Head and Neck Radiation Dose and Radiation Safety for Interventional Physicians

• Published in: JACC. Cardiovascular interventions Vol. 10; no. 5; pp. 520 - 528
• Main Authors: Fetterly, Kenneth, PhD, Schueler, Beth, PhD, Grams, Michael, PhD, Sturchio, Glenn, PhD, Bell, Malcolm, MD, Gulati, Rajiv, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 13.03.2017
• Subjects: Brain - radiation effects; Cardiovascular; Eye Protective Devices; head and neck; Head Protective Devices; Humans; interventional fluoroscopy; Lens, Crystalline - radiation effects; Models, Anatomic; Neck - radiation effects; Occupational Exposure - adverse effects; Occupational Exposure - prevention & control; Occupational Health; Occupational Injuries - etiology; Occupational Injuries - prevention & control; occupational radiation dose; Protective Clothing; Protective Factors; Radiation Dosage; Radiation Dosimeters; Radiation Exposure - adverse effects; Radiation Exposure - prevention & control; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiation Protection; Radiography, Interventional - adverse effects; Radiologists; Risk Assessment; Risk Factors; Scattering, Radiation; 2-dimensional; 2D; ERR; radiation protection; head and neck; occupational radiation dose; excess relative risk; LCD; left collar dose; interventional fluoroscopy
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2016.11.026

Abstract Objectives The first aim of this study was to assess the magnitude of radiation dose to tissues of the head and neck of physicians performing x-ray-guided interventional procedures. The second aim was to assess protection of tissues of the head offered by select wearable radiation safety devices. Background Radiation dose to tissues of the head and neck is of significant interest to practicing interventional physicians. However, methods to estimate radiation dose are not generally available, and furthermore, some of the available research relating to protection of these tissues is misleading. Methods Using a single representative geometry, scatter radiation dose to a humanoid phantom was measured using radiochromic film and normalized by the radiation dose to the left collar of the radioprotective thorax apron. Radiation protection offered by leaded glasses and by a radioabsorbent surgical cap was measured. Results In the test geometry, average radiation doses to the unprotected brain, carotid arteries, and ocular lenses were 8.4%, 17%, and 50% of the dose measured at the left collar, respectively. Two representative types of leaded glasses reduced dose to the ocular lens on the side of the physician from which the scatter originates by 27% to 62% but offered no protection to the contralateral eye. The radioabsorbent surgical cap reduced brain dose by only 3.3%. Conclusions A method by which interventional physicians can estimate dose to head and neck tissues on the basis of their personal dosimeter readings is described. Radiation protection of the ocular lenses by leaded glasses may be incomplete, and protection of the brain by a radioabsorbent surgical cap was minimal.