Shielding for Diagnostic X-rays:

UK Guidance

Jerry Williams
Royal Infirmary of Edinburgh
 BIR/ IPEM Working Party Report

British Institute of Radiology

Institute of Physics and Engineering in Medicine

Working Party:
David Sutton
Sutton, Jerry Williams
Williams, Colin Martin,
Martin Don McIntosh,
McIntosh Tony
Cotterill, Graham Hart, David Gallacher
Publication date: 2000
 BIR/ IPEM Working Party Report
Content:
Design criteria and dose
constraints
Primary & Secondary radiations
Building materials
X-ray
ay transmission
t a s ss o factors
acto s
Assessment of shielding
Worked examples

Working Party:
David Sutton
Sutton, Jerry Williams
Williams, Colin Martin,
Martin Don McIntosh,
McIntosh Tony
Cotterill, Graham Hart, David Gallacher
Publication date: 2000
 Radiation
d Sources
Radiography (film/ screen)
Radiography + Fluoroscopy
Angiography
CT ((single
i l slice)
li )
Mammography
Dental
DEXA
 This
h talk
lk
Design criteria
Transmission factors
Shielding materials
Primary
P i anddSSecondary
d Radiations
R di ti
 Design Criteria:
Dosimetric Quantities
Dose limits
Effective dose, E mSv
Dose monitoring
Operational quantity
Personal dose equivalent, Hp(d) mSv
Shielding
Shi ldi calculations
l l ti
Air kerma, K mGy
 Design Criteria
Dose constraint (people)
Based on public dose limit (1 mSv/ year)
Applied
A li d to everyone (staff
( ff + public)
bli )
0.3 mGy/ year (6 Gy/ week)
Occupancy factor
5%
Dose to be < 6 mGy/ year
(Controlled area)
Dose constraint (film or CR)
0.4 Gy// d
day ((2 Gy// week)
k)
 Occupancy factors
f
Based on individual occupancy
Examples:
p
Office 100%
Reception area 100%
X-ray control room 100%
Patient examination room 50%
Corridor 20%
Toilets/ bathrooms 10%
Outdoor area with seating 10%
Store rooms 5%
Unattended waiting rooms 5%
X-ray Transmission factors
f
Adopted Archers empirical model
1

B = 1 + t

Used Simpkins , , values

Added data for brick and barium
plaster
Archer et al (1983) Health Physics, 44, 507.
Simpkin (1995) Health Physics, 68, 704
 Shielding
h ld materiall

UK Standard lead thicknesses

Code t mm
3 1.32
4 1.80
5 2.24
6 2.65
Primary and Secondary
Radiations

Leakage
g radiation
Primary/ transmitted beams
Scatter
 X-ray
X ray Tube Leakage

Assumptions:
Tube leakage factor: 150 kV/ 3.3 mA
Field size: 1000 cm2
Distance: 1 m from tube/ patient

WP Recommendation:
Leakage contribution may be ignored
Primary & Transmitted
Radiation
Fluoroscopy
Beam restricted to
X-ray image intensifier/ flat
beam panel detector
Detector has > 2mm
lead equivalent
Patient Mammography

Imaging
device
Radiography: Film dose method

Dose to film/ imaging plate

400 speed system
Dose 10 Gy
Lead equivalence (100 kV)
Cassette
0.19
0 19 mm
Cassette + grid
0.26 mm
Cassette
Cassette/grid/table
Bucky
0.8 mm
system
Cassette/grid/chest Bucky
0.7
0 7 mm

Lead equivalence data derived from Dixon (1994) Med Phys, 21, 1785
Radiography: Film dose method

Dose to film/ imaging plate

400 speed system
Dose 10 Gy
Lead equivalence (100 kV)
Cassette
0.19
0 19 mm
Cassette + grid
0.26 mm
Cassette/grid/table
0.8 mm
Cassette/grid/chest Bucky
0.7
0 7 mm
 Attenuated primary: limiting HVL
1

Limiting HVL: = ln(2) /

t
0.1
D = D oe

0.3
Transmission

Limiting H VL mm
0.01

02
0.2
T

0.001 0.1

0
0.0001 40 60 80 100 120
0 0.5 1 1.5 2 2.5 3
Lead thickness mm
kV
Radiography: ESD method
Unattenuated p
primary
y beam
Beam outside patient
Entrance Surface Dose (ESD)
Situations include
Beam not collimated to cassette
Beam not directed to Bucky
Examples
Chest radiography
Cross table radiography
Out of Bucky radiography (e.g.
extremities)
Area of wall irradiated
Not easy to predict
Variable
Examples
l
Chest Radiography (film dose)
Parameters
100 films/ week
90 kV
ESD = 0.15 mGy
Film dose = 10 Gy
FFD = 1.8 m
FSD = 1.4 m
Fil
Film-wall
ll = 0.7
07m

Best Radiographic Practice

 Calculation (Film-dose method)

Attenuated kerma at wall per week:

Film dose x Workload x ISL correction
2
1 .8
10 10 100
-3
= 0.52 mGy
1 .8 + 0 .7
No of HVLs required (6 Gy/ week) = 6.5
Limiting HVL of lead @ 90 kV = 0.23 mm
Total equivalent lead thickness = 1.5 mm
Additional lead shielding =
0 8 mm
0.8
 Chest Radiography (ESD)
Parameters
100 films/ week
90 kV
ESD = 0.15 mGy
Film dose = 10 Gy
FFD = 1.8 m
FSD = 1.4 m
Fil
Film-wall
ll = 0.7
07m
 Calculation ((ESD method))
Worst case assumption:
Beam size greater than patient and Bucky system
Unattenuated kerma at wall per week:
ESD x Workload x ISL correction
2
1 .4
0.15 100 = 4.7 mGy
1 . 8 + 0 .7

Maximum transmission permitted

= 6x10-33/ 4.7
47
= 0.0013
Lead shielding @ 90 kV
1.4 mm
 Summary
Best practice
Beam collimated to patient/ image
plate/ Bucky
0.8 mm lead
Poor practice
Beam outside patient and Bucky
1.4 mm lead
Scatter
 Scatter Model
NCRP 49 method

K s = a Ku F
400
Ks scatter kerma; Ku primary kerma
F Field size (cm2); a scatter factor
Trout and Kelly (1972), Radiology, 104, 161

Ku . F
Area-air kerma product (AKP) or
Dose area product (DAP)

K s = S DAP
 Why
h DAP?
No assumptions on field size
Availability of DAP data
Requirement in UK legislation to
record patient dose
DAP preferred patient dose metric
(fluoroscopy and radiography)
National surveys of patient dose
Scatter factor normalised to DAP (S)
12

m2)-1
125 kVp
Gy.(Gy.cm 10 100 kVp
85 kVp
70 kVp
8 50 kVp
Scatterr factor, S

0
0 30 60 90 120 150 180
Angle of scatter

(
S = a 4 + b3 + c2 + d + e [(kV 85 )f + 1] )
JR Williams (1996) Br J Radiol, 69, 1032
 Scatter factor normalised to DAP (S)
12
Gy.(Gy.cm2)--1

125 kVp
10 100 kVp
85 kVp
70 kVp
8 50 kVp
Scatter ffactor, S G

4 a -1.04E-07
b 3 27E 05
3.27E-05
2
c -2.75E-03
0
d 8.37E-02
0 30 60 90 120 150 180 e 1 58E+00
1.58E+00
Angle of scatter f 5.99E-03

(
S = a 4 + b3 + c2 + d + e [(kV 85 )f + 1])
JR Williams (1996) Br J Radiol, 69, 1032
 Calculation vs measurement

No of DAP/ week Ave Calc Measured/ Calc dose

Cli i l application
Clinical li ti
positions Gy cm2 Dose mGy Mean Min Max
Interventional Radiology (liver disease) 8 520 0.71 0.22 0.02 0.42
Abdominal + lower limb angiograpy 8 1120 2.15 0.17 0.02 0.43
Cardiac angiography 7 780 0.81 0.99 0.71 1.26
Cerebral angiography 7 460 1.48 0.97 0.67 1.23
Ba contrast studies (o/c tube) 9 430 0.66 0.74 0.50 1.13
B contrast
Ba t t studies
t di (u/c
( / tube)
t b ) 10 960 1 62
1.62 0 28
0.28 0 05
0.05 0 86
0.86
General Radiography 10 460 0.96 0.64 0.30 1.06
Validation of scatter data by
Monte-Carlo
Scatter fraction (S) @ 85 kV
12
Measured
10 MC
Gy cm2

8
S Gy/ G

6
4
2
0
0 30 60 90 120 150 180
Angle
Comparison with NCRP 147

Scatter fraction (S) @ 85 kV

12
UK
10
2 -1

NCRP 147
Gy cm )

MonteCarlo
8

6
S Gy (G

0
0 30 60 90 120 150 180
Angle
 Differences in scatter factors?

Phantom
XX-ray
ray spectrum
Measurement methods
 Method in practice
p
12

m2)-1
125 kVp
Gy.(Gy.cm 10 100 kVp
85 kVp
70 kVp
8 50 kVp
Scatterr factor, S

0
0 30 60 90 120 150 180
Angle of scatter

(
S = a 4 + b 3 + c 2 + d + e [(kV 85 )f + 1] )
Method
h d in practice (1)
( )
1.0

Relative dose
0.8
d
06
0.6

0.4
r
02
0.2

0.0
0 30 60 90 120 150 180
S tt i angle
Scattering l

Smax = [(0.031 kV ) + 2.5] Gy Gy cm ( )

2 1

d = 1 m; = 117

d=1m

30 S( ) d
150
S ave =
d
 Method
h d in practice (2)
( )
Save over C-arm rotation
(30 to 150
150))
Smax for parallel beam
kV Smax Save
50 4.05 3.73
70 4.67 4.30
85 5.14 4.72
100 5 60
5.60 5 15
5.15
125 6.38 5.86
 To be
b continued..
d
Application examples
Fluoroscopy
Radiography
Comparisons with NCRP 147