Efficacy of an X-Ray Protective Drape in Reducing Operator Radiation Dose in Transfemoral Arterial Liver Interventions: a Randomized-Controlled Trial

Abstract

PurposeInterventional radiologists are among the healthcare professionals most exposed to ionizing scatter radiation. A 0.5 mm lead equivalent X-ray protective drape (MXPD, Mavig, Germany) was introduced to reduce operator radiation dose and has demonstrated efficacy during cardiac interventions. This study evaluates the efficacy of the MXPD during transfemoral liver interventions.Materials & MethodsA single-center randomized controlled study was conducted to compare operator radiation exposure during transfemoral liver interventions (n = 100) with and without the MXPD. Primary outcome was the ratio of the combined operator radiation dose values-measured at the chest, eyes and both hands and normalized to the respective dose area products - between MXPD and control groups. Secondary outcomes included the ratios in operator radiation doses measured for the individual dosimeter locations.ResultsThe MXPD group showed a significantly lower normalized radiation dose per DAP (mean reduction 0.31 mu Sv; 95% CI 0.083-0.536, p = 0.009), representing a 43% reduction. The effect of the drape was the highest for the whole-body dose measured above the lead apron (55% reduction, p = 0.10), the left hand finger dose (43%, p = 0.20) and the eye lens dose estimated at the left temple (63%, p = 0.10) and in between the eyes (47%, p = 0.10).ConclusionThe MXPD can effectively reduce operator radiation dose during transfemoral arterial liver interventions, offering a practical adjunct to standard protective measures.Level of EvidenceLevel 1b, Randomized Controlled Trial.