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

    2 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

    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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