Abstract：
BACKGROUND: Anecdotal reports are appearing in the scientific literature about cases of brain tumors in interventional physicians who are exposed to ionizing radiation. In response to this alarm, several designs of leaded caps have been made commercially available. However, the results reported on their efficacy are discordant.
OBJECTIVE: To synthesise, by means of a systematic review of the literature, the capacity of decreasing radiation levels conferred by radiation attenuating devices (RAD) at the cerebral level of interventional physicians.
METHODS: A systematic review were performed including the following databases: MEDLINE, SCOPUS, EBSCO, Science Direct, Cochrane Controlled Trials Register (CENTRAL), WOS, WHO International Clinical Trials Register, Scielo and Google Scholar, considering original studies that evaluated the efficacy of RAD in experimental or clinical contexts from January 1990 to May 2022. Data selection and extraction were performed in triplicate, with a fourth author resolving discrepancies.
RESULTS: Twenty articles were included in the review from a total of 373 studies initially selected from the databases. From these, twelve studies were performed under clinical conditions encompassing 3801 fluoroscopically guided procedures, ten studies were performed under experimental conditions with phantoms, with a total of 88 procedures, four studies were performed using numerical calculations with a total of 63 procedures. The attenuation and effectiveness of provided by the caps analysed in the present review varying from 12.3% to 99.9%, y 4.9% to 91% respectively.
CONCLUSIONS: RAD were found to potentially provide radiation protection, but a high heterogeneity in the shielding afforded was found. This indicates the need for local assessment of cap efficiency according to the practice.
OBJECTIVE: To synthesise, by means of a systematic review of the literature, the capacity of decreasing radiation levels conferred by radiation attenuating devices (RAD) at the cerebral level of interventional physicians.
METHODS: A systematic review were performed including the following databases: MEDLINE, SCOPUS, EBSCO, Science Direct, Cochrane Controlled Trials Register (CENTRAL), WOS, WHO International Clinical Trials Register, Scielo and Google Scholar, considering original studies that evaluated the efficacy of RAD in experimental or clinical contexts from January 1990 to May 2022. Data selection and extraction were performed in triplicate, with a fourth author resolving discrepancies.
RESULTS: Twenty articles were included in the review from a total of 373 studies initially selected from the databases. From these, twelve studies were performed under clinical conditions encompassing 3801 fluoroscopically guided procedures, ten studies were performed under experimental conditions with phantoms, with a total of 88 procedures, four studies were performed using numerical calculations with a total of 63 procedures. The attenuation and effectiveness of provided by the caps analysed in the present review varying from 12.3% to 99.9%, y 4.9% to 91% respectively.
CONCLUSIONS: RAD were found to potentially provide radiation protection, but a high heterogeneity in the shielding afforded was found. This indicates the need for local assessment of cap efficiency according to the practice.
摘要：
背景：科学文献中出现了关于暴露于电离辐射的介入医生的脑肿瘤病例的轶事报道。为了响应这个警报，引线帽的几种设计已经在商业上可用。然而,报告的疗效结果不一致.
目的：合成，通过对文献的系统回顾，降低辐射水平的能力由辐射衰减设备（RAD）在介入医生的大脑水平。
方法：进行了系统评价，包括以下数据库：MEDLINE，Scopus,EBSCO,科学直接，Cochrane控制试验登记册（中央），WOS,世卫组织国际临床试验登记册，Scielo和谷歌学者，考虑1990年1月至2022年5月评估RAD在实验或临床环境中疗效的原始研究。数据选择和提取一式三份，与第四作者解决差异。
结果：从数据库中最初选择的总共373项研究中纳入了20篇文章。从这些,在临床条件下进行了12项研究，包括3801个透视引导程序，在实验条件下使用幻影进行了十项研究，共有88个程序，我们使用数值计算进行了4项研究,共63项手术.本综述中分析的上限提供的衰减和有效性从12.3%到99.9%不等，y分别为4.9%至91%。
结论：发现RAD可能提供辐射防护，但是在屏蔽中发现了高度的异质性。这表明需要根据实践对上限效率进行本地评估。
目的：合成，通过对文献的系统回顾，降低辐射水平的能力由辐射衰减设备（RAD）在介入医生的大脑水平。
方法：进行了系统评价，包括以下数据库：MEDLINE，Scopus,EBSCO,科学直接，Cochrane控制试验登记册（中央），WOS,世卫组织国际临床试验登记册，Scielo和谷歌学者，考虑1990年1月至2022年5月评估RAD在实验或临床环境中疗效的原始研究。数据选择和提取一式三份，与第四作者解决差异。
结果：从数据库中最初选择的总共373项研究中纳入了20篇文章。从这些,在临床条件下进行了12项研究，包括3801个透视引导程序，在实验条件下使用幻影进行了十项研究，共有88个程序，我们使用数值计算进行了4项研究,共63项手术.本综述中分析的上限提供的衰减和有效性从12.3%到99.9%不等，y分别为4.9%至91%。
结论：发现RAD可能提供辐射防护，但是在屏蔽中发现了高度的异质性。这表明需要根据实践对上限效率进行本地评估。
