Luke Anthony Byers DO, Presenter: Nothing to Disclose

William Werner Orrison MD, Abstract Co-Author: Consultant, RadSite Consultant, World Wide Innovations & Technologies

Peter Cartwright BS, Abstract Co-Author: Nothing to Disclose

Individuals involved in interventional procedures are chronically exposed to ionizing radiation, the only unequivocal risk factor for developing intracranial neoplasms. A recent report identified 31 interventionalists who developed brain cancer with the concern that physicians performing interventional procedures have disproportionate left-sided brain tumors. This study was designed to evaluate the effectiveness of using a novel personal cranial radiation protection surgical cap as a means of reducing the risk of radiation induced cerebral neoplasms.

Following IRB waiver disposable surgical caps containing various levels of protective lead-free radiation shielding (No Brainer -RADPAD, Kansas City, KS) were used to protect the cranium in one interventionalist and one assistant during multiple fluoroscopic procedures. Radiation monitoring during the fluoroscopic procedures was accomplished using real-time radiation detectors (UNFORS, Billdal, Sweden). Simultaneous monitor recordings were performed with radiation detectors positioned identically above and below the protective material at the level of the anterior left cranium (above the left eye). Four levels of radiation protection were tested (lead equivalency at 90 kVp): 1) Red - 0.375 mm, 2) Orange - 0.25 mm, 3) Yellow - 0.125 mm and 4) Blue - 0.07 mm.

A total of 34 patient procedures were completed. Average distance from the calvarium to the Image intensifier was approximately 1 meter. The interventionalist and the assistant reported that the surgical caps were minimally different from those typically worn for interventional procedures and there was no reported discomfort even after multiple hours (day long) wearing. Dose reductions for the procedures are as follows: Overall (92%), Red (100%), Orange (100%), Yellow (96%) and Blue (78%).

The “No Brainer”is aptly named, as this simple inexpensive approach to cranium protection is easy to use, comfortable and highly effective at decreasing brain radiation exposure. This device should stem the increasing number of interventionalists reported with cerebral malignancies.

Comfortable disposable surgical caps containing a lead-free radiation protection barrier can serve as a means of reducing the risk of radiation induced cerebral neoplasms.

Byers, L, Orrison, W, Cartwright, P, Protection Against Radiation-induced Brain Tumors in Interventional Professionals.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005443.html