A dose of prevention for reducing radiation exposure

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A dose of prevention for reducing radiation exposure

by Sean Ruck, Contributing Editor | August 12, 2020
Cardiology Risk Management
From the August 2020 issue of HealthCare Business News magazine

In her cath lab, Itchhaporia says they’re using disposable lead aprons to decrease the scatter exposure. Having shields, making sure you collimate, keeping the image intensifier close to the patient, and of course wearing lead skirts and thyroid collars decreases the risk. “I think if you’re a female, even wearing a sleeve on the left hand is a good idea,” she says, though she notes that there’s not currently enough research to determine if an interventionalist faces an increased rate of breast cancer.

Ceiling-suspended radiation shields have also come to market in recent years. Itchhaporia’s organization installed one of those systems, but she says in her experience, it’s not comfortable for those performing percutaneous coronary interventions. “So we’ve actually left it for our EP colleagues who have very long cases. Some of the EP doctors really like it and I think it may be more helpful to them.”

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While not financially feasible for some facilities, robotic systems can also decrease exposure. On the other side of the tech scale, the relatively recent introduction of skullcaps to the protective gear wardrobe has been welcomed by some. “About 30 percent of interventionalists wear those skullcaps today,” Itchhaporia says. She has also heard about hand cream that can be used to decrease radiation exposure for hands that are in the field, but she hasn’t had personal experience with the products.

Dr. Dipti Itchhaporia
ACC's vice president
Although lead is still the go-to for protective personal shielding, the lead in vests and collars have gotten thinner, lighter and more comfortable over the years. Other materials like bismuth, tungsten and metal-infused polymers are also being explored as potentially safer alternatives to lead both in their ability to shield users and to limit health and environmental issues that can result from lead use. The alternatives can be particularly attractive to those with back pain and limited mobility due to the heavy lead aprons.

Although interventionalists hold the main responsibility for their safety and the reduction of radiation exposure, manufacturers are trying to do their part and are stepping forward to help. New systems continue to decrease radiation dose and offer dose lowering technologies, often while managing to increase image quality and reduce noise. Artificial intelligence is also making inroads, thereby providing another tool to decrease the number of images needed or the intensity of radiation.

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