title: CT fluoroscopy-guided intervention: marked reduction of scattered radiation dose to the physician's hand by use of a lead plate and an improved I-I device.
abstract: OBJECTIVE
  To estimate the effects of a lead plate, three types of needle holders, tube current, and slice thickness on decreasing the radiation dose to the physician's hand during interventional procedures with computed tomographic (CT) fluoroscopic guidance. The needle holders (I-I devices), which were developed by the authors, maintained the distance between the physician's hand and the CT plane at 7 cm, 10 cm, and 15 cm, respectively.
  
  
  METHODS
  The dose rate (mSv/tube current/CT fluoroscopy time) was measured in 55 cases, which were divided into six groups. In group A (n = 14), the current was 135 kV, there was a 5-mm slice thickness, and a 7-cm I-I device was used without the lead plate. Group B (n = 11) entailed a 120-kV current, a 5-mm slice thickness, and a 7-cm I-I device without the lead plate. Group C (n = 8) entailed a 120-kV current, 5-mm slice thickness, and 7-cm I-I device with the lead plate. Group D (n = 9) entailed a 120-kV current, 5-mm slice thickness, and 10-cm I-I device with the lead plate. Group E (n = 7) entailed a 120-kV current, 5-mm slice thickness, and 15-cm I-I device with the lead plate. Group F (n = 6) entailed a 120-kV current, 1-mm slice thickness and 10-cm I-I device with the lead plate. To compare the effects of tube voltage, lead plate use, slice collimation, and I-I devices, differences were compared between groups A and B, B and C, D and F, and among groups C, D, and E.
  
  
  RESULTS
  The dose rates of groups A, B, C, D, E, and F were 126.3, 75.2, 17.8, 13.9, 2.8, and 4.1 mSv/mA/sec x 100,000, respectively. There were significant differences in dose rates between groups A and B (t-test, P =.037), B and C (Student t-test, P =.002), D and F (Mann-Whitney test, P =.011), and among groups C, D, and E (Kruskal-Wallis test, P =.016).
  
  
  CONCLUSIONS
  The lead plate, the improved I-I devices, use of a 120 kV (vs 135 kV) current, and 1-mm (vs 5 mm) collimation were all useful in decreasing the dose rate.
authors.affiliation: Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan. toshiyuki.irie@nifty.com
authors.forename: T
authors.initials: T
authors.lastname: Irie
authors.forename: M
authors.initials: M
authors.lastname: Kajitani
authors.forename: Y
authors.initials: Y
authors.lastname: Itai
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation*; D005471:Fluoroscopy; D006225:Hand / Q000528:radiation effects*; D006801:Humans; D007854:Lead; D016273:Occupational Exposure / Q000517:prevention & control*; D010820:Physicians; D011829:Radiation Dosage; D011835:Radiation Protection; D015642:Radiology, Interventional / Q000295:instrumentation* / Q000379:methods*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D007854:Lead