Effectiveness of radiation shields to minimize operator dose in the bronchoscopy suite: a phantom study and clinical cases

Abstract

Background The purpose of this study was to 1) evaluate the effectiveness of radiation shields to minimize radiation exposure to the bronchoscopist location in a phantom study and 2) determine the dose of radiation exposure to medical staff with radiation shields in clinical cases. Methods To mimic bronchoscopic operations, an anthropomorphic torso phantom was positioned on the fluoroscopic table between the C-arm X-ray tube and the image detector. A combination of upper body lead shields and lower body lead shields was placed to examine the effectiveness of radiation shielding. Scatter radiation rates were assessed at a primary operator location using real-time dosimeters with and without the presence of protective devices. In clinical cases, the radiation exposure of the primary operator and main assistant was measured using wearable radiation dosimeters during 20 cases of procedures under the combination of upper body and lower body lead shields. Results In the phantom study, the scattered radiation without shielding were 266.34 ± 8.86 µSv/hr in the glabella level, 483.90 ± 8.01 µSv/hr in the upper thorax level, 143.97 ± 8.20 µSv/hr in the hypogastrium level, and 7.22 ± 0.28 µSv/hr in the ankle level, respectively. The combination of upper body and lower body lead shields reduced the radiation exposure by 98.7%, 98.3%, 66.2%, and 79.9% in the glabella, upper thorax, hypogastrium, and ankle levels in the phantom study, respectively. The mean exposure rates and their standard deviations from 20 clinical cases were 0.14 ± 0.05 µSv/procedure at the bronchoscopist’s eye, 0.46 ± 0.51 µSv/procedure at the bronchoscopist’s chest, 0.67 ± 0.50µSv/procedure at the bronchoscopist’s hypogastrium, and 1.57 ± 2.84 µSv/procedure at the assistant’s wrist, respectively. Conclusions 1) Combination of radiation shields significantly reduces radiation exposure in the operator site in the phantom study. And 2) the radiation exposure to medical staff during bronchoscopy can be kept at a low level with the aid of a shielding system.