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Novel Radiation Protection System Provides Significant Reduction in Radiation Dose To The Head And Eyes of Interventionalists During Real-time Patient Procedures
Angelyn Thayer1, Bruce Zwiebel1,2, Murray Shames1, Christina K Tran1
1University of South Florida, Tampa, FL;2StemRad Ltd., StemRad Inc., Tampa, FL

INTRODUCTION: Current lead protection equipment is cumbersome and offers little eye or head protection. Previous studies of the weightless StemRadMD exoskeleton on anthropomorphic phantom mannequins demonstrated an average dose reduction of 93% across critical radiosensitive body regions compared to conventional lead aprons. We sought to study the dose reduction in the clinical setting during real-time interventional cases with particular attention to the head and eyes which are often under-protected in everyday practice. METHODS:
The weightless exoskeleton suit worn in the study consisted of four components: a customized bismuth-antimony bilayer protective apron, a transparent lead-acrylic attenuation face shield, a thyroid collar, and an exoskeleton system to redirect the weight of the components from the user onto the floor. Radiation measurements were recorded across a total of 150 procedures performed by 10 different physicians. For 105 of the procedures, a set of 7 direct-ion storage-based detectors were placed in various radiation-sensitive locations both inside and outside of the coverage area of the custom-fitted exoskeleton suits. Analogous sets or pairs included a) top of forehead, edge of protective glasses, and a superimposed sensor on the outside of the visor, b) inner and outer thyroid collar, and c) inner and outer axillary area. For the remaining 45 procedures, 3 additional configurations were used to place analogous detectors measuring doses specifically to the head, eyes, and thyroid. Procedures performed included interventions for critical limb ischemia, endovascular aortic repairs, diagnostic angiograms, visceral embolizations, endarterectomies, fistulagrams, endoleak repairs, and stent replacements. Radiation data, physician position, and exposure times were recorded for each case. Dose reduction was calculated by dividing the difference between the outside and inside doses by the outside dose as the denominator and converting to a percentage.
RESULTS:
The analogous detector sets placed in the region of the face, eyes, and upper torso showed 100% protection within the visor of the exoskeleton suit with no measurable radiation inside the visor. The analogous detector sets in the region of the head (at mid-scalp) showed a dose reduction of 88+ or - 4%.
CONCLUSIONS:
Real world use of the weightless StemRadMD exoskeleton system provides the wearer with protection to the thyroid and axilla/torso that is non-inferior to the conventional lead apron. The visor system significantly reduces the forehead dose equivalent, for which currently available lead skull caps have proven inadequate. Additionally, the system provides significant and consistent reduction in eye dose equivalent which has been shown to vary widely with conventional lead glasses depending on style and fit. This is particularly important in light of the International Committee on Radiological Protectionís recent call for lowered eye dose limit.


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