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

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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.

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Authors and Affiliations

  1. Department of Radiology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop C278, Aurora, CO, 80045, USA

    Joshua R. Smith, Rebecca M. Marsh & Michael S. Silosky

Authors
  1. Joshua R. Smith
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  2. Rebecca M. Marsh
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  3. Michael S. Silosky
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Correspondence to Rebecca M. Marsh.

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The authors declare that they have no conflict of interest.

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Smith, J.R., Marsh, R.M. & Silosky, M.S. Is lead shielding of patients necessary during fluoroscopic procedures? A study based on kyphoplasty. Skeletal Radiol 47, 37–43 (2018). https://doi.org/10.1007/s00256-017-2756-9

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  • DOI: https://doi.org/10.1007/s00256-017-2756-9

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