CURRENT TRENDS OF RADIATION PROTECTION EQUIPMENT IN INTERVENTIONAL RADIOLOGY

A systematic review of the effectiveness of leaded glasses for ensuring safety among healthcare professionals in fluoroscopy

BACKGROUND

Currently, there is an increase in procedures across various clinical specialties involving the use of ionising radiation.

OBJECTIVE

The primary objective of this systematic review is to analyse and compare the existing literature regarding the effectiveness of leaded glasses for healthcare professionals.

METHODS

Comprehensive literature searches were conducted for relevant studies published between 2018 and 2023 using the Scopus, PubMed, and Web of Science databases according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology.

RESULTS

After the complete text screening, 11 articles were deemed suitable for inclusion in the review. Leaded glasses significantly reduce eye radiation exposure, with studies showing shielding effects ranging from 10% to 88,9%, depending on the configuration and thickness of the glasses. For instance, lightweight glasses achieved a shielding effect of 61.4%, while thicker lead equivalents (≥0.5 mm) offered up to ninefold dose reductions. Studies also noted the importance of lateral shielding and ergonomic designs for optimal protection. Leaded glasses significantly reduce eye lens doses but are most effective when combined with other protective measures. Factors such as head orientation, procedural complexity, and operator movement influence their performance. The findings underscore the need for standardised guidelines on protective eyewear use and further research under real-world clinical conditions.

CONCLUSION

It is essential to ensure the proper use of leaded glasses to minimize the risks of ionising radiation for healthcare professionals in fluoroscopy procedures.

Analysis of Periprocedural X-ray Exposure in Transarterial Radioembolization with Glass or Resin Microspheres

Background: Transarterial Radioembolization (TARE) is an effective treatment option for both primary and secondary liver malignancies. However, challenging anatomical conditions can lead to prolonged fluoroscopy times (FT), elevated doses of periprocedural X-radiation (DAP), and increased use of contrast agents (CAs). In this study, we examined the influence of our radiologists' experience and the choice of microspheres on X-ray exposure and CA doses in TARE. Material and Methods: Datasets comprising 161 TARE and 164 preprocedural evaluation angiographies (TARE-EVA) were analyzed. Our study focused on assessing DAP, FT, and CA concerning both microsphere types, the radiologist's experience, and whether the same radiologist performed both the TARE-EVA and the actual TARE. Results: In TARE, the use of resin microspheres resulted in significantly higher FT and CA compared to glass microspheres (14.3 ± 1.6 min vs. 10.6 ± 1.1 min and 43 ± 2.2 mL vs. 33.6 ± 2.1 mL, p < 0.05), with no notable differences in DAP (p = 0.13). Experienced radiologists demonstrated reduced FT/DAP, with a 19% decrease in DAP and 53% in FT during the evaluation angiography (p < 0.05) and a 49% reduction in DAP during the actual TARE (p < 0.05), with no statistical differences in FT. Performing TARE and TARE-EVA under the same radiologist led to a 43% reduction in DAP and a 25% decrease in FT (p < 0.05, respectively). Conclusions: To mitigate X-radiation exposure, it is advisable for radiologists to undergo thorough training, and, ideally, the same radiologist should conduct both the TARE and the TARE-EVA. While the use of glass spheres may decrease intraarterial CA, it does not significantly impact periprocedural X-ray exposure.