Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Purpose: Although many studies have examined the efficiency of various protective devices for reducing the dose of radiation exposure to physicians during interventional pain procedures, no study has compared the protective effect of these devices when they are used in combination. The purpose of this prospective experimental study was to determine the best combination of radiation-shielding devices. Materials and Methods: Using anthropomorphic phantoms of a physician and patient, we measured the radiation protection efficiency (RPE) of each of the following protection methods and in combination during C-arm-guided simulated lumbar epidural injection: (a) personal protective equipment (PPE), (b) bedside curtain shield (Curtain), (c) x-ray tube filter (Filter), and (d) fluoroscopic collimation method (Collimation). We measured exposure doses using personal electronic dosimeters at the eye, thyroid, and gonad levels for 1 minute. Each experiment was repeated 15 times. Results: The radiation exposure dose and RPE with the best single-, double-, and triple-protection methods were as follows: PPE for the single-protection method (11.82 mu Sv/min, 80.04%), PPE + Collimation for the double-combination method (4.68 mu Sv/min, 92.09%), and PPE + Collimation + Curtain for the triple-combination method (3.08 mu Sv/min, 93.39%). Additionally, PPE + Collimation + Curtain + Filter for the quadruple-combination method resulted in a radiation exposure and RPE of 2.91 mu Sv/min and 93.61%, respectively, compared with nonprotection. Conclusions: The best single-, double-, and triple-protection method was PPE, PPE + Collimation, and PPE + Collimation + Curtain, respectively. While preparing protective equipment, we recommend prioritizing equipment in this order.

Automated summary

The purpose of this study was to compare the protective effect of different radiation-shielding devices when used individually or in combination, and to determine the best combination. The results showed that PPE, PPE + Collimation, and PPE + Collimation + Curtain were the best single, double, and triple-protection methods, respectively.