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Thyroid dose during neurointerventional procedures: does lead shielding reduce the dose?

C P Shortt1, N F Fanning, L Malone

  • 1Department of Radiology, Beaumont Hospital, Dublin 9, Ireland.

Cardiovascular and Interventional Radiology
|May 30, 2007
PubMed
Summary
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Thyroid lead shielding significantly reduces radiation dose during neurointerventional procedures by 48%. This inexpensive method enhances patient radiation protection and should be routinely used when feasible.

Area of Science:

  • Radiology
  • Medical Physics
  • Interventional Neuroradiology

Background:

  • Neurointerventional procedures, while crucial for treating vascular conditions, expose patients to ionizing radiation.
  • The thyroid gland is particularly vulnerable to radiation during these procedures, necessitating protective measures.

Purpose of the Study:

  • To quantify radiation dose to the thyroid gland in patients undergoing neurointerventional procedures.
  • To evaluate the effectiveness of lead shielding in reducing thyroid radiation dose.

Main Methods:

  • A randomized controlled trial involving 65 patients undergoing endovascular treatment for arteriovenous malformations and aneurysms.
  • Patients were assigned to either a no-shield group or a thyroid lead shield group.
  • Thermoluminescent dosimeters measured thyroid dose, while dose-area product (DAP), fluoroscopy time, and digital subtraction angiography (DSA) runs were recorded.

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Main Results:

  • A mean thyroid dose reduction of 48% was observed in the lead-shielded group compared to the unshielded group (p < 0.001).
  • The mean relative thyroid dose was 7.23 mSv/cGy² x 10⁵ in the unshielded group versus 3.77 mSv/cGy² x 10⁵ in the shielded group.
  • Lead shielding proved practical and effective in reducing radiation exposure.

Conclusions:

  • Neurointerventional procedures deliver substantial radiation doses to the thyroid gland.
  • Thyroid lead shielding is an effective, inexpensive method for significantly reducing patient radiation exposure.
  • Routine use of thyroid lead shielding is recommended when it does not impede the procedure.