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Operator Radiation Safety During Spine Interventions 2003

Luchs J.S., Rosioreanu A., Gregorius D., Natarajan V., Koehler V., Ortiz O.
Department of Radiology
Winthrop-University Hospital
Mineola, N.Y.

Methods:
A prospective collection of data points was obtained during routine interventional spine procedures (epidural steroid injections, discography, steroid facet injection). Exposure levels were tested utilizing a hand-held ionization chamber and an electronic pocket dosimeter, which was placed on the radiologist during multiple interventional spine procedures. Several exposure variables were also investigated including distance from the patient, additional shielding of the lateral x-ray tube, and additional shielding from scatter radiation from the patient. These values were analyzed to determine the best possible way of minimizing the exposure rates to the spine interventional radiologist while still maintaining the ability to perform the procedure efficiently and effectively.

Results:
Shielding of the lateral tube housing with 1 mm lead equivalency did not reduce exposure levels. Adding a 0.5 mm lead equivalency mobile barrier reduced exposure levels by 94 to 96% depending upon tube selection (AP, lateral, or biplane). Increasing shielding to 1.0 mm lead equivalency mobile barrier reduced exposure levels by 97 to 98%. Utilizing a 0.5 mm lead equivalent apron placed on the buttocks and upper legs of the patient reduced exposure levels by approximately 46 to 48% dependent on tube selection. Increased distance from patient (scatter source) was shown to effectively reduce exposure by use of inverse square principle. The operator was made aware of received radiation dosage by increased chirp frequency from a personal radiation monitor.

Conclusion:
Multiple factors should be taken into account when trying to limit exposure rates to the spine interventional radiologist. If the methods are used regularly, then the interventional spine radiologist will significantly decrease their yearly exposure rates and maintain proper radiation safety.

References:

1. Radiation protection system for interventional procedures of the upper extremity: evaluation in a phantom model. Haku, T. etal. JIVR 2002;13:815-822.
2. Using a sterile disposable protective surgical drape for reduction of radiation exposure to interventionalists. King, J. etal. AJR 2002;178:153-157.
3. Occupational radiation exposure to interventional radiologist: a prospective study. Marx, MV etal. JVIR 1992; 597-606.