title: A novel perineal shield for low-dose-rate prostate brachytherapy.
abstract: OBJECTIVE
  To study the impact on radiation exposure to staff through the use of an original perineal shield during low-dose-rate prostate brachytherapy.
  
  
  METHODS
  We designed a 1 mm thick stainless steel shield that duplicates and is able to slide directly over a standard commercialized prostate brachytherapy grid. We then analyzed the post-procedure exposure in 15 consecutive patients who underwent Iodine-125 seed placement. Measurements were performed with and without the shield in place at fixed locations relative to the grid template. Endpoints were analyzed using the paired two-sample t-test, with statistical significance defined as a p-value < 0.05.
  
  
  RESULTS
  The exposure at the midline grid template ranged from 0.144-0.768 mSv/hr without the shield, and 0.038-0.144 mSv/hr with the shield (p < 0.0001). The exposure 10 cm left of the grid template was 0.134-0.576 mSv/hr without the shield, and 0.001-0.012 mSv/hr with the shield (p < 0.0001). The exposure 10 cm right of the grid template was 0.125-0.576 mSv/hr without the shield, and 0.001-0.012 mSv/hr with the shield (p < 0.0001). The median reduction of exposure at the grid was 76% midline, 98.5% left, and 99% right. Similarly, each individual dose rate was recorded at 25 cm from the perineum, both with and without shield. The median reduction of exposure 25 cm from the perineum was 73.7% midline, 77.7% left and 81.6% right (p < 0.0001).
  
  
  CONCLUSIONS
  Our novel shield took seconds to install and was non-restrictive during the procedure, and provided at least a four-fold reduction in radiation exposure to the brachytherapist.
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York ; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Weiner
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York ; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schwartz
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York ; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Safdieh
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York.
authors.forename: Alex
authors.initials: A
authors.lastname: Polubarov
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York.
authors.forename: Tejas
authors.initials: T
authors.lastname: Telivala
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York.
authors.forename: Matthew
authors.initials: M
authors.lastname: Worth
authors.affiliation: Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York ; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schreiber
keywords: ALARA; brachytherapy; iodine-125; prostate cancer; seeds; shield