Derek Bok of Harvard University once said, “If you think education is expensive, try ignorance”. I can say that, in spite of the student loans incurred during my college years, Mr. Bok is correct. Now you may ask, "What does this have to do with C-Arms?" So glad you asked...
Looking to educate myself and eliminate a little ignorance, I recently researched some information on c-arm shielding, wondering: Does my C-Arm require lead shielding? Unfortunately, some of the initial information I came across was conflicting and because the truth was only discovered after quite a bit of research, I felt prompted to write this article to help others going through this same process.
Honestly, there is no straightforward answer to our titular question. Regulations concerning shielding vary in a number of ways, so much that I’ve decided the best way for any c-arm user to answer it is with three more questions. Answering these questions on your own or with the help of a credible c-arm vendor will help you educate yourself and reduce the risk of shelling out big money over those “I dunno” moments.
1. What state are you in?
Visit your state’s Radiation Protection homepage and read the regulations surrounding shielding. Requirements often vary by modality, so make sure you are reading about fluoroscopy. Some states do not require shielding at all but have other requirements that must be met. Take Texas for instance; there are no shielding requirements for a c-arm, but you do have to monitor dose output for a year after installation.
Then there are states like Ohio where the shielding requirements are not on the website. In order to know what shielding is needed you must call out a physicist to evaluate the site and tell you what you need.
2. Where in the building will the C-Arm be operating?
Florida is a great example of the relevance of this question. If you are shooting less than 200 kVp, no shielding plan review is required. If you are shooting higher than 200 kVp, the level of shielding will depend on the size of your room and its location within the building. The typical requirement in Florida is 1/32nd of an inch lead lining or double drywall- no permanent barrier needed.
3. Will you be moving your unit from room to room or will it be stationary?
The state of Georgia is a good example of why this is important information to know ahead of time. The website of Georgia’s Department of Community Health says, “Shielding designs for all x-ray installations must be submitted to the DCH for review and approval with the exception of bone densitometry and some portable units. C-arm units that are used in a fixed location require submittal of a shielding design.”
So, for the main moral of this article, back to the quote “If you think education is expensive, try ignorance”. Don’t let ignorance be the reason you are fined for not meeting your state’s requirements on shielding. Not every state makes it easy to find (c’mon Ohio) but the information is out there if you look hard enough. Contact me if you need assistance and I will try my best to help. We are in this together… you matter to us!