Phantom study to determine radiation exposure to medical personnel involved in ERCP fluoroscopy and its reduction through equipment and behavior modifications

Objective: The aim of this work is to evaluate the potential radiation exposure to medical personnel by comparing results from phantom studies of two different fluoroscopic units used for ERCP, and to determine which equipment or behavior modification can reduce radiation exposure. Methods: Radiation exposures using an opaque tissue equivalent chest phantom with an abdominal insert were performed on a stationary dedicated fluoroscopy unit and a mobile C-arm unit, comparing varying equipment manipulations. Scatter radiation was recorded at 1) the patients' head, 2) where the endoscopist stands, and 3) where the equipment personnel stands. Results: Radiation exposures were significantly higher for the mobile C-arm unit, revealing a 4160-times greater dosage increase for head and neck and a 8660-times increase for body than the fixed unit. Tower position and vertically stationed lead shields facilitated exposure reduction by means of equipment manipulation. The positioning of the endoscopist away from the right corner of the units also decreased exposure. Conclusions: Dedicated stationary fluoroscopy units provide significantly less radiation exposure. Equipment and behavior modification including tower positioning down and vertical shielding are essential for reduction in radiation exposure to medical personnel.