Comparing strategies for operator eye protection in the interventional radiology suite.

PURPOSE: To evaluate the impact of common radiation-shielding strategies, used alone and in combination, on scattered dose to the fluoroscopy operator's eye. MATERIALS AND METHODS: With an operator phantom positioned at the groin, upper abdomen, and neck, posteroanterior low-dose fluoroscopy was performed at the phantom patient's upper abdomen. Operator lens radiation dose rate was recorded with a solid-state dosimeter with and without a leaded table skirt, nonleaded and leaded (0.75 mm lead equivalent) eyeglasses, disposable tungsten-antimony drapes (0.25 mm lead equivalent), and suspended and rolling (0.5 mm lead equivalent) transparent leaded shields. Lens dose measurements were also obtained in right and left 15° anterior obliquities with the operator at the upper abdomen and during digital subtraction angiography (two images per second) with the operator at the patient's groin. Each strategy's shielding efficacy was expressed as a reduction factor of the lens dose rate compared with the unshielded condition. RESULTS: Use of leaded glasses alone reduced the lens dose rate by a factor of five to 10; scatter-shielding drapes alone reduced the dose rate by a factor of five to 25. Use of both implements together was always more protective than either used alone, reducing dose rate by a factor of 25 or more. Lens dose was routinely undetectable when a suspended shield was the only barrier during low-dose fluoroscopy. CONCLUSIONS: Use of scatter-shielding drapes or leaded glasses decreases operator lens dose by a factor of five to 25, but the use of both barriers together (or use of leaded shields) provides maximal protection to the interventional radiologist's eye.

Less-restrictive, patient-specific radiation safety precautions can be safely prescribed after permanent seed implantation.

PURPOSE: To use radiation exposure rate measurements to determine patient-specific radiation safety instructions with the aim of reducing unnecessary precaution times and to evaluate potential doses to members of the public. METHODS AND MATERIALS: Radiation exposure rate measurements were obtained from 1279 patients with Stage T1-2 prostate cancer who underwent transperineal (125)I or (103)Pd seed implantation from January 1995 through July 2008. An algorithm was developed from these measurements to determine the required precaution times to maintain public effective doses below 50% of the limits for specific exposure situations. RESULTS: The median air kerma rates at 30 cm from the anterior skin surface were 4.9 microGy/h (range: 0.1-31.5) for (125)I and 1.5 microGy/h (range: 0.02-14.9) for (103)Pd. The derived algorithms depended primarily on the half-life T(p), the measured exposure rate at 30 cm, and specific exposure situation factors. For the typical (103)Pd patient, no radiation safety precautions are required. For the typical (125)I patient, no precautions are required for coworkers, nonpregnant adults who do not sleep with the patient, or nonpregnant adults who sleep with the patient. Typical (125)I patients should only avoid sleeping in the "spoon" position (i.e., in contact) with pregnant adults and avoid holding a child for long periods of time in the lap for about 2 months. CONCLUSIONS: The large number of cases available for this study permitted the development of an algorithm to simply determine patient-specific radiation safety instructions. The resulting precaution times are significantly less restrictive than those generally prescribed currently.