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A novel perineal shield for low-dose-rate prostate brachytherapy.

Weiner JP, Schwartz D, Safdieh J, Polubarov A, Telivala T, Worth M, Schreiber D - J Contemp Brachytherapy (2015)

Bottom Line: 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.Similarly, each individual dose rate was recorded at 25 cm from the perineum, both with and without shield.

View Article: PubMed Central - PubMed

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.

ABSTRACT

Purpose: To study the impact on radiation exposure to staff through the use of an original perineal shield during low-dose-rate prostate brachytherapy.

Material and 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.

No MeSH data available.


Related in: MedlinePlus

A) Perineal shield: B) oblique anterior view, C) oblique posterior view, D) posterior view
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Figure 0001: A) Perineal shield: B) oblique anterior view, C) oblique posterior view, D) posterior view

Mentions: A novel shield model system was constructed to enable sufficient dose reduction to medical personal (Fig. 1). The overall design of the system was a 1 mm thick stainless steel shield with duplicate holes and markings to a standard, commercially available prostate brachytherapy grid (Civco Medical Solutions, Disposable Template Grid, Orange City, Iowa, USA). Stainless steel was chosen for shield as this material provides significant attenuation of the radiation and is also able to safely undergo autoclaving after use, allowing for repeated use of the shield. The thickness of 1 mm was similarly chosen in order to provide radiation shielding with the minimal width shield, in order to make the shield as lightweight and unobtrusive to the procedure as possible. The shield was designed to be taller and wider in dimensions than the grid (21 cm by 21 cm in size) and was constructed to be compatible with our ultrasound stepper system (Civco Medical Solutions, Classic Stepper) but easily adaptable to other systems.


A novel perineal shield for low-dose-rate prostate brachytherapy.

Weiner JP, Schwartz D, Safdieh J, Polubarov A, Telivala T, Worth M, Schreiber D - J Contemp Brachytherapy (2015)

A) Perineal shield: B) oblique anterior view, C) oblique posterior view, D) posterior view
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499515&req=5

Figure 0001: A) Perineal shield: B) oblique anterior view, C) oblique posterior view, D) posterior view
Mentions: A novel shield model system was constructed to enable sufficient dose reduction to medical personal (Fig. 1). The overall design of the system was a 1 mm thick stainless steel shield with duplicate holes and markings to a standard, commercially available prostate brachytherapy grid (Civco Medical Solutions, Disposable Template Grid, Orange City, Iowa, USA). Stainless steel was chosen for shield as this material provides significant attenuation of the radiation and is also able to safely undergo autoclaving after use, allowing for repeated use of the shield. The thickness of 1 mm was similarly chosen in order to provide radiation shielding with the minimal width shield, in order to make the shield as lightweight and unobtrusive to the procedure as possible. The shield was designed to be taller and wider in dimensions than the grid (21 cm by 21 cm in size) and was constructed to be compatible with our ultrasound stepper system (Civco Medical Solutions, Classic Stepper) but easily adaptable to other systems.

Bottom Line: 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.Similarly, each individual dose rate was recorded at 25 cm from the perineum, both with and without shield.

View Article: PubMed Central - PubMed

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.

ABSTRACT

Purpose: To study the impact on radiation exposure to staff through the use of an original perineal shield during low-dose-rate prostate brachytherapy.

Material and 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.

No MeSH data available.


Related in: MedlinePlus