Skip to main content
SpringerLink
Log in

New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

The videofluoroscopic swallowing study (VFSS) is a recognized standard diagnostic imaging technique that is used to investigate swallowing disorders and dysphagia. Patients were assessed in a seated posture on a chair or wheelchair. Using X-ray fluoroscopy, the state of patients’ swallowing was checked by eating and drinking according to the physician's instructions. VFSS procedures are prolonged, and VFSS staff members are exposed to radiation. Therefore, we evaluated original lead shielding device (OLSD) that can be attached to the handrail of a table and placed vertically. The OLSD has a lead-equivalent thickness of 0.3 mmPb, weighs about 6 kg, and has the dimensions 50 cm × 50 cm × 8.0 mm. We used a human phantom and a radiation survey meter with and without protection from scattered radiation at the positions of the physician and medical staff at the height of 150 cm above the floor (i.e., the height of the eye’s crystalline lens). After measuring the scattered radiation, we created radiation maps with and without the OLSD. The dose rate at the physician’s position without and with the OLSD was 190 µSv/h and 92 µSv/h, respectively, and a dose reduction of 51.6% with the plate. Moreover, the radiation maps added clarity to the distribution of the scattered radiation. Such information should lead to greater awareness about exposures to physicians and other medical staff. Thus, the OLSD effectively provided protection from scattered radiation at the physician’s position during fluoroscopy. It may contribute to the reduction of staff exposure for VFSS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Logemann JA. Role of the modified barium swallow in management of patients with dysphagia. Otolaryngol Head Neck Surg. 1997;116(3):335–8. https://doi.org/10.1016/s0194-5998(97)70269-9.

    Article  CAS  PubMed  Google Scholar 

  2. Chan CB, Chan LK, Lam HS. Scattered radiation level during videofluoroscopy for swallowing study. Clin Radiol. 2002;57(7):614–6.

    Article  CAS  PubMed  Google Scholar 

  3. Crawley MT, Savage P, Oakley F. Patient and operator dose during fluoroscopic examination of swallow mechanism. Br J Radiol. 2004;77(920):654–6.

    Article  CAS  PubMed  Google Scholar 

  4. Hersh C, Wentland C, Sally S, de Stadler M, Hardy S, Fracchia MS, Liu B, Hartnick C. Radiation exposure from videofluoroscopic swallow studies in children with a type 1 laryngeal cleft and pharyngeal dysphagia: a retrospective review. Int J Pediatr Otorhinolaryngol. 2016;89:92–6. https://doi.org/10.1016/j.ijporl.2016.07.032.

    Article  PubMed  Google Scholar 

  5. Kim HM, Choi KH, Kim TW. Patients’ radiation dose during videofluoroscopic swallowing studies according to underlying characteristics. Dysphagia. 2013;28(2):153–8. https://doi.org/10.1007/s00455-012-9424-y.

    Article  PubMed  Google Scholar 

  6. Earl VJ, Badawy MK. Radiation Exposure to Staff and Patient During Videofluoroscopic Swallowing Studies and Recommended Protection Strategies. Dysphagia. 2019;34(3):290–7. https://doi.org/10.1007/s00455-018-9945-0.

    Article  PubMed  Google Scholar 

  7. Morishima Y, Chida K, Watanabe H. Estimation of the dose of radiation received by patient and physician during a videofluoroscopic swallowing study. Dysphagia. 2016;31(4):574–8. https://doi.org/10.1007/s00455-016-9718-6.

    Article  PubMed  Google Scholar 

  8. Ertel A, Nadelson J, Shroff AR, Sweis R, Ferrera D, Vidovich MI. Radiation dose reduction during radial cardiac catheterization: evaluation of a dedicated radial angiography absorption shielding drape. ISRN Cardiol. 2012;2012:769167. https://doi.org/10.5402/2012/769167.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Authors on behalf of I, Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, Aleman BM, Edgar AB, Mabuchi K, Muirhead CR, Shore RE, Wallace WH. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs—threshold doses for tissue reactions in a radiation protection context. Ann ICRP. 2012;41(1–2):1–322. https://doi.org/10.1016/j.icrp.2012.02.001.

    Article  Google Scholar 

  10. Muniraj T, Aslanian HR, Laine L, Farrell J, Ciarleglio MM, Deng Y, Ho H, Jamidar PA. A double-blind, randomized, sham-controlled trial of the effect of a radiation-attenuating drape on radiation exposure to endoscopy staff during ERCP. Am J Gastroenterol. 2015;110(5):690–6. https://doi.org/10.1038/ajg.2015.85.

    Article  PubMed  Google Scholar 

  11. Dumonceau JM, Garcia-Fernandez FJ, Verdun FR, Carinou E, Donadille L, Damilakis J, Mouzas I, Paraskeva K, Ruiz-Lopez N, Struelens L, Tsapaki V, Vanhavere F, Valatas V, Sans-Merce M, European Society of Digestive E. Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy. 2012;44(4):408–21. https://doi.org/10.1055/s-0031-1291791.

    Article  PubMed  Google Scholar 

  12. Morishima Y, Chida K, Meguro T. Effectiveness of additional lead shielding to protect staff from scattering radiation during endoscopic retrograde cholangiopancreatography procedures. J Radiat Res. 2018;59(2):225–32. https://doi.org/10.1093/jrr/rrx039.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Minami T, Sasaki T, Serikawa M, Kamigaki M, Yukutake M, Ishigaki T, Ishii Y, Mouri T, Yoshimi S, Shimizu A, Tsuboi T, Kurihara K, Tatsukawa Y, Miyaki E, Chayama K. Occupational radiation exposure during endoscopic retrograde cholangiopancreatography and usefulness of radiation protective curtains. Gastroenterol Res Pract. 2014;2014:926876. https://doi.org/10.1155/2014/926876.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Chida K, Takahashi T, Ito D, Shimura H, Takeda K, Zuguchi M. Clarifying and visualizing sources of staff-received scattered radiation in interventional procedures. AJR Am J Roentgenol. 2011;197(5):W900-903. https://doi.org/10.2214/AJR.10.6396.

    Article  PubMed  Google Scholar 

  15. Hayes A, Alspaugh JM, Bartelt D, Campion MB, Eng J, Gayler BW, Henkel SE, Jones B, Lingaraj A, Mahesh M, Rostkowski M, Smith CP, Haynos J. Radiation safety for the speech-language pathologist. Dysphagia. 2009;24(3):274–9. https://doi.org/10.1007/s00455-008-9201-0.

    Article  PubMed  Google Scholar 

  16. Morishima Y, Chida K, Muroya Y, Utsumi Y. Effectiveness of a new lead-shielding device and additional filter for reducing staff and patient radiation exposure during videofluoroscopic swallowing study using a human phantom. Dysphagia. 2018;33(1):109–14. https://doi.org/10.1007/s00455-017-9839-6.

    Article  PubMed  Google Scholar 

  17. Morishima Y, Chida K, Katahira Y. The effectiveness of additional lead-shielding drape and low pulse rate fluoroscopy in protecting staff from scatter radiation during cardiac resynchronization therapy (CRT). Jpn J Radiol. 2019;37:95–101. https://doi.org/10.1007/s11604-018-0783-7.

    Article  PubMed  Google Scholar 

  18. Morishima Y, Chida K, Katahira Y, Seto H, Chiba H, Tabayashi K. Need for radiation safety education for interventional cardiology staff, especially nurses. Acta Cardiol. 2016;71(2):151–5. https://doi.org/10.2143/AC.71.2.3141844.

    Article  PubMed  Google Scholar 

  19. Cornacchia S, Errico R, La Tegola L, Maldera A, Simeone G, Fusco V, Niccoli-Asabella A, Rubini G, Guglielmi G. The new lens dose limit: implication for occupational radiation protection. Radiol Med. 2019;124(8):728–35. https://doi.org/10.1007/s11547-019-01027-7.

    Article  PubMed  Google Scholar 

  20. Chida K, Inaba Y, Morishima Y, Taura M, Ebata A, Yanagawa I, Takeda K, Zuguchi M. Comparison of dose at an interventional reference point between the displayed estimated value and measured value. Radiol Phys Technol. 2011;4(2):189–93. https://doi.org/10.1007/s12194-011-0121-6.

    Article  PubMed  Google Scholar 

  21. Inaba Y, Chida K, Shirotori K, Shimura H, Yanagawa I, Zuguchi M, Takahashi S. Comparison of the radiation dose in a cardiac IVR X-ray system. Radiat Prot Dosimetry. 2011;143(1):74–80. https://doi.org/10.1093/rpd/ncq287.

    Article  PubMed  Google Scholar 

  22. Inaba Y, Chida K, Kobayashi R, Kaga Y, Zuguchi M. Fundamental study of a real-time occupational dosimetry system for interventional radiology staff. J Radiol Prot. 2014;34(3):N65–71. https://doi.org/10.1088/0952-4746/34/3/N65.

    Article  PubMed  Google Scholar 

  23. Chida K, Morishima Y, Inaba Y, Taura M, Ebata A, Takeda K, Shimura H, Zuguchi M. Physician-received scatter radiation with angiography systems used for interventional radiology: comparison among many X-ray systems. Radiat Prot Dosimetry. 2012;149(4):410–6. https://doi.org/10.1093/rpd/ncr312.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Hiroo Chiba (Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital) and Fumi Kayaba (Speech-Language Pathologist, Tohoku Medical and Pharmaceutical University Hospital) for their help during this study. We thank Richard Lipkin, PhD from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. This study was supported by JSPS Kakenhi (JP20K19443).

Author information

Authors and Affiliations

  1. Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan

    Yoshiaki Morishima

  2. Department of Radiological Technology, Tohoku University School of Health Sciences, Sendai, 980-8575, Japan

    Yoshiaki Morishima & Koichi Chida

  3. Rehabilitation Center, Tohoku Medical and Pharmaceutical University Hospital, Sendai, 983-8512, Japan

    Osamu Ito

Authors
  1. Yoshiaki Morishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koichi Chida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Osamu Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshiaki Morishima.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Part of this paper is written based on my doctoral dissertation.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morishima, Y., Chida, K. & Ito, O. New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS. Dysphagia 37, 1519–1524 (2022). https://doi.org/10.1007/s00455-022-10411-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-022-10411-x

Keywords

Search

Navigation