Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield

Carmelo J. Panetta, Erin M. Galbraith, Marat Yanavitski, Patrick K. Koller, Binita Shah, Sohah Iqbal, Joaquin E. Cigarroa, Gregory Gordon, Sunil V. Rao

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: Investigation of novel vertical radiation shield (VRS) in reducing operator radiation exposure. Background: Radiation exposure to the operator remains an occupational health hazard in the cardiac catheterization laboratory (CCL). Methods: A mannequin simulating an operator was placed near a computational phantom, simulating a patient. Measurement of dose equivalent and Air Kerma located the angle with the highest radiation, followed by a common magnification (8 in.) and comparison of horizontal radiation absorbing pads (HRAP) with or without VRS with two different: CCL, phantoms, and dosimeters. Physician exposure was subsequently measured prospectively with or without VRS during clinical procedures. Results: Dose equivalent and Air Kerma to the mannequin was highest at left anterior oblique (LAO)-caudal angle (p <.005). Eight-inch magnification increased mGray by 86.5% and μSv/min by 12.2% compared to 10-in. (p <.005). Moving 40 cm from the access site lowered μSv/min by 30% (p <.005). With LAO-caudal angle and 8-in. magnification, VRS reduced μSv/min by 59%, (p <.005) in one CCL and μSv by 100% (p =.016) in second CCL in addition to HRAP. Prospective study of 177 procedures with HRAP, found VRS lowered μSv by 41.9% (μSv: 15.2 ± 13.4 vs. 26.2 ± 31.4, p =.001) with no difference in mGray. The difference was significant after multivariate adjustment for specified variables (p <.001). Conclusions: Operator radiation exposure is significantly reduced utilizing a novel VRS, HRAP, and distance from the X-ray tube, and consideration of lower magnification and avoiding LAO-caudal angles to lower radiation for both operator and patient.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume95
Issue number1
DOIs
StatePublished - Jan 1 2020
Externally publishedYes

Keywords

  • Air Kerma
  • distance
  • dose equivalent
  • horizontal radiation absorbing pad
  • magnification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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