Head and Neck Radiation Dose and Radiation Safety for Interventional Physicians.

K Fetterly et al. JACC Vol 10 No 5 2017. Link to manuscript

This excellent study provides further confirmation that attenuating head caps do very little to protect the brain due to their geometry relative to the scatter field. It also confirms older studies showing the poor lens protection provided by leaded glasses, especially to the contrateral (often the right) eye where it is nil. Head and neck protection requires large shields located between the patient and the operator’s head, and uncomfortable wearable gear is insufficient. 

Key excerpts:

LEAD GLASSES: “…Similar to the findings of Geber et al. (19), the results of this work indicate incomplete protection of the ocular lenses by the glasses. In particular, neither model of glasses protected the ocular lens contralateral to scatter source. This is because dose to the contralateral lens enters the eye obliquely through the face, whereas the glasses preferentially protect against radiation incident from the front.

ATTENUATING HEAD CAP:  “This work demonstrates that the radiation absorbing surgical cap provides essentially no protection to the brain of an interventional physician. This result is readily explained by geometry…This finding contradicts marketing materials and published works suggesting that these or similar types of caps offer substantial brain protection (13–15). The experimental methods used in these other works measured attenuation of the surgical cap rather than dose to tissues. As demonstrated herein, the optimistic perspective that radiopaque surgical caps substantially reduce brain dose is misleading.”