On-Field Evaluation of Operator Lens Protective Devices in Interventional Radiology

Strocchi, Sabina; Chiaravalli, Anna Maria; Veronese, I.; Novario, Raffaele

doi:10.1093/rpd/ncv412

Cited by 5 publications

(7 citation statements)

References 25 publications

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“…the segment in our simulations) where the maximum dose is achieved. Such an effect for oblique projections is consistent with what was experimentally found by Strocchi et al (2015). The operator's turning with respect to the x-ray beam becomes particularly important for a correct positioning of the dosemeter.…”

Section: Comparison To Literature Datasupporting

confidence: 88%

Monte Carlo study of the scattered radiation field near the eyes of the operator in interventional procedures

et al. 2016

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Interventional radiology and cardiology guarantee high benefits for patients, but are known to be associated with a high level of radiation exposure of medical staff. The recently suggested decrease of the annual dose limit for the eye lens, from 150 to 20 mSv, caused a need for a reconsideration of practices ensuring sufficient protection for the lens of the eyes of medical staff. In such context the study of the scattered radiation around the operator's head could help in finding the best solutions to be adopted for the ceiling-suspended shield and lead glasses in the most common situations in interventional practices. MCNPX Monte Carlo code was employed with anthropomorphic mathematical phantoms to simulate interventional practice projections. For each projection the effect of changing selected parameters on the evaluated scattered radiation towards the operator's head has been calculated. The variety of modelled situations provides plentiful material regarding the spatial distribution of the scattered radiation, useful to improve eye lens radiation protection, such as the following: (a) Glasses, which provide shielding from both lateral and bottom-up scattered radiation, can reduce by ten times the exposure to the most exposed eyes; (b) The ceiling-suspended shield offers valuable protection, but such effectiveness can diminish by 90% if the shielding is not correctly positioned; (c) The transition from femoral to radial access usually intensifies the scattered radiation toward the operator head (a factor of 1.5 for AP projection), but for RAO projections, a reduction of the order by two to three times, in the case of radial access, can be seen, due to the protection provided by the image receptor. The detailed fluence outcomes show that there is a preferential direction of the impinging scattered radiation that should be considered when radiation protection options are evaluated or when a dedicated eye lens dosemeter is used for monitoring.

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Section: Comparison To Literature Datasupporting

confidence: 88%

Monte Carlo study of the scattered radiation field near the eyes of the operator in interventional procedures

et al. 2016

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“…In this study, a DRF of 1.6 was estimated for glasses with lateral shielding and good contact with the face (nose and cheeks) of the operator. Our factor is quite lower, however, in agreement with the ones found in literature (Table 4) [9][10][11][12][13]. Most of the lead glasses provided a frontal lead equivalent protection of 0.75 mm and lateral 0.50 mm, as the ones tested in our study.…”

Section: Discussionsupporting

confidence: 92%

“…Magee et al estimated DRF values for situations similar to those used in clinical practice between 1.4 and 5.2 affirming that specially designed lead glasses with side shields or of a wraparound style with angled lenses performed better than lead glasses of standard spectacles design [12]. Strocchi et al estimated the DRF for different lead glass models between 3.7 and 5.4 [13]. As a rule, a DRF of 2 is conservatively applied for cases where glasses are employed.…”

Section: Discussionmentioning

confidence: 98%

“…The effectiveness of radiation glasses was studied in multiple studies either by means of phantom studies or measurements in clinical settings [9][10][11][12][13][14][15]. Great variation of DRF is observed as the efficiency of the glasses depends on factors, such as the geometry of the irradiation (projection, field size, distance of the operator from the X-ray tube, distance from the patient, angle of the head in relationship with the X-ray field, etc.)…”

Section: Discussionmentioning

confidence: 99%

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Efficiency evaluation of leaded glasses and visors for eye lens dose reduction during fluoroscopy guided interventional procedures

et al. 2022

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“…Depending on the study under consideration, the DRF was derived for both the left (L) and right (R) eye [17,20,21,26,30,33,34,38], as the mean over them [35], only for the most exposed eye [11,15,16,22,25,27,28,37], as the mean over both eyes plus three additional nearby positions [25] or even only for the R eye [19].…”

Section: Description Of the Examined Experiments And Grouping Of The ...mentioning

confidence: 99%

Review of experimental estimates for the protection afforded by eyewear for interventional x-ray staff

Petrucci¹

2020

J. Radiol. Prot.

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This paper attempts to systematise all published experimental results for the dose reduction factor (DRF) offered by leaded eyewear on clinicians performing interventional procedures. We aim to present a comprehensive analysis of the issue and a comparison of the various equipment models at different exposure geometries. The main purpose of the paper is, however, to clarify the best choice for the DRF within the possible diverse contexts and approaches to eye lens dose assessment. Evidence has been obtained that the lowest estimates of DRF are associated with larger scatter incidence angles and that, except for the slightly better performance exhibited by wraparound eyeglasses, there is no real distinction between the DRFs for the different equipment categories. The dataset as a whole confirms that, when measurements for the concerned eyewear model and irradiation conditions are unattainable, assuming DRF = 2 represents an adequately conservative choice. Nonetheless, this value includes only 17% of all results from the literature, whereas their histogram follows a distribution skewed towards higher values, represented by a median equal to 5. Therefore, if more realistic dose reconstructions are necessary, such as for purposes of epidemiological investigations or compensation decisions, the adoption of this central tendency index appears to be more reasonable. The complexity of characterising the DRF behaviour as a function of the various exposure factors reinforces the consideration of a statistical approach to eye lens dose assessment as a viable alternative. In this perspective, assuming for DRF a lognormal distribution with parameters and which has been verified to satisfactorily approximate the literature data distribution, should be deemed to be an appropriate option.

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On-Field Evaluation of Operator Lens Protective Devices in Interventional Radiology

Cited by 5 publications

References 25 publications

Monte Carlo study of the scattered radiation field near the eyes of the operator in interventional procedures

Monte Carlo study of the scattered radiation field near the eyes of the operator in interventional procedures

Efficiency evaluation of leaded glasses and visors for eye lens dose reduction during fluoroscopy guided interventional procedures

Review of experimental estimates for the protection afforded by eyewear for interventional x-ray staff

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