Does a Novel Lead-Free Radiation Shield Improve Surgeon Protection Compared with Lead Apron Alone?

Area of Science:

• Medical Physics
• Surgical Safety
• Radiation Protection

Background:

• Surgical procedures utilizing fluoroscopy expose healthcare professionals to scatter radiation.
• Conventional lead shielding (LATS) offers significant protection but has limitations in covering all critical areas.
• Novel shielding solutions are needed to enhance surgeon safety without increasing weight burden.

Purpose of the Study:

• To evaluate the effectiveness of RADPAD, a lead-free radiation shield, in reducing scatter radiation during simulated percutaneous nephrolithotomy (PCNL).
• To compare the protective capabilities of RADPAD against conventional lead apron and thyroid shield (LATS).
• To assess the added benefit of combining RADPAD with LATS for comprehensive surgeon protection.

Main Methods:

• Simulated PCNL using a radiographical phantom and mannequin surgeon.
• Radiation dose measurements (µSv) at seven critical surgeon locations using a real-time dosimeter.
• Comparison of shielding strategies: LATS alone, RADPAD alone, and LATS with RADPAD, against baseline (no shielding).

Main Results:

• LATS alone provided >95% reduction at shielded sites but failed to protect the head, forearm, and leg.
• RADPAD alone significantly reduced radiation at most sites, except the legs.
• Combining LATS with RADPAD offered the greatest radiation reduction, significantly outperforming LATS alone for the head, pelvis, and forearm.

Conclusions:

• RADPAD is an effective lead-free shield that enhances scatter radiation protection for surgeons.
• Combining RADPAD with conventional LATS provides superior protection to the head and arms without adding weight.
• Further research may be needed to address radiation protection for the legs during PCNL procedures.