Staff dose evaluation by application of radiation protection during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed with a mobile C-arm

Background The radiation dose to staff performing endoscopic retrograde cholangiopancreatography (ERCP) is not negligible. Purpose To evaluate the shielding effect of a table-suspended lower-body radiation shield for the positions in the room occupied by the operator, assisting nurse, and anesthesiologist, used during ERCP procedures with a mobile C-arm. Material and Methods Eye lens dose, whole body dose, and extremity dose were measured with and without a table-suspended lower-body radiation shield in a phantom model and in clinical routine work. The effect of the shield was evaluated for each scenario and compared, and a projection was made for when shielding should be required from a regulatory point of view. Results In the phantom measurements, the shield provided significant shielding effects on the body and lower extremities for the operator but no significant shielding of the eye lens. The shielding effect for the assisting nurse was limited to the lower extremity. The clinical measurements yielded the same general result as the phantom measurements, with the major difference that the shield provided no significant reduction in the whole-body dose to the operator. Conclusion The table-suspended shield has a significant shielding effect for the lower extremities of the operator and assisting nurse. For annual dose-area product values >300,000 cGycm(2), the protection of the operator should be reinforced with a ceiling-suspended shield to avoid doses to the eye lens and body in excess of regulatory dose restrictions.