Using a sterile disposable protective surgical drape for reduction of radiation exposure to interventionalists.

Abstract

The purpose of this paper is to show the effectiveness of a new radiation protection method designed to decrease the amount of scatter radiation received by practitioners performing procedures under fluoroscopic guidance. A sterile, disposable, lead-free surgical drape containing radiation protection material composed primarily of bismuth was evaluated for effectiveness in reducing radiation doses to health care personnel. Measurements of phantom scatter, patient scatter, skin entrance, and the effects of collimation, together with comparative monthly thermoluminescent dosimeter recordings, were taken to determine the effectiveness of X-ray beam attenuation using the bismuth drapes. Scatter radiation to physicians, as measured by thermoluminescent dosimeters placed on each eye, the thyroid, and the wrist, was reduced by 12-fold for the eyes, 25-fold for the thyroid, and 29-fold for the hands when the radiation-attenuating surgical drape was used when compared with control studies performed with a standard nonattenuating surgical drape alone. Monthly thermoluminescent dosimeter measurements decreased fourfold in one physician. Using the protective drape reduced exposure to the assistant in each case to negligible levels. Skin entrance dose was not increased unless the protective drape was placed directly in the X-ray beam. An X-ray attenuation factor equivalent to 0.1 mm of lead with 8 x 8 cm collimation reduced the scatter rates from five- to ninefold despite a 30-40% increase in entrance exposure rate as the lead equivalence increased. Depending on the procedure, the height of the practitioner, and the positioning of the radiation-attenuating surgical drape, use of this drape can substantially reduce the radiation dose to personnel with minimal or no additional radiation exposure to the patient.