{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:59:52Z","timestamp":1769522392006,"version":"3.49.0"},"reference-count":13,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007872","name":"Grieg Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007872","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004257","name":"Helse Vest","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>There is increasing concern and focus in the interventional cardiology community on potential long term health issues related to radiation exposure and heavy wearable protection. Optimized shielding measures may reduce operator dose to levels where lighter radioprotective garments can safely be used, or even omitted. X-ray blankets (XRB) are commercially available but suffer from small size and lack of stability. A larger XRB may reduce operator dose but could hamper vascular access and visualization. The aim of this study is to assess shielding effect of an optimized XRB during cardiac catheterization and estimate the potential reduction in annual operator dose based on DICOM Radiation Dose Structured Report (RDSR) data reflecting everyday clinical practice.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data accumulated from 7681 procedures over three years in our RDSR repository was used to identify projection angles and radiation doses during cardiac catheterization. Using an anthropomorphic phantom and a scatter radiation detector, radiation dose to the operator (mSv) and patient (dose area product\u2014DAP) was measured for each angiographic projection for three different shielding setups. Relative operator dose (mSv\/DAP) was calculated and multiplied by DAP per projection to estimate effect on operator dose.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Adding an optimized XRB to a standard shielding setup comprising a table- and ceiling-mounted shield resulted in a 94.9% reduction in estimated operator dose. The largest shielding effect was observed in left and cranial projections where the ceiling-mounted shield offered less protection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>An optimized XRB is a simple shielding measure that has the potential to reduce operator dose.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0277436","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T18:46:15Z","timestamp":1668105975000},"page":"e0277436","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of an optimized X-ray blanket design on operator radiation dose in cardiac catheterization based on real-world angiography"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1396-6985","authenticated-orcid":true,"given":"Cedric","family":"Davidsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Bolstad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Ytre-Hauge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5849-8214","authenticated-orcid":true,"given":"Andreas Tefre","family":"Samn\u00f8y","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjell","family":"Vikenes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vegard","family":"Tuseth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"pone.0277436.ref001","doi-asserted-by":"crossref","first-page":"9602942","DOI":"10.1155\/2020\/9602942","article-title":"Temporal Trends in X-Ray Exposure during Coronary Angiography and Percutaneous Coronary Intervention","volume":"2020","author":"C Davidsen","year":"2020","journal-title":"Journal of interventional cardiology"},{"issue":"4","key":"pone.0277436.ref002","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1002\/ccd.20201","article-title":"Occupational hazards of interventional cardiologists: prevalence of 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Vlastra","year":"2017","journal-title":"Circulation Cardiovascular interventions"},{"issue":"8","key":"pone.0277436.ref005","doi-asserted-by":"crossref","first-page":"e002384","DOI":"10.1161\/CIRCINTERVENTIONS.115.002384","article-title":"Randomized Controlled Trial of Radiation Protection With a Patient Lead Shield and a Novel, Nonlead Surgical Cap for Operators Performing Coronary Angiography or Intervention","volume":"8","author":"A Alazzoni","year":"2015","journal-title":"Circulation Cardiovascular interventions"},{"issue":"11","key":"pone.0277436.ref006","doi-asserted-by":"crossref","first-page":"e009627","DOI":"10.1161\/CIRCINTERVENTIONS.120.009627","article-title":"Efficacy of MAVIG X-Ray Protective Drapes in Reducing Operator Radiation Dose in the Cardiac Catheterization Laboratory: A Randomized Controlled Trial","volume":"13","author":"K McCutcheon","year":"2020","journal-title":"Circulation Cardiovascular 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Cardiology"},{"key":"pone.0277436.ref009","doi-asserted-by":"crossref","first-page":"3146104","DOI":"10.1155\/2021\/3146104","article-title":"Efficacy of MAVIG X-Ray Protective Drapes in Reducing CTO Operator Radiation","volume":"2021","author":"K McCutcheon","year":"2021","journal-title":"Journal of interventional cardiology"},{"issue":"7","key":"pone.0277436.ref010","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1002\/ccd.25777","article-title":"A randomized study comparing the use of a pelvic lead shield during trans-radial interventions: Threefold decrease in radiation to the operator but double exposure to the patient.","volume":"85","author":"A Musallam","year":"2015","journal-title":"Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions"},{"issue":"7","key":"pone.0277436.ref011","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1016\/j.jacc.2004.06.057","article-title":"Identification of 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