose and effective dose according to the lead equivalent of radiation protection devices in performing angiography and interventional procedures

Radiation Protection Device Composite of Epoxy Resin and Iodine Contrast Media for Low-Dose Radiation Protection in Diagnostic Radiology

Radiation protection in radiology is important because radiation may cause harm to the human body. The equipment for radiation protection is essential to ensure safe operations. Currently, there is widespread research on lead-free radiation shielding material. The aim of this research was to study lead-free material containing epoxy and iodine contrast media that was easy to form, low in cost, and environmentally friendly. The results showed that 2-cm material thickness with a concentration of 20% iodine had the greatest properties of radiation attenuate in the peak potential applied at technique 60-120 kVp, but the structure and strength of the shielding materials were decreased in accordance with increasing concentrations of iodine contrast media. It can be concluded that the lead-free epoxy radiation-shielding materials are able to absorb radiation at energy levels of 60-120 kVp. However, with improvement on homogeneity in the future, it could be used as a refractory shielding material in the radiology department.

Creation of Protective Equipment for Portable Radiography in Neonatal Intensive Care Unit

Portable imaging in the NICU requires the assistance of a nurse, and the nurse is in close proximity to the X-ray tube, In all, 64 percent of our nurses thought that additional protective equipment was needed. Therefore, a radiation protection device was created and its usefulness was verified. A protective equipment of 0.13 mmPb with a width of 38 cm and a length of 70 cm was made and hung from the mono-tank X-ray unit of the mobile X-ray unit. The position of the nurse was set at 30 cm outward from the center of the irradiation field, and the protective effect was measured at three points: (a) the patient's height, (b) 30 cm above the patient, and (c) 60 cm above the patient. For the imaging conditions, a 2-liter plastic bottle filled with water was placed in the incubator, and measurements were taken with an SID of 100 cm, irradiated field of 20.3 cm×25.4 cm, tube voltage of 58 kV, and tube current-time product of 10 mAs, which was converted to the actual imaging condition of 1 mAs. Based on the results obtained, a questionnaire survey was conducted on nurses' thoughts for the protective equipment created for them. Only 3% reduction in height of (a) where no protective equipment is reached but (b) 50% and (c) 92%, respectively. In all, 82 percent of the nurses had a favorable impression of the new protective equipment. It is expected that the protective equipment designed to control lens dose and reduce anxiety of nurses will be useful.

Eye lens dose assessment in interventional cardiology

Introduction: Medical professionals performing fluoroscopy guided interventional procedures in cardiology are exposed to a risk of radiation induced cataract, especially if the eye lens dose exceeds the annual dose limit of 20 mSv. Aim: The aim of the current study is to measure the eye lens exposure in three interventional cardiology departments, to analyze the relationship between patient dose and eye lens dose and to study the effectiveness of lead goggles without side protection. Material and methods: Measurements were performed in three departments with participation of 4 interventional cardiologists and 6 nurses. The exposure of the eye lens was measured with EYE-DTM (Radcard) passive dosimeters. Results: For nurses the annual eye lens dose varied from 1.6 mSv to 4.3 mSv. For the interventional cardiologists the results were between 3.2 mSv and 31.4 mSv. The dose reduction factor of the studied safety goggles without side protection is 1 and 1.1. Conclusions: There is a risk of exceeding the annual exposure limit of 20 mSv among interventional cardiologists The eye lens exposure depends on the workload and the clinical complexity of the procedures, as well as on the use of radiation protection devices. Due to the specifics of the procedures, the use of goggles with side protection is recommended. The eye lens dose for nurses is lower than the annual limit, which can be explained with the larger distance between the patient and the nurses and partial shielding by the main operator. Lead glasses without side shielding are not recommended because the exposure occurs from the side.

TCT-248 Systematic Comparison of the Efficacy of Various Radiation Protection Devices in Reducing Operator Scatter Radiation Dose in the Cardiac Catheterisation Laboratory

TCT-248 Systematic Comparison of the Efficacy of Various Radiation Protection Devices in Reducing Operator Scatter Radiation Dose in the Cardiac Catheterisation Laboratory