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

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

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.

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).

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.

Journal of contemporary brachytherapy. 2015 Jun 08 [Epub]

Joseph P Weiner, David Schwartz, Joseph Safdieh, Alex Polubarov, Tejas Telivala, Matthew Worth, David Schreiber

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. , 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. , 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. , Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York. , Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York. , Department of Radiation Oncology, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York. , 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.

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