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Article

Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application

by
Hosang Jeon
1,
Dong Woon Kim
2,
Ji Hyeon Joo
3,
Yongkan Ki
3,
Suk-Woong Kang
4,
Won Chul Shin
4,
Seong Hoon Yoon
5,
Yun Seong Kim
6,
Seung Hyun Yong
7,
Hyun Sung Chung
8,
Taehoon Lee
9 and
Hee Yun Seol
6,*
1
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
2
Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
3
Department of Radiation Oncology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
4
Department of Orthopedics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
5
Division of Pulmonary and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
6
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
7
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
8
Division of Pulmonology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Republic of Korea
9
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(6), 2114; https://doi.org/10.3390/jcm14062114
Submission received: 17 February 2025 / Revised: 17 March 2025 / Accepted: 18 March 2025 / Published: 20 March 2025
(This article belongs to the Special Issue Interventional Pulmonology: Advances and Future Directions)
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Abstract

Background/Objectives: Fluoroscopy has been widely adopted in interventional pulmonology, as it facilitates real-time visualization of the bronchoscope, endobronchial ultrasound, and biopsy tools during procedures. The purpose of this study was to evaluate the effectiveness of radiation shields in minimizing scattered X-ray dose to the bronchoscopist in a phantom study and to determine the dose of scattered X-ray dose to medical staff with radiation shields in clinical application. Methods: An anthropomorphic torso phantom was positioned on the fluoroscopic table between the C-arm X-ray tube and the image detector to mimic bronchoscopic operations. Upper and lower body lead shields were used to examine the effectiveness of radiation shielding. Scatter radiation rates were assessed at a first operator location using real-time dosimeters with and without protective devices. In clinical application, the scattered X-ray dose of the first operator and main assistant was measured using wearable radiation dosimeters during 20 procedures. Results: In the phantom study, scattered radiation without shielding was 266.34 ± 8.86 μSv/h (glabella), 483.90 ± 8.01 μSv/h (upper thorax), 143.97 ± 8.20 μSv/h (hypogastrium), and 7.22 ± 0.28 μSv/h (ankle). The combination of upper and lower body lead shields reduced the scattered X-ray dose by 98.7%, 98.3%, 66.2%, and 79.9% at these levels, respectively. In clinical application, mean scattered X-ray dose rates were 0.14 ± 0.05 μSv/procedure (eye), 0.46 ± 0.51 μSv/procedure (chest), 0.67 ± 0.50 μSv/procedure (hypogastrium), and 1.57 ± 2.84 μSv/procedure (assistant’s wrist). Conclusions: The combination of radiation shields significantly reduced the scattered X-ray dose at the operator site in the phantom study. The scattered X-ray dose to medical staff during bronchoscopy can be kept at a low level with the aid of a shielding system.
Keywords: scattered radiation; radiation shields; bronchoscopist; assistant; phantom study; clinical application scattered radiation; radiation shields; bronchoscopist; assistant; phantom study; clinical application

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MDPI and ACS Style

Jeon, H.; Kim, D.W.; Joo, J.H.; Ki, Y.; Kang, S.-W.; Shin, W.C.; Yoon, S.H.; Kim, Y.S.; Yong, S.H.; Chung, H.S.; et al. Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application. J. Clin. Med. 2025, 14, 2114. https://doi.org/10.3390/jcm14062114

AMA Style

Jeon H, Kim DW, Joo JH, Ki Y, Kang S-W, Shin WC, Yoon SH, Kim YS, Yong SH, Chung HS, et al. Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application. Journal of Clinical Medicine. 2025; 14(6):2114. https://doi.org/10.3390/jcm14062114

Chicago/Turabian Style

Jeon, Hosang, Dong Woon Kim, Ji Hyeon Joo, Yongkan Ki, Suk-Woong Kang, Won Chul Shin, Seong Hoon Yoon, Yun Seong Kim, Seung Hyun Yong, Hyun Sung Chung, and et al. 2025. "Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application" Journal of Clinical Medicine 14, no. 6: 2114. https://doi.org/10.3390/jcm14062114

APA Style

Jeon, H., Kim, D. W., Joo, J. H., Ki, Y., Kang, S.-W., Shin, W. C., Yoon, S. H., Kim, Y. S., Yong, S. H., Chung, H. S., Lee, T., & Seol, H. Y. (2025). Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application. Journal of Clinical Medicine, 14(6), 2114. https://doi.org/10.3390/jcm14062114

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