Laboratory investigation
Comparing Strategies for Operator Eye Protection in the Interventional Radiology Suite

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Purpose

To evaluate the impact of common radiation-shielding strategies, used alone and in combination, on scattered dose to the fluoroscopy operator's eye.

Materials and Methods

With an operator phantom positioned at the groin, upper abdomen, and neck, posteroanterior low-dose fluoroscopy was performed at the phantom patient's upper abdomen. Operator lens radiation dose rate was recorded with a solid-state dosimeter with and without a leaded table skirt, nonleaded and leaded (0.75 mm lead equivalent) eyeglasses, disposable tungsten-antimony drapes (0.25 mm lead equivalent), and suspended and rolling (0.5 mm lead equivalent) transparent leaded shields. Lens dose measurements were also obtained in right and left 15° anterior obliquities with the operator at the upper abdomen and during digital subtraction angiography (two images per second) with the operator at the patient's groin. Each strategy's shielding efficacy was expressed as a reduction factor of the lens dose rate compared with the unshielded condition.

Results

Use of leaded glasses alone reduced the lens dose rate by a factor of five to 10; scatter-shielding drapes alone reduced the dose rate by a factor of five to 25. Use of both implements together was always more protective than either used alone, reducing dose rate by a factor of 25 or more. Lens dose was routinely undetectable when a suspended shield was the only barrier during low-dose fluoroscopy.

Conclusions

Use of scatter-shielding drapes or leaded glasses decreases operator lens dose by a factor of five to 25, but the use of both barriers together (or use of leaded shields) provides maximal protection to the interventional radiologist's eye.

Section snippets

Materials and Methods

Using an Integris Allura fluoroscopy system (Philips, Eindhoven, The Netherlands) with an image intensifier 3 cm above the upper abdominal skin surface of an anthropomorphic patient phantom (Real-bone Sectional Phantom; Radiology Support Devices, Long Beach, California) and a 15-cm field of view, low-dose fluoroscopy was performed using an under-table tube system in posteroanterior (PA; 70 kVp, 4.6 mA) and 15° left (75 kVp, 4.2 mA) and right anterior oblique (72 kVp, 4.4 mA) projections. An

Operator Position at the Groin

During low-dose fluoroscopy (Table 1), the reference lens dose rate obtained with the image intensifier situated 3 cm above the upper abdominal skin surface with a leaded table skirt in place was 0.49 mSv/h (56.2 mR/h). Low-dose fluoroscopy with an inappropriately high position of the image intensifier (20 cm above upper abdominal surface, such as might be encountered when observing early trainee operations) was associated with a twofold increase in lens dose rate versus the reference dose

Discussion

The lens is a biconvex structure of the eye, suspended by its attachments to the ciliary muscles between the iris and the vitreous body. Contraction or relaxation of the ciliary muscles alters the thickness of the lens, permitting accommodation—the ability to sharply focus on objects near or far. The lens fibers are continuously renewed throughout life by progenitor epithelial cells located at the lens periphery. Opacities in the normally transparent lens are termed cataracts. Whether

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Cited by (0)

S.B.S. serves as an advisor and researcher for GE Research (Niskayuna, New York) and Angiodynamics (Queensbury, New York) and as a paid consultant for Johnson and Johnson (Warren, New Jersey) and Althera (New York, New York). None of the other authors have identified a conflict of interest.

From the SIR 2009 Annual Meeting.

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