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How Much Does Lead Shielding during Fluoroscopy Reduce Radiation Dose to Out-of-Field Body Parts?

Andrew S Phelps1, Robert G Gould1, Jesse L Courtier1

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Routine gonad shielding during fluoroscopy may not be clinically useful. This study found that leakage radiation contributes negligibly to out-of-field radiation dose, questioning the practice of shielding these areas.

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Area of Science:

  • Medical Physics
  • Radiological Sciences
  • Radiation Protection

Background:

  • Fluoroscopy technologists often shield gonads, even when not in the primary x-ray field.
  • Internal scatter is the main source of out-of-field radiation, and external shielding does not block it.
  • Previous research suggested minimal dose reduction from shielding leakage radiation in non-fluoroscopy settings.

Purpose of the Study:

  • To evaluate the effectiveness of shielding leakage radiation during fluoroscopy.
  • To determine if shielding leakage radiation reduces radiation dose to out-of-field areas.

Main Methods:

  • An in vitro study comparing radiation doses under various collimation and shielding conditions.
  • Ionization chamber measurements were taken in-field and at multiple out-of-field distances.
  • Tested strategies included collimation and shielding of leakage radiation.

Main Results:

  • Collimation significantly reduced out-of-field radiation dose by 87%.
  • The remaining dose was attributed to internal scatter.
  • Shielding leakage radiation showed no measurable difference in dose (P = .48), indicating a negligible contribution.

Conclusions:

  • The clinical utility of routinely shielding out-of-field body parts during fluoroscopy is questionable.
  • Findings suggest that current practices may not be optimizing radiation protection for non-target areas.