Nuclear Engineering and Technology

Korean Nuclear Society (한국원자력학회)
권호 표지
DOI QR코드

DOI QR Code

Performing angiographic intervention with a femoral entry shield: Element analysis microscopy and hand dose reduction for interventional radiologist

  • Law, Martin (Proton Therapy Pte Ltd) ;
  • Ng, Dickon H.L. (Department of Physics, The Chinese University of Hong Kong) ;
  • Yoon, Do-Kun (Proton Therapy Pte Ltd) ;
  • Djeng, Shih-Kien (Proton Therapy Pte Ltd)
  • Received : 2020.06.29
  • Accepted : 2020.09.14
  • Published : 2021.04.25
Download PDF
⟨ Previous Next ⟩

Abstract

To unveil and delineate the elements applicable to the radiation protection of a femoral entry shield, calculate its mass attenuation coefficient, and demonstrate its dose reduction efficacy for interventional radiologist performing transarterial embolization (TAE) of ruptured hepatocellular carcinoma (rHCC). The lead equivalency of the shield was firstly validated. Electron microscopy was used to confirm the femoral entry shield being lead-free and to analyze the elemental content, with which the mass attenuation coefficient of the shield was calculated. An adult phantom, irradiated at the upper abdomen to simulate the TAE of rHCC, was used together with a dosimeter attached to the palm of a hand phantom. The dose rates at the hand phantom were measured, with the rHCC clinical protocol, without and with the femoral entry shield placed over the right femoral access site of the adult phantom. Without using the shield, the average hand dose rate was measured to be 0.325 µSv/sec. While using the shield, it was determined to be 0.110 µSv/sec. There was significant 66% dose reduction to the hand dose of IRs performing angiographic intervention with the femoral entry shield.

Keywords

Acknowledgement

One of the authors (ML) would like to express his appreciation to the Department of Radiology of Queen Mary Hospital of Hong Kong for the use of its interventional radiology facility.

References

  1. J. McCaffrey, F. Tessier, H. Shen, Radiation shielding materials and radiation scatter effects for interventional radiology (IR) physicians, Med. Phys. 39 (2012) 4537-4546. https://doi.org/10.1118/1.4730504
  2. M. Law, K. Wong, W. Tso, V. Lee, M. Luk, C. Tong, F. Chu, Personnel dose reduction in 90Y microspheres liver-directed radioembolization: from interventional radiology suite to patient ward, Br. J. Radiol. 90 (2017) 20160591. https://doi.org/10.1259/bjr.20160591
  3. ICRP, Occupational radiological protection in interventional procedures. ICRP Publication 139, Ann. ICRP 47 (2018).
  4. Q. Meisinger, C. Stahl, M. Andre, et al., Radiation protection for the fluoroscopy operator and staff, Am. J. Roentgenol. 207 (2016) 745-754. https://doi.org/10.2214/AJR.16.16556
  5. R. Kohlbrenner, E. Lehrman, A. Taylor, et al., Operator dose reduction during transjugular liver biopsy using a radiation-attenuating drape: a prospective, randomized study, J. Vasc. Intervent. Radiol. 29 (2018) 1248-1253. https://doi.org/10.1016/j.jvir.2018.05.006
  6. https://physics.nist.gov/PhysRefData/XrayMassCoef/tab3.html. Last accessed on 09/May/2020 20:15 hr.
  7. S. Peters, D. Zweers, F. Lange, J. Mourik, Lead composite vs. non lead protective garments: which are better? A multivendor comparison, Radiat. Protect. Dosim. 175 (2017) 460-465.
  8. C. Certin, A. Yurt, S. Yuksel, et al., The absorption properties of lead-free garments for use in radiation protection, Radiat. Protect. Dosim. 173 (2017) 345-350.
  9. NCRP Report No 147, Structural shielding design for medical X-ray imaging facilities recommendations of the national council on radiation protection and measurements, Issue (November 19, 2004) 3-5. Revised March 18, 2005 (Appendix A).
  10. M. Finnerty, P. Brennan, Protective aprons in imaging departments: manufacturer stated lead equivalence values require validation, Eur. Radiol. 15 (2005) 1477-1484. https://doi.org/10.1007/s00330-004-2571-2
  11. M. Scimeca, S. Bischetti, H. Lamsira, R. Bonfiglio, E. Bonanno, Energy Dispersive X-ray (EDX) microanalysis: a powerful tool in biomedical research and diagnosis, Eur. J. Histochem. 62 (1) (2018), https://doi.org/10.4081/ejh.2018.2841.
  12. K. Ho, D. Tse, M. Law, et al., Development and validation of an imaging and clinical scoring system to predict early mortality in spontaneous ruptured hepatocellular carcinoma treated with transarterial embolization, Abdom. Radiol. 44 (2019) 903. https://doi.org/10.1007/s00261-019-01895-7
  13. P. Kamusella, F. Scheer, C. Ludtke, et al., Interventional angiography: radiation protection for the examiner by using lead-free gloves, J. Clin. Diagn. Res. 11 (2017) TC26-TC29.
  14. R. DiPalma, Bismuth toxicity, often mild, can result in severe poisonings, Emerg. Med. News 23 (2001) 3-16. https://doi.org/10.1097/00132981-200104000-00012
  15. H. Kosaka, H. Monzen, K. Matsumoto, et al., Reduction of operator hand exposure in interventional radiology with a novel finger sack Using tungsten-containing rubber, Health Phys. 116 (5) (May 2019) 625-630, https://doi.org/10.1097/HP.0000000000000992.