Radiation shielding system

Abstract

To provide a radiation shield assembly.SOLUTION: A radiation shield assembly configured to block radiation emanating from a radiation source comprises a support arm constructed to support at least the majority of the weight of the shield assembly, a first generally planar vertical shield, and a second generally planar vertical shield. The first generally planar vertical shield connects to the second generally planar vertical shield to form a radiopaque barrier. The first generally planar vertical shield and the second generally planar vertical shield can be positioned on a table. The radiation shield assembly is configured to be able to rotate at least one of the first generally planar vertical shield and the second generally planar vertical shield relative to the other around a generally vertical axis with each other and to protect a user's bust from radiation emanating from the radiation source.SELECTED DRAWING: Figure 10

Description

[Technical field]

[0001] The present disclosure relates generally to radiation protection devices and, more particularly, to devices that protect medical personnel from radiation hazards in operating rooms. [Background technology]

[0002] Recent advances in electronics and robotics have enabled surgeons to use non-invasive microsurgery techniques to replace many open incision techniques. When the site of surgical intervention is not well-sighted to the operating room, it must be constantly visualized in order to properly guide and control the instruments. This can be achieved by radiation monitoring, the most common example of which is X-ray monitoring. During surgery, an X-ray generator is placed on one side of the patient to emit X-rays at the surgical site (which is typically below the patient, although the location of the X-ray generator can vary as needed). After the emitted X-rays pass through the surgical site, an X-ray intensifier is placed to receive the emitted X-rays and transmit the image data to a monitor or other means that presents a visible image to the surgeon.

[0003] Although these microsurgery techniques represent a significant improvement over previous open body techniques in terms of trauma to the patient, recovery time, and risk of infection, the constant radiation monitoring exposes everyone involved to much more radiation than was required using the older techniques. This is of minor concern to patients who are likely to undergo only a few such surgeries in their lifetime. However, the specialized medical staff performing these procedures are exposed much more frequently, and the cumulative radiation exposure can easily exceed safety limits unless the staff has some protection.

[0004] Previous attempts to solve these problems have serious limitations. Placing heavy shielding around the patient can prevent radiation from reaching medical staff. However, complete shielding is impractical because medical staff need constant access to the patient's body, and because the human body is transparent to x-rays ("radiolucent"), x-rays can penetrate the patient's body and expose medical staff. Any surgical procedure poses the risk of complications that could be life-threatening, requiring medical staff to have direct access to the patient's body. Heavy shielding around the patient's body is bulky and difficult to move, which can impede emergency access by medical staff to the patient in such situations.

[0005] Other attempts to protect medical staff during such procedures involved wearable shielding, or essentially radiation "protection gear." These took the form of lead vests, lead skirts, lead thyroid collars, lead acrylic face shields, lead acrylic glasses, and "zero gravity" lead suits. Radiation protection gear has significant drawbacks in that it must be of significant weight to stop X-rays (generally containing lead, a very dense metal), and is heavy to wear. Wearing heavy radiation protection gear can be exhausting even for a fit wearer, and chronic use can cause orthopedic disorders. Using radiation protection gear to protect medical staff from X-rays merely substitutes one health hazard for another.

[0006] Although personal glasses and face shields can be manageable in weight, they alone protect only a small portion of the body.

[0007] "Zero Gravity" suits are lead-containing body suits suspended by a rigid metal frame. The frame rests on some support structure, such as the floor or ceiling. As a result, the wearer does not support the suit with his or her body. This type of suspended armor has additional disadvantages. It allows the wearer to engage in fine manual tasks with the hands and lower arms exposed and unprotected. This limits the wearer's body movements to those that can be accommodated in the frame, and often prevents the wearer from bending or sitting. They use a static face shield that prevents the wearer from bringing anything close to the face, for example for visual inspection. Suspended armor systems are extremely expensive due to their complexity and due to material costs, currently costing about $70,000 per suit.

[0008] Another form of radiation protection equipment is a mobile "cabin" that is a radio-opaque box that the user stands inside. The user can push the cabin to various locations while inside. The cabin has arm ports at a certain height and viewing parts at a certain height. As a result, the user's hands and face cannot be repositioned or reoriented too much, for example to stand or lean forward. They also use a static face shield that prevents the wearer from bringing anything close to the face, for example for visual inspection.

[0009] Thus, there is a need in the art for a means of shielding medical staff from x-rays to which the patient must be exposed that allows access to the patient's body without interfering with the user's body, and that can be quickly reconfigured as needed. [Prior art documents] [Non-patent literature]

[0010] [Non-Patent Document 1] ASTM International “Standard Test Method for Determining Protection Provided by X-ray Shielding Garments Used in Medical X-ray Fluoroscopy from Sources of Scattered X-Rays” ASTM Volume 11.03 Occupational Health and Safety, Protective Clothing(2017) [Non-Patent Document 2] International Electrotechnical Commission, “Protective devices against diagnostic medical X-radiation -Part 1, Determination of attenuation properties of materials” (2014), available at: https: / / webstore.iec.ch / publication / 5289 Summary of the Invention

[0011] The present disclosure describes a radiation shielding assembly that addresses the above-mentioned challenges by interposing a barrier between the surgical area and the area containing medical personnel. In cooperation with a shielding curtain suspended below the operating table, the shielding assembly significantly reduces radiation reaching the personnel directly from the radiation generator and indirectly from the patient's radiolucent body, allows access to the patient's body, allows full freedom of movement on the part of the user, and can be easily reconfigured as needed. The shielding assembly generally comprises two shielding structures supported by a support member such as a mast or suspension arm. Each shielding structure has at least one generally vertical shielding, and the two vertical shieldings can be rotated relative to each other about the longitudinal axis of the support member and can be translated relative to each other about the longitudinal axis of the support member.

[0012] In a first aspect, there is provided a radiation shielding assembly configured to block radiation emanating from a radiation source, the assembly comprising: a support means for supporting the assembly, a first shielding means for blocking radiation from the radiation source in a first substantially vertical plane, the first shielding means being secured to the support means and comprising an appendage opening dimensioned to allow a human appendage to pass through the first shielding means, and a second shielding means for blocking radiation from the radiation source in a second substantially vertical plane, the second shielding means being secured to the support means to allow the second shielding means to translate and rotate relative to the first shielding means along a substantially vertical axis.

[0013] A second embodiment of a radiation shielding assembly is provided, comprising: a support arm having a longitudinal axis configured to support at least a majority of the weight of the shielding assembly; a first generally flat, vertical shield secured to the support arm and having an opening near a lower end sized to receive a human limb; and a second generally flat, vertical shield translatably and rotatably connected to the support arm for rotation about and translation along an axis that is generally parallel to the longitudinal axis of the support arm, wherein the first vertical shielding, the first horizontal shielding, the second vertical shielding, the second horizontal shielding, and the lower vertical shielding are all radiopaque.

[0014] In a third aspect, there is provided a system for shielding a user from a bottom mounted x-ray generator while the user treats a lying patient positioned above the x-ray generator, the system including a table configured to support a patient having a longitudinal axis and a lateral axis, an x-ray generator positioned below the table, an image intensifier positioned above the table to receive x-rays projected from the x-ray generator, a radiopaque curtain shield extending downwardly from the table on at least a first side of the table, a radiation shielding assembly, a support arm configured to support a weight of the shielding assembly and having a generally vertical longitudinal axis, and a first shielding assembly secured to the support arm, the first shielding assembly positioned near the first side of the table and extending downwardly from the table. and a radiation shielding assembly comprising: a first shielding assembly having a first generally flat and vertical shielding generally parallel to the longitudinal axis and an opening in the first vertical shielding disposed above the table to allow a patient's arm to pass through the opening; and a second shielding assembly having a second generally flat and vertical shielding disposed above the table, the second shielding assembly being secured to the support arm to allow the second shielding assembly to rotate and translate about an axis generally parallel to the longitudinal axis of the support arm, the second vertical shielding being capable of rotating about an axis of the second vertical shielding that is generally perpendicular to the longitudinal axis of the table or that is generally parallel to the longitudinal axis of the table.

[0015] In a fourth aspect, a radiation shielding assembly configured to block radiation emanating from a radiation source is provided, the assembly comprising: a support arm having a longitudinal axis configured to support at least a majority of the weight of the shielding assembly; a first generally flat and vertical shielding secured to the support arm via a first radiopaque joint; and a second generally flat and vertical shielding translatably and rotatably connected to the support arm via a second radiopaque joint for rotation about and translation along an axis that is generally parallel to the longitudinal axis of the support arm.

[0016] In a fifth aspect, a radiography method is provided, comprising: positioning any of the above-described radiation shielding assemblies between a patient and a user such that the patient's limb extends through an limb opening in the shielding assembly; inserting a medical device into the vasculature of the limb; and irradiating the patient with radiation using a radiation generator positioned such that the radiation passes at least partially through the patient while being blocked from reaching the user by the shielding assembly.

[0017] The above presents a simplified summary to provide a basic understanding of some aspects of the claimed subject matter. This summary is not an exhaustive overview. It is not intended to identify key or critical elements or to delineate the scope of the claimed subject matter. Its sole purpose is to present some concepts in a simplified form as a prelude to the more detailed description that is presented later. [Brief description of the drawings]

[0018] [Figure 1] 1 is an embodiment of a shield assembly showing a first vertical shield and a second vertical shield orthogonal to one another, with the second vertical shield lowered. [Diagram 2] The shield assembly shown in FIG. 1, wherein the first vertical shield and the second vertical shield are orthogonal to each other and the second vertical shield is elevated. [Diagram 3] 2. The shield assembly shown in FIG. 1 with the second vertical shield rotated so that it is approximately parallel to the first vertical shield. [Figure 4] 1 illustrates an embodiment of a shield assembly supported by a floor unit. [Diagram 5] 11 is an embodiment of a shield assembly supported by a boom mounted on a ceiling. [Figure 6] 11 is an embodiment of a shield assembly supported by a ceiling mounted monorail. [Figure 7]An embodiment of a shield assembly supported by a wall mounted boom (wall not shown). [Figure 8] An embodiment of a shield assembly supported by a wall mounted monorail (wall not shown). [Figure 9] 11 illustrates an embodiment of a shield assembly having a sixth shield. [Figure 10] 1 is a perspective view of an embodiment of a shielding system including a surgical table, an X-ray generator, and an X-ray image intensifier, with a patient shown in an exemplary position. [Figure 11] FIG. 11 is a front view of the embodiment of the shielding system of FIG. [Figure 12] FIG. 13 is a diagram of an exemplary on-shield sensor arrangement during a dosimetry test. [Figure 13] Diagram of sensor placement on the lead apron during dosimetry testing. [Figure 14] FIG. 13 is a diagram of the sensor placement on the shield during non-uniformity inspection. [Figure 15] FIG. 13 shows sensor results on a shield for non-uniformity inspection. [Figure 16] An embodiment of a shield assembly comprising a flexible radiopaque member on the bottom of a first shielding means and showing a pneumatic piston that raises and lowers a second horizontal shield. [Figure 17] 1 is an embodiment of a shielding system including a surgical table, an x-ray generator, and an x-ray image intensifier, showing a radiation drape below the surgical table. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0019] A.Definition Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by those skilled in the art of this disclosure. Terms such as those defined in commonly used dictionaries should be interpreted as having a meaning consistent with their meaning in the context of this specification, and it will be further understood that they should not be interpreted in an idealized or overly formal sense unless expressly defined as such in this specification. For the sake of brevity or clarity, well-known functions or configurations may not be described.

[0020] The terms "about" and "approximately" are generally intended to mean an acceptable degree of error or variation of a measured quantity given the nature or precision of the measurement. A typical, exemplary degree of error or variation is within 20 percent (%), preferably within 10%, and more preferably within 5% of a given value or range of values. For example, the terms "approximately parallel" or "approximately vertical" refer to angles within an acceptable degree of error or variation from true parallel or vertical, such as within 45, 25, 20, 15, 10, or 1° of true parallel or vertical. Numerical quantities given in this description are approximate unless otherwise stated, meaning that the terms "about" or "approximately" can be assumed when not explicitly stated. Numerical quantities claimed are exact unless otherwise stated.

[0021] When a feature or element is referred to as being "on" another feature or element, it will be understood that the feature or element can be directly on the other feature or element, or there may be intervening features and / or elements present. In contrast, when a feature or element is referred to as being "directly on" another feature or element, there are no intervening features or elements present. When a feature or element is referred to as being "connected," "attached," "fixed," or "coupled" to another feature or element, it will also be understood that the feature or element can be directly connected, attached, fixed, or coupled to the other feature or element, or there may be intervening features or elements present. In contrast, when a feature or element is referred to as being "directly connected," "directly attached," "directly fixed," or "directly coupled" to another feature or element, there are no intervening features or elements present. Features or elements so described or illustrated may be described or illustrated with respect to one embodiment, but may apply to other embodiments.

[0022] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms (i.e., at least one of whatever the article modifies) unless the context clearly dictates otherwise.

[0023] For ease of description in describing the relationship of one element or feature to another element or feature when the device is in a normal orientation as shown in the accompanying drawings, terms indicating spatial relationships such as "below," "downward," "lower," "above," and "upper" may be used herein.

[0024] A term such as "at least one of A and B" shall be interpreted as meaning "A only, B only, or both A and B." The same syntax shall apply to longer lists (e.g., "at least one of A, B, and C"). In contrast, a term such as "at least one A and at least one B" shall be interpreted as requiring both A and B.

[0025] Although terms such as "first," "second," and "third" are used herein to describe various features or elements, these features or elements are not intended to be limited by these terms. These terms are used only to distinguish one feature or element from another. Thus, a first feature or element described below can be referred to as a second feature or element, and similarly, a second feature or element described below can be referred to as a first feature or element without departing from the teachings of the present disclosure.

[0026] The term "consisting essentially of" allows the claimed thing to include, in addition to the recited elements, other elements (steps, structures, ingredients, compositions, etc.) that do not adversely affect the functionality of the claimed thing for its intended purpose as referred to in this disclosure. The term excludes other elements that would adversely affect the functionality of the claimed thing for its intended purpose as referred to in this disclosure, even if such other elements may improve the functionality of the claimed thing for some other purpose.

[0027] It will be apparent that a given element of a disclosed embodiment of the present invention may be embodied in a single structure, a single step, a single substance, etc. Likewise, a given element of a disclosed embodiment may be embodied in multiple structures, steps, substances, etc.

[0028] B. Radiation Shield Assembly A radiation shielding assembly 100 is provided, configured to block radiation emanating from a radiation source and supported by a support means 145 that supports the assembly 100. As shown in Figures 1-3, a first shielding means 105 is disposed in a first generally vertical plane. The first shielding means 105 is secured to the support means 145 and has an appendage opening 110 sized to allow a human appendage to pass through the first shielding means 105. This provides access to a patient's arm (or alternatively, leg or torso) for introduction of a medical device (such as an arthroscopic instrument) via the patient's vascular system.

[0029] The second shielding means 115 is arranged in a second substantially vertical plane and is fixed to the support means 145 in a manner that allows the second shielding means 115 to translate and rotate relative to the first shielding means 105 along a substantially vertical axis. The second shielding means 115 can therefore be raised, lowered or swung relative to the first shielding means 105 as required to ensure access to the patient (compare Figures 1 to 3).

[0030] To protect medical staff from radiation irradiating through the appendage 110, the third shielding means 120 may be arranged to block radiation from the appendage opening 110 in a first substantially horizontal plane that is substantially perpendicular to the first vertical plane. The third shielding means 120 may be fixed to the first shielding means 105 such that the third shielding means 120 translates and rotates with the first shielding means 105. That is, the first shielding means 105 and the third shielding means 120 may be stationary relative to each other in at least one configuration of the assembly 100 (although in some embodiments the first shielding means 105 and the third shielding means 120 may be movable in at least one degree of freedom relative to the support arm 150 or other parts of the assembly 100). Additional (or alternative) protection in the form of a flexible radiopaque member may be provided at the bottom of the first shielding means 105. In an alternative embodiment of the shield assembly 100, a flexible radiopaque member 220 is used in place of the third shielding means 120 to block radiation emanating through the limb opening 110. Examples of such flexible radiopaque members 220 include shrouds, sleeves, curtains, and one or more leaves of an iris port. They may be constructed from any suitable flexible and radiopaque material.

[0031] A fourth shielding means 125 may be disposed in a second generally horizontal plane. The second horizontal plane is generally perpendicular to the second vertical plane. The fourth shielding means 125 is fixed to the second shielding means 115, for example along a support means 145, such that the fourth shielding means 125 translates and rotates together with the second shielding means 115. Additional protection in the form of a flexible radiopaque shroud may be provided at the bottom of the fourth shielding means 125. In an alternative embodiment of the shield assembly 100, a flexible radiopaque shroud is used instead of the fourth shielding means 120.

[0032] There may be a fifth shielding means 135 arranged in a third generally vertical plane generally perpendicular to the second generally vertical plane and to the second generally horizontal plane, and the fifth shielding means 135 may be connected to the second shielding means 115 such that the fifth shielding means 135 translates and rotates together with the second shielding means 115 and extends downwardly.

[0033] Some embodiments of the shield assembly 100 include a sixth shielding means 140 disposed in a fourth generally vertical plane, the sixth shielding means 140 being connected to the first shielding means 105 such that the sixth shielding means 140 extends downward. The fourth generally vertical plane may be generally parallel to the first vertical plane. The sixth shielding means 140 may be positioned to shield the lower body of a user from radiation. The sixth shielding means 140 may take any of a number of suitable forms, including one or more of a generally flat shield, a flexible drape, and an extension of the first shielding means 105.

[0034] The first shielding means 105 and the second shielding means 115 may be configured to swing around a common axis, such as a hinge (compare FIG. 1 and FIG. 2). This axis may be, for example, the longitudinal axis of the support means 145. In other embodiments, the first shielding means 105 and the second shielding means 115 may each swing around two separate axes, which are substantially parallel to each other. In some embodiments, the axes may both be substantially parallel to the longitudinal axis of the support means 145. By analogy, the first shielding means 105 and the second shielding means 115 may be allowed to swing relative to each other, like the front and back covers of a book. In some embodiments, the first shielding means 105 and the second shielding means 115 may be in a relative position of about 180° from each other, such that the first shielding means 105 and the second shielding means 115 are substantially parallel and / or collinear when viewed from above. Such an "open" configuration is useful for forming a barrier along the entire length of a reclining patient. In some embodiments, the first shielding means 105 and the second shielding means 115 can be at or approaching 0° relative to each other, where the first shielding means 105 and the second shielding means 115 can be in contact with each other or in close proximity to each other and generally parallel. In some embodiments, the first shielding means 105 and the second shielding means 115 are configured to rotate relative to each other through an arc of at least about 90°. In some further embodiments, the first shielding means 105 and the second shielding means 115 are configured to rotate relative to each other through an arc of up to about 180°, and in more particular embodiments, through an arc of about 0-180°.

[0035] The first shielding means 105 and the second shielding means 115 may also be configured to translate relative to one another or to translate in concert along the support means 145 (compare Figures 1 and 2). The shield assembly 100 may comprise a means 225 for translating at least one of the first shielding means 105 and the second shielding means 115 along the support means 145. By way of example, such a translating means 225 may be an assist mechanism, a counterweight mechanism, an electric motor, a hydraulic mechanism, a pneumatic mechanism, a manual mechanism, or any combination thereof.

[0036] The support means 145 may be configured to allow the entire shielding assembly 100 to be translated relative to the operating table 305 in the operating room. For example, the support means 145 may be configured to allow manual translation of the entire shielding assembly 100 or to allow mechanical translation of the shielding assembly 100 by one or more actuators. Some embodiments of the support means 145 comprise a support arm 150 that is configured to support most, if not all, of the weight of the assembly 100. In the illustrated embodiment of Figures 2 and 3, the support arm 150 is an elongated steel structure having a longitudinal axis that is generally vertical when the shielding assembly 100 is in use. The support arm 150 may be constructed from any material that has sufficient mechanical strength to support the assembly 100 and may be designed by one of ordinary skill in the art. Preferably, the support arm 150 is constructed from a material that is similarly opaque to radiation of the anticipated frequencies and intensities. For example, some embodiments of the support arm 150 are opaque to x-rays of energies typical of radiography applications.

[0037] The support means 145 may be supported by a ceiling, floor, wall, or another structure. If floor mounted (as in FIG. 4), the support means 145 may be suspended by a variety of structures. The support means 145 may be integrally mounted on the floor, or alternatively, may be supported by a movable or stationary stand.

[0038] Some embodiments of the support means 145 include a generally vertical mast 155. The support means 145 can support the shield assembly 100 to some extent. For example, some embodiments of the support means 145 can support most of the weight of the assembly 100. In further embodiments, the support means 145 can support approximately the entire weight, or the entire weight, of the assembly 100. The mast 155 can be supported by various means. In some embodiments of the radiation shield assembly 100, the mast 155 is supported by a floor stand 170. The floor stand 170 can further include a number of wheels 175 that allow for easy deployment and removal of the assembly 100. In further embodiments of the system, the mast 155 is suspended by an overhead boom 160 (see Figures 5 and 7). The use of the overhead boom 160 can provide easy mobility to the relatively heavy assembly 100, allowing the assembly 100 to be quickly and easily deployed and removed from the patient. Various configurations utilizing the boom 160 are contemplated. For example, the mast 155 may be configured to rotate about a longitudinal axis of the overhead boom 160 or to pivot relative to the overhead boom 160. The mast 155 may be capable of translating along the longitudinal axis of the overhead boom 160. In a further embodiment of the system, the overhead boom 160 is supported by a second mast 165. The second mast 165 may then be supported on a wheeled floor stand 170, may be ceiling mounted, or may be wall mounted. For example, the second mast 165 may be supported by a wall mounted rail 180 or a ceiling mounted rail 185 (see Figures 6 and 8), and in such an embodiment, the second mast 165 may be capable of translating along the wall mounted rail 180 or the ceiling mounted rail 185. As another example, the secondary mast 165 may be supported by a wall-mounted swing arm 190 or a ceiling-mounted swing arm 195 (see Figures 5 and 7).In a further embodiment, the second mast 165 may be supported by a swing arm which in turn is supported by a wall mounted rail 180 or a ceiling mounted rail 185, and the swing arm is capable of translating along the wall mounted rail 180 or the ceiling mounted rail 185.

[0039] In some embodiments where a third horizontal shielding means 120 is present, the first shielding means 105 and the third shielding means 120 are configured to translate vertically in unison. For example, the first shielding means 105 and the third shielding means 120 may be configured to translate in unison along the support means 145. The degree of translation may be configured to optimize shielding of the user from X-rays while the user is standing or sitting. For example, the first shielding means 105 may be configured to translate along such that, in the first position, the top end of the first shielding means 105 is at least about the height of an adult human above the floor. Taking into account the dimensions of a normal human, such height may be 175 cm, 180 cm, 185 cm, 190 cm, 195 cm, or 200 cm above the floor.

[0040] Similarly, the first shielding means 105 itself is sized to provide adequate radiation protection when in the correct position during use. For example, the first shielding means 105 may have a height of at least about the distance from the top of the operating table 305 to the total body length of an average human. In various embodiments, the first shielding means 105 has a height of at least about the distance from the top of the operating table 305 to a height of 175 cm, 180 cm, 185 cm, 190 cm, 195 cm, or 200 cm above the floor when the operating table 305 is on the floor. A larger height has the advantage of a larger area shielded from X-rays, while a smaller height has the advantage of reduced weight and cost.

[0041] In the embodiment shown in the drawings, the first shielding means 105 is positioned approximately parallel to the long axis of the operating table 305 and to protect the upper body of the user from X-rays emitted from a point below the table 305. In the embodiment shown, the first shielding means 105 is a generally flat and vertical shield fixed to the support arm 150. Of course, the first shielding means 105 can function even if it is not exactly vertical, and can be designed to tilt as necessary or desired to customize the shielding area. Some embodiments of the first vertical shielding 105 are designed to extend above the head of the user to prevent direct radiation from reaching the user's head. The first vertical shielding 105 can be designed to extend above the head of a standing user, or even a seated user in some situations. The illustrated embodiment of the first vertical shielding 105 has a sufficient length to extend from the patient's head to about the patient's waist. Such a configuration is particularly useful for visualizing the patient's chest in procedures where radiography is used. The length can be increased to provide greater protection, but such an increase in length must be balanced against the additional weight and reduced flexibility of the configuration that would accompany such a change.

[0042] In the illustrated embodiment, an opening 110 is shown in the first shielding means 105 to allow the patient's arm to extend from the shielded area. The opening 110 may optionally include a flexible shielding material, such as a radiopaque curtain, or a flexible flange 220. The illustrated opening 110 is semicircular, but may be any shape that allows the patient's limb to extend through the shielding. The opening 110 provides a possible path for radiation leakage. The third shielding means 120 is positioned to block radiation shining through the opening 110 from irradiating the user. In the illustrated embodiment, the third shielding means 120 is a horizontal shield positioned over the opening 110 and perpendicular to the first vertical shield 105. This particular configuration is useful for blocking radiation from emission locations below the opening 110 and on the side of the vertical shield opposite where the user is standing. The third shielding means 120 can be oriented differently to accommodate different emission positions relative to the opening 110 .

[0043] In the embodiment shown in Figures 1-3, the second shielding means 115 is configured to rotate and translate relative to the first shielding means 105 to allow the assembly 100 to be adjusted according to the size of the patient and to allow the assembly 100 to be reconfigured to provide varying angles of patient access and radiation protection. In the embodiment shown, this takes the form of a second generally vertical shielding 115 connected to the support arm 150 to allow the second generally vertical shielding 115 to rotate about the longitudinal axis of the arm and translate parallel to the same longitudinal axis. In Figure 1, the second vertical shielding 115 is shown in an orthogonal position relative to the first vertical shielding 105. Such an arrangement is useful in practice to give the user access to the legs of the patient when the second vertical shielding 115 crosses the patient's body. If the patient is positioned with the head closest to the second vertical shield 115, the second vertical shield 115 may be lowered onto the platform 305 to provide complete shielding. In FIG. 3, the second vertical shield 115 is shown generally parallel to the first vertical shield 105.

[0044] The fourth shielding means 125 functions to block radiation that may irradiate from below the second shielding means 115 when the second shielding means 115 is positioned above the table 305. In the accompanying drawings, the fourth shielding means 125 is shown as a horizontal shield having a notch 130. This trapezoidal notch 130 functions to provide access to the patient's groin during surgery and may be useful to allow access to the femoral vein for arthroscope insertion. The notch 130 is a useful, but optional, feature of the second horizontal shield 125. In the illustrated embodiment, the second horizontal shield 125 is positioned to block radiation emitted from below the operating table 305, but this structure may be variously positioned to block radiation from other directions.

[0045] The fifth shielding means 135, if present, functions to prevent radiation from exposing the lower half of the user's body if the user were positioned on the opposite side of the support arc 150 as the radiation source. Such a structure is generally not required below the first shielding means 150, as operating tables are typically equipped with a lead curtain suspended from the table for procedures requiring radiation monitoring, although the curtain does not necessarily extend the full length of the table, nor does it necessarily extend along the width of the table.

[0046] The majority of the surface area of ​​the shielding means is opaque to radiation of the frequency and intensity that they are intended to block. Some embodiments of the shielding means may be entirely radiopaque. Exemplary materials that are opaque to x-rays include lead plates, lead filings, leaded acrylic glass, and polymeric suspensions of lead particles. Lead has the advantage of a very high atomic number and stable nuclide, but other heavy metals such as barium may be used. As the thickness increases along the radiation vector, radiopacity increases. The design of the shielding means presents a difficult balance between achieving adequate radiopacity and limiting the weight of the device. For example, some embodiments of lead shielding are about 0.5-1.5 mm thick. Further embodiments of lead shielding are about 0.8-1.5 mm thick. Less dense materials such as leaded acrylic must be thicker to achieve the same level of radiopacity as lead. For example, some embodiments of leaded acrylic shielding are about 12-35 mm thick. Further embodiments of the lead-containing acrylic shield are approximately 18-22 mm thick. Lead-barium type glass is another suitable material. For example, some embodiments of the lead-barium type glass shield are approximately 7-17 mm thick. Further embodiments of the lead-barium type glass shield are approximately 7, 9, 14, or 17 mm thick. Comparing these exemplary materials, lead has the advantage of better radiopacity per unit thickness, whereas the lead-containing acrylic glass and the lead-barium type glass have the advantage of visible transparency and radiopacity. In some embodiments of the assembly 100, at least one of the first through fifth shielding means 105, 115, 120, 125, 135 is transparent to visible light. In such embodiments, the transparent shielding means may have a light transmittance equal to or greater than one of 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 99%, and 100%.

[0047] Outside of the context of any particular material, the radiopacity of the shielding means can be expressed as millimeter lead equivalent. In various embodiments of the system, at least one of the first shielding means 105, the second shielding means 115, the third shielding means 120, the fourth shielding means 125, or the fifth shielding means 135 has a radiopacity of at least 0.5 mm, 1.0 mm, 1.5, 2, 3, or 3.3 mm lead equivalent.

[0048] Any of the above mentioned shielding means may be joined to each other or to the support means 145 via a radiopaque joint 205. Such a radiopaque joint 205 is one that minimizes the transmission of radiation from the generator through the joint 205. This can be achieved, for example, between the plates by joining the plates with a gap that is narrow enough so that no straight line can be traced from the radiation source through the gap when in its intended position on the operating table 305. Such a joint 205 can be constructed, for example, using a radiopaque brace or lap joint. The radiopaque joint 205 with the support arm 150 can be constructed, for example, using a radiopaque sleeve around the support arm 150 that is fixed to the shielding means.

[0049] The radiation shielding assembly 100 is supported by a support arm 150 and is positioned to position a first shielding assembly and a second shielding assembly between the patient and the user. The first shielding assembly is secured to the support arm 150 and includes a first generally vertical shielding 105 and a first generally horizontal shielding 120. The second shielding assembly is also secured to the support arm 150 and is adapted to rotate and translate relative to the first shielding assembly along a longitudinal axis of the support arm 150. The second shielding assembly includes a second generally flat and vertical shielding 115 disposed above the platform 305, a second generally horizontal shielding 125 connected to the second vertical shielding 115 and disposed above the platform 305, and a lower generally flat and vertical shielding 135 extending below the platform 305 from the second horizontal shielding 125. The second vertical shield 115 may be rotated about an axis of the second vertical shield 115 that is generally perpendicular to the longitudinal axis of the base 305 or that is generally parallel to the longitudinal axis of the base 305 .

[0050] The shielding assembly may be part of a larger system that includes an operating table 305, an x-ray generator 310, and an image intensifier 315 (see Figs. 10 and 11). The x-ray generator 310 is positioned to direct x-rays through the table 305 to the image intensifier 315 on the other side, as known in the art. The generator 310 and the image intensifier 315 may be commonly mounted on a C-arm 320, for example. The operating table 305 often has a radiopaque curtain 325 suspended from at least one side of the table 305. The curtain 325 may also extend around two or more sides of the table 305. The curtain 325 is particularly useful when the system is configured with the x-ray generator 310 below the table 305. The patient is generally adapted to "lie down", meaning to lie on the table 305 in any suitable orientation, including supine, prone, and lateral. Conventionally, the patient is adapted to be positioned on the table 305 between an X-ray generator 310 and an image intensifier 315, which are typically mounted on a C-arm 320, for example. In the accompanying figures, the X-ray generator 310 is shown below the patient, which is one commonly used configuration, but not the only configuration in which the system may be used. A table (such as the operating table 305) is capable of supporting the patient. Depending on the age and size of the patient, various configurations of the operating table 305 may be used. The image intensifier 315 is adapted to be positioned to receive X-rays projected from the X-ray generator 310 (such as positioned above the table 305 when the X-ray generator 310 is below). Typically, the radiopaque curtain shield 325 extends downward from the table 305 on the side where medical personnel will be working (the "first side"). The first shielding means 105 may be positioned to contact the edge of the table along the long dimension of the first shielding means 105 or such that the bottom edge of the first shielding means 105 is below the surface of the table 305 along the long dimension of the first shielding means 105. The second shielding means 115 may also be positioned parallel to the long dimension of the table 305 to form a barrier between the user and the patient's lower extremities.In such a configuration, the second shielding means 115 is also arranged so that the lower edge of the second shielding means 115 contacts the table 305 or is suspended below the height of the surface of the table to prevent radiation from reaching the user. Alternatively, the second shielding means 115 may be rotated at a substantially orthogonal angle relative to the first shielding means 105 so as to cross the operating table 305 laterally. If the second shielding means 115 has a notch at the bottom to fit the patient's body, this may give the user access to the patient's lower legs, for example to ensure access to the femoral vein. The second shielding means 115 may be raised along the support means 145 appropriately to fit the patient's physiology. It is also conceivable that the second shielding means 115 may be arranged to cross the table 305 laterally and in contact with the table 305, for example when the patient's head is positioned close to the second shielding means 115 (not shown). Therefore, a medical device such as a catheter or arthroscopic instrument can be inserted into a patient's vascular system through an arm or leg extending through the first shielding means 105 or the second shielding means 115 while minimizing radiation reaching the user.

[0051] A method of radiography is provided using any of the embodiments of the radiation shielding assembly 100 disclosed above. The method includes positioning any of the above radiation shielding assemblies or systems between a patient and a user such that the patient's limb extends through the limb opening 110 in the shielding assembly, inserting a medical device into the vasculature of the limb, and irradiating the patient with radiation using a radiation generator 310 positioned such that the radiation passes at least partially through the patient but is blocked from reaching the user by the shielding assembly 100.

[0052] C. Working Example For the purpose of evaluating embodiments of the shielding system, an analysis was performed at the examination site. A Siemens C-ARM x-ray source, typically used in fluoroscopic surgery, was used to generate secondary scatter radiation in two CIRS76-125 patient-equivalent phantoms. An analysis was performed to examine the scatter radiation through the custom shielding and contrast the results with unprotected shielding versus a lead apron.

[0053] The test specimen was a custom-made lead-acrylic radiation protection shield manufactured specifically for the C-ARM application. The shielding material had a density of 4.36 gcm -3 The shielding system consisted of a series of custom-fabricated, 18.8 mm thick lead acrylic materials (Sharp Mfg., West Bridgewater, MA) with a minimum density of 1.0 mm, a refractive index of 1.71, a coefficient of thermal expansion of 8E-6 / °C (30-380°), and a Knoop hardness of 370. Specifically, this material is a high optical grade lead barium type glass with over 60 percent heavy metal oxides, at least 55 percent PbO. The lead equivalent of this material is guaranteed by the manufacturer to be greater than 3.3 mmPb. A custom-fabricated shielding design with labels was constructed generally as shown in Figure 4. With the exception of the support system, which was fabricated from aluminum, the shielding system was fabricated from the exact same source material throughout. All panels were fabricated and cut by this manufacturer.

[0054] Scattered radiation was generated with a Siemens model 10394668 Medical C-ARM source with serial number 138 through a CIRS76-125 lead acrylic patient equivalent phantom limbs and torso (Computerized Imaging Reference Systems, Norfolk) used to represent a patient's torso with arms. The Siemens Medical C-ARM has a reported intrinsic filtration of 0.8 mmAl at 70 kV in addition to a size B diamentor chamber with 0.2 mmAl at 70 kV. No secondary filtration was used for the measurements described in this report.

[0055] Radiation measurements were made using a Victoreen 470A Panoramic Survey Meter with serial number 2029. Calibration was performed using a Cc-137 isotope source at the University of Alabama at Birmingham (UAB) Radiation Laboratory.

[0056] A comparison with lead aprons was conducted using two products: Techno Aide lead apron with serial number T116969 and Xenolite with serial number 102001. According to manufacturer information, both lead aprons have a lead equivalent of 0.5 mmPb.

[0057] The test methods and procedures were guided by ASTM F3094 (Non-Patent Document 1), IEC 61331-1 (Non-Patent Document 2), and medical physicists. The test methodology was developed and invented prior to implementation. ASTM F3094 and IEC 61331-1 are incorporated herein by reference so that those skilled in the art can implement the protocols.

[0058] The custom-made lead acrylic shielding was tested for attenuation of scattered radiation as well as uniformity. Additionally, measurements were taken along the main edges of the entire shield as well as the semicircular area where the surgeon places the patient's arm during surgery. Equivalent scattered radiation measurements were compared to a 0.5mm lead equivalent lead apron. A final set of measurements was taken without the shielding in place. All data was recorded on-site. All measurements were recorded using a 10 second exposure time and a minimum of three repeated measurements. The protection rating criteria was based on the measured attenuation of scattered radiation from an 81kV X-ray C-ARM source.

[0059] The radiation detected by the Victoreen 470A represents scattered x-ray radiation produced by x-ray interaction with a CIRS 76-125 patient equivalent phantom. The distance between the C-ARM x-ray source was set as the default distance used for patient exams of 17 inches or 43.18 cm. This convention is referred to as the "Modified ASTM F3094 / IEC 61331-1 Convention."

[0060] The average scatter radiation measurements without shielding can be seen in Table 1 below. All measurements were performed with a minimum of three replicates. Radiation measurements were first performed with the custom fabricated shield in place so that the exact location of the shield, phantom, and detector were marked for subsequent measurements without shielding or comparison measurements with two lead aprons.

[0061] [Table 1]

[0062] All measurements were performed with a minimum of three replicates. The average scattered radiation measurements made with the custom fabricated lead acrylic shield (FIG. 12) can be seen in Table 2 below. Measurements made through the custom fabricated shield and even the currently accepted lead apron were of very low intensity, only slightly above background radiation. As a result, the replicate measurements produced a lower standard deviation compared to the measurements without shielding in Table 1 above.

[0063] [Table 2]

[0064] Additionally, measurements were taken to detect the level of radiation at precise locations on the physician during use, specifically at the level of the physician's groin and also at the level of the physician's mid-chest, and the results are summarized in Table 3 below.

[0065] [Table 3]

[0066] Scatter radiation measurements were then made using Techno Aide 0.5mmPb lead equivalent aprons and can be seen in Table 4 below. Measurements were made through lead aprons (Figure 13) for the purpose of comparing accepted medical radiation protection devices with those proposed in this study. In an attempt to provide as accurate information and comparison as possible, strict comparisons under actual locations as they would occur in real life were used. A graphical representation was made using Table 4 below which summarises the mean values ​​of the observed scattered radiation measurements along with the standard deviations.

[0067] [Table 4]

[0068] Once the survey measurements were completed for the first 0.5mm lead equivalent apron, a second lead apron was selected and replicate measurements were performed exactly as was done for the Techno Aide product. The average measurements for the scattered radiation measurements for the second Xenolite lead apron comparison are summarized below in Table 5.

[0069] [Table 5]

[0070] Two shielding components were measured as a uniformity exemplar to ensure the absence of voids throughout the shielding device. These measurements were performed in the same manner as described above. The results can be seen in Figures 14 and 15. The data is presented in the same format as Tables 1-4, with the average scatter radiation measurements reported and the standard deviation in parentheses.

[0071] As illustrated by Figure 14, no significant voids were observed during the conduct of the survey measurements of main panel A. The radiometric measurements yielded values ​​very close to previous measurements previously reported based on median values ​​for individual panels. Additionally, replicate measurements were essentially identical and yielded low standard deviations.

[0072] Using main body panel A, four regions were surveyed for uniformity as illustrated by Figure 15. The average measured radiation values ​​are presented above with the standard deviation in parentheses. A quick comparison of Figures 14 and 15 shows very similar values ​​between main panel A and main body panel B.

[0073] The pass / fail criteria are based on previously accepted performance standards for industrial grade lead acrylic custom manufactured into the C-ARM shielding device. Additionally, the shielding device must provide greater protection than currently accepted lead aprons used in the same application. Using the Alabama guide, healthcare workers receive no more than 5 rem per year, which is used as the shallow dose equivalent and as the pass / fail criteria.

[0074] The study endpoints are based on successful completion of all measurements mandated by the Alabama guidelines for protective devices used by physicians in C-ARM patient testing. Study endpoints are specifically based on comparable measurements made using currently accepted lead aprons versus no protective shielding of any kind versus custom-fabricated lead acrylic shielding.

[0075] The levels of radiation detectable behind the certified custom-made lead acrylic shielding were consistent with calculations based on the manufacturer's performance standards. The levels of radiation detected are within the maximum allowable radiation doses for medical personnel.

[0076] Relatively comparable levels of attenuated radiation were detected behind the custom shielding material when compared to currently accepted lead aprons. The performance of the custom shielding material and the lead apron is due in large part to the detection of secondary radiation as opposed to primary radiation in this case. The scattered equivalent primary radiation is used to determine the official lead equivalence of the material. Under realistic scattering conditions such as those used in this study, the amount of measurable secondary radiation is so low that no measurable differences between materials with different lead equivalences are expected.

[0077] Using the currently accepted dose equivalent of 5 rem (R) per year, with 52 work weeks per year and 40 hour exposure per week, the total annual radiation exposure was calculated using the shielding prototype. According to the highest observed radiation measurement of 0.25 mR / hr obtained during the study, a 40 hour work week would give a total dose of 10 mR per week. Using the average value calculated from all measurements of 0.25 mR / hr, a 40 hour work week would give a total dose of 6.6 mR per week. Using the maximum possible dose of 10 mR per week, the custom manufactured shielding device would give 520 mR or 0.52 R per year.

[0078] D. Conclusion The above description illustrates the process, machine, manufacture, composition of matter, and other teachings of the present disclosure. In addition, the present disclosure shows and describes only certain embodiments of the process, machine, manufacture, composition of matter, and other teachings of the present disclosure, but as noted above, it is apparent that the teachings of the present disclosure can be used in various other combinations, modifications, and environments, consistent with the skill and / or knowledge of one of ordinary skill in the art, and that modifications and variations are possible within the scope of the teachings set forth herein. The above-described embodiments are further intended to illustrate certain best modes known for carrying out the process, machine, manufacture, composition of matter, and other teachings of the present disclosure, and to enable one of ordinary skill in the art to utilize the teachings of the present disclosure in such or other embodiments, and with various modifications as required by a particular application or use. Thus, the process, machine, manufacture, composition of matter, and other teachings of the present disclosure are not intended to limit the precise embodiments and examples disclosed herein. Any section headings herein are provided solely for consistency with the proposed 37 C.FR Section 1.77 or to provide an organizational arrangement. These headings do not limit or characterize the invention(s) described herein.

[0079] The present invention may alternatively or additionally include the following features. [Item 1] 1. A radiation shielding assembly configured to block radiation emanating from a radiation source, comprising: (a) a support means for supporting the assembly; (b) a first shielding means for blocking radiation from the radiation source in a first generally vertical plane, the first shielding means being secured to the support means and including a limb opening sized to allow a human limb to pass through the first shielding means; (c) a second shielding means that lies in a second generally vertical plane and blocks radiation from the radiation source, the second shielding means being fixed to the support means to permit the second shielding means to translate and rotate relative to the first shielding means along a generally vertical axis. [Item 2] Item 2. The radiation shielding assembly of item 1, comprising a third shielding means that lies in a first generally horizontal plane that is generally orthogonal to the first vertical plane and blocks radiation from the limb opening, the third shielding means being secured to the first shielding means such that the third shielding means translates and rotates with the first shielding means. [Item 3] 3. The radiation shielding assembly of claim 1 or 2, comprising a fourth shielding means in a second generally horizontal plane generally orthogonal to the second vertical plane and configured to block radiation from the radiation source, the fourth shielding means being fixed to the second shielding means such that the fourth shielding means translates and rotates with the second shielding means. [Item 4] 4. The radiation shielding assembly according to any one of claims 1 to 3, further comprising a fifth shielding means for blocking radiation from the radiation source, the fifth shielding means being in a third generally horizontal plane that is generally perpendicular to the second generally vertical plane and the second horizontal plane, the fourth shielding means being connected to the second shielding means such that the fourth shielding means translates and rotates together with the second shielding means. [Item 5] 5. The radiation shielding assembly according to any one of items 1 to 4, further comprising a sixth shielding means that is in a fourth substantially vertical plane that is substantially parallel to the first substantially vertical plane and that blocks radiation from the radiation source, the sixth shielding means being fixed to the first shielding means. [Item 6] 6. The radiation shielding assembly of any one of items 1 to 5, further comprising a sixth shielding means that is in a fourth generally vertical plane that is generally parallel to the first generally vertical plane and that blocks radiation from the radiation source, the sixth shielding means being fixedly attached to the first shielding means, the sixth shielding means being selected from the group consisting of a generally flat shield, a flexible drape, and an extension of the first shielding means. [Item 7] 7. The radiation shielding assembly of any one of claims 1 to 6, wherein the first shielding means and the second shielding means are configured to rotate relative to one another through an arc of at least about 90 degrees. [Item 8] 8. The radiation shielding assembly of any one of claims 1 to 7, wherein the first shielding means and the second shielding means are configured to rotate relative to one another through an arc of up to about 180°. [Item 9] Item 9. The radiation shielding assembly of any one of items 1 to 8, wherein the first shielding means and the second shielding means are configured to rotate relative to one another through an arc of approximately 0 to 180 degrees. [Item 10] Item 10. The radiation shielding assembly of any one of items 1 to 9, wherein the support means comprises a substantially vertical mast. [Item 11] Item 11. The radiation shielding assembly of any one of items 1 to 10, wherein the support means is capable of supporting approximately the entire weight of the radiation shielding assembly. [Item 12] Item 12. The radiation shielding assembly according to any one of items 1 to 11, wherein the support means is capable of supporting a full weight of the radiation shielding assembly. [Item 13] Item 13. The radiation shielding assembly of any one of items 1 to 12, wherein in operation, the support means supports a full weight of the radiation shielding assembly. [Item 14] Item 14. The radiation shielding assembly of any one of items 1 to 13, wherein the first shielding means and the third shielding means are configured for co-moving vertical translation. [Item 15] Item 15. The radiation shielding assembly of any one of items 1 to 14, wherein the first shielding means and the third shielding means are configured for co-moving vertical translation along the support means. [Item 16] Item 16. The radiation shielding assembly of any one of items 1 to 15, wherein the first shielding means is configured to translate along a substantially vertical axis such that, in the first position, an uppermost end of the first shielding means is at least about the height of an adult human above a floor. [Item 17] Item 17. The radiation shielding assembly of any one of items 1 to 16, wherein the first shielding means is configured to translate along a substantially vertical axis such that, in the first position, an uppermost end of the first shielding means is about 2 m or more above the floor. [Item 18] Item 18. The radiation shielding assembly according to any one of items 1 to 17, wherein the first shielding means has a height equal to or greater than the distance from the top surface of the operating table to the total body length of an average human. [Item 19] 19. The radiation shielding assembly according to any one of items 1 to 18, wherein the first shielding means has a height of about 2 m or more from the top surface of the operating table when the operating table is placed on the floor. [Item 20] 20. The radiation shielding assembly of any one of claims 1-19, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of minimum 0.5 mm lead equivalent. [Item 21] 21. The radiation shielding assembly of any one of items 1 to 20, wherein the first through sixth shielding means have a radiopacity of at least 0.5 mm lead equivalent. [Item 22] 22. The radiation shielding assembly of any one of the preceding claims, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of a minimum of 1 mm lead equivalent. [Item 23] 23. The radiation shielding assembly of any one of items 1 to 22, wherein the first through sixth shielding means have a radiopacity of at least 1 mm lead equivalent. [Item 24] 24. The radiation shielding assembly of any one of claims 1-23, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of a minimum of 1.5 mm lead equivalent. [Item 25] 25. The radiation shielding assembly of any one of items 1 to 24, wherein the first through sixth shielding means have a radiopacity of at least 1.5 mm lead equivalent. [Item 26] 26. The radiation shielding assembly of any one of the preceding claims, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of a minimum of 2 mm lead equivalent. [Item 27] 27. The radiation shielding assembly of any one of items 1 to 26, wherein the first through sixth shielding means have a radiopacity of a minimum of 2 mm lead equivalent. [Item 28] 28. The radiation shielding assembly of any one of the preceding claims, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of a minimum of 3 mm lead equivalent. [Item 29] Item 29. The radiation shielding assembly of any one of items 1 to 28, wherein the first through sixth shielding means have a radiopacity of a minimum of 3 mm lead equivalent. [Item 30] 30. The radiation shielding assembly of any one of the preceding claims, wherein at least one of the first shielding means, the second shielding means, the third shielding means, the fourth shielding means, or the fifth shielding means has a radiopacity of a minimum of 3.3 mm lead equivalent. [Item 31] Item 31. The radiation shielding assembly of any one of items 1 to 30, wherein the first through sixth shielding means have a radiopacity of at least 3.3 mm lead equivalent. [Item 32] 32. The radiation shielding assembly of any one of items 1 to 31, wherein at least one of the first through sixth shielding means reduces radiation exposure by at least 85% as measured by modified ASTM F3094 / IEC 61331-1 protocol. [Item 33] 33. The radiation shielding assembly according to any one of items 1 to 32, wherein the first through sixth shielding means reduce radiation exposure by at least 85% as measured by modified ASTM F3094 / IEC 61331-1 protocol. [Item 34] 34. The radiation shielding assembly according to any one of items 1 to 33, wherein at least one of the first through sixth shielding means reduces radiation exposure to less than 2.5 mR / hr as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 35] Item 35. The radiation shielding assembly according to any one of items 1 to 34, wherein the first through sixth shielding means reduce radiation exposure to less than 2.5 mR / hr as measured by modified ASTM F3094 / IEC 61331-1 protocol. [Item 36] 36. The radiation shielding assembly of any one of items 1 to 35, wherein at least one of the first through sixth shielding means reduces radiation exposure to about 2.5 mR / hr or less as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 37] 37. The radiation shielding assembly according to any one of items 1 to 36, wherein the first through sixth shielding means reduce radiation exposure to about 2.5 mR / hr or less when measured according to the modified ASTM F3094 / IEC 61331-1 protocol. [Item 38] Item 38. The radiation shielding assembly of any one of the preceding items, comprising a flexible, radiopaque member disposed to at least partially cover the limb opening and configured to allow a human limb to pass through the limb opening. [Item 39] Item 39. The radiation shielding assembly of any one of the preceding items, comprising a flexible radiopaque member positioned to at least partially cover the limb opening and configured to allow a human limb to pass through the limb opening, the flexible radiopaque member being selected from the group consisting of a curtain, an iris port leaf, and a sheath. [Item 40] Item 40. The radiation shielding assembly of any one of items 1-39, wherein the second shielding means and the fourth shielding means are configured to translate in cooperation with the support means. [Item 41] Item 41. The radiation shielding assembly according to any one of items 1 to 40, comprising a means for raising and lowering at least one of the first shielding means and the third shielding means along the support means. [Item 42] Item 42. The radiation shielding assembly according to any one of items 1 to 41, comprising a means for raising and lowering the first shielding means and the second shielding means along the support means independently of each other. [Item 43] Item 43. The radiation shielding assembly of any one of items 1 to 42, comprising a means for raising and lowering the first shielding means and the second shielding means along the support means. [Item 44] Item 44. The radiation shielding assembly according to any one of items 1 to 43, wherein the means for lifting is selected from the group consisting of an assist mechanism, a counterweight system, an electric motor, a hydraulic system, a pneumatic system, and a manual system. [Item 45] Item 45. The radiation shielding assembly of any one of the preceding items, wherein the support means comprises a mast supported by a floor stand. [Item 46] Item 46. The radiation shielding assembly of any one of items 1 to 45, wherein the support means is a mast suspended by an overhead boom. [Item 47] 47. The radiation shielding assembly of any one of claims 1 to 46, wherein the support means is a mast suspended by the overhead boom, the mast being capable of rotating about a longitudinal axis of the overhead boom. [Item 48] Item 48. The radiation shielding assembly of any one of items 1 to 47, wherein the support means is a mast suspended by the overhead boom, the mast being capable of pivoting relative to the overhead boom. [Item 49] Item 49. The radiation shielding assembly of any one of items 1 to 48, wherein the support means is a mast suspended by the overhead boom, the mast being capable of translating along a longitudinal axis of the overhead boom. [Item 50] 50. The radiation shielding assembly of any one of claims 1 to 49, wherein the support means is a mast suspended by an overhead boom, the overhead boom being supported by a second mast. [Item 51] 51. The radiation shielding assembly of any one of claims 1 to 50, wherein the support means is a mast suspended by an overhead boom, the overhead boom being supported by a second mast, the second mast being supported by a rail mounted on a wall or ceiling, the second mast being capable of translating along the rail mounted on the wall or ceiling. [Item 52] 52. The radiation shielding assembly of any one of claims 1 to 51, wherein the support means is a mast suspended by an overhead boom, the overhead boom being supported by a second mast, the second mast being supported by a swing arm mounted to a wall or ceiling. [Item 53] 53. The radiation shielding assembly of any one of items 1 to 52, wherein the support means is a mast suspended by an overhead boom, the overhead boom being supported by a second mast, the second mast being supported by a swing arm, the swing arm being supported by a rail mounted on a wall or ceiling, the swing arm being capable of translating along the rail mounted on the wall or ceiling. [Item 54] Item 54. The radiation shielding assembly of any one of items 1 to 53, wherein at least one of the first to sixth shielding means is transparent to visible light. [Item 55] Item 55. The radiation shielding assembly according to any one of items 1 to 54, wherein the first to sixth shielding means are transparent to visible light. [Item 56] Item 56. The radiation shielding assembly of any one of the preceding items, wherein the support means is configured to support at least a majority of the weight of the radiation shielding assembly. [Item 57] Item 57. The radiation shielding assembly of any one of items 1-56, wherein the first shielding means is a first generally flat and vertical shield. [Item 58] Item 58. The radiation shielding assembly of any one of items 1-57, wherein the third shielding means is a first generally horizontal shield. [Item 59] Item 59. The radiation shielding assembly of any one of items 1-58, wherein the second shielding means is a second generally flat and vertical shield. [Item 60] Item 60. The radiation shielding assembly of any one of items 1-59, wherein the fourth shielding means is a second generally horizontal shield. [Item 61] Item 61. The radiation shielding assembly of any one of items 1-60, wherein the fifth shielding means is a lower generally flat and vertical shield. [Item 62] (a) the first shielding means is a first generally flat and vertical shield; (b) the third shielding means is a first substantially horizontal shield; (c) the second shielding means is a second generally flat and vertical shield; (d) the fourth shielding means is a second generally horizontal shield; (e) The radiation shielding assembly of any one of the preceding claims, wherein the fifth shielding means is a lower generally flat and vertical shield. [Item 63] 1. A radiation shielding assembly configured to block radiation emanating from a radiation source, comprising: (a) a support arm having a longitudinal axis configured to support at least a majority of the weight of the shield assembly; (b) a first generally flat, vertical shield secured to the support arm and having an opening near a lower end sized to receive a human limb therethrough; (c) a second generally flat and vertical shield translatably and rotatably connected to the support arm for rotation about and translation along an axis that is generally parallel to the longitudinal axis of the support arm; A radiation shielding assembly, wherein the first vertical shield, the first horizontal shield, the second vertical shield, the second horizontal shield, and the lower vertical shield are all radiopaque. [Item 64] Item 64. The radiation shielding assembly of item 63, comprising a first generally horizontal shielding body connected to the first vertical shielding body for translation and rotation therewith and positioned to block radiation emanating from an opening in the first vertical shielding body. [Item 65] Item 65. The radiation shielding assembly of item 63 or 64, comprising a second generally horizontal shielding body connected to the second vertical shielding body for translation and rotation therewith. [Item 66] 66. The radiation shielding assembly of any one of claims 63 to 65, comprising a lower generally flat and vertical shielding connected to the second horizontal shielding for translation and rotation therewith, the lower shielding being generally orthogonal to the second vertical shielding and the second horizontal shielding. [Item 67] 67. The radiation shielding assembly of any one of claims 63 to 66, further comprising a third generally vertical shielding that blocks radiation from the radiation source in a generally vertical plane that is generally parallel to the generally flat and vertical shielding, the third generally vertical shielding being fixedly attached to the first shielding means. [Item 68] Item 68. The radiation shielding assembly of any one of items 1-67, further comprising a sixth shielding means for blocking radiation from the radiation source in a fourth generally vertical plane that is generally parallel to the first generally vertical plane, the sixth shielding means being fixedly attached to the first shielding means, and the third generally vertical shielding is selected from the group consisting of a generally flat and rigid shielding, a flexible drape, and an extension of the first generally flat and vertical shielding. [Item 69] 1. A radiation shielding assembly configured to block radiation emanating from a radiation source, comprising: (a) a support arm having a longitudinal axis configured to support at least a majority of the weight of the shield assembly; (b) a first generally flat and vertical shield secured to the support arm via a first radiopaque joint; and (c) a second generally flat, vertical shield translatably and rotatably connected to the support arm via a second radiopaque joint to rotate about and translate along an axis that is generally parallel to the longitudinal axis of the support arm. [Item 70] 70. The radiation shielding assembly of claim 69, comprising a lower generally flat and vertical shielding body connected to the second generally flat and vertical shielding body for translation and rotation therewith, the lower shielding body being approximately orthogonal to the second vertical shielding body and the second horizontal shielding body. [Item 71] 1. A system for shielding a user from a bottom mounted X-ray projection device while the user is treating a reclining patient positioned above the X-ray projection device, comprising: (a) a table configured to support a patient, the table having a longitudinal axis and a lateral axis; (b) an X-ray projection device disposed below the table; (c) an image intensifier disposed above the table to receive the X-rays projected from the X-ray projection device; (d) a radiopaque curtain shield extending downwardly from the platform on at least a first side of the platform; and (e) a radiation shielding assembly comprising: (i) a support arm configured to support a weight of the shield assembly and having a generally vertical longitudinal axis; (ii) a first shield assembly secured to the support arm, (A) a first generally flat and vertical shield disposed adjacent a first side of the platform and generally parallel to a longitudinal axis of the platform; (B) a first shield assembly having an opening in a first vertical shield, the opening being positioned above the table to allow a patient's arm to pass through the opening; (iii) a second shielding assembly secured to the support arm in a manner allowing the second shielding assembly to rotate and translate about an axis generally parallel to a longitudinal axis of the support arm, the second shielding assembly having a second generally flat and vertical shield disposed above the platform; A system in which the second vertical shield can be rotated about an axis of the second vertical shield that is generally perpendicular to the longitudinal axis of the table or that is generally parallel to the longitudinal axis of the table. [Item 72] Item 72. The system of item 71, wherein the first shield assembly comprises a first generally horizontal shield positioned above the opening to block radiation emitted through the opening. [Item 73] Item 73. The system of item 71 or 72, wherein the second shield assembly comprises a second generally horizontal shield connected to the second vertical shield and positioned above the pedestal. [Item 74] 74. The system of any one of claims 71 to 73, wherein the second shield assembly comprises a lower generally flat, vertical shield extending below the platform from the second horizontal shield. [Item 75] 75. The radiation shielding assembly or system of any one of claims 62-74, wherein the first generally flat and vertical shielding and the second generally flat and vertical shielding are configured to rotate relative to one another through an arc of at least about 90 degrees. [Item 76] 76. The radiation shielding assembly or system of any one of claims 62 to 75, wherein the first generally flat and vertical shielding and the second generally flat and vertical shielding are configured to rotate relative to one another through an arc of up to 180 degrees. [Item 77] 77. The radiation shielding assembly or system of any one of claims 62-76, wherein the first generally flat and vertical shielding and the second generally flat and vertical shielding are configured to rotate relative to one another through an arc of approximately 0 to 180 degrees. [Item 78] Item 78. The radiation shielding assembly or system of any one of items 62 to 77, wherein the support arm comprises a generally vertical mast. [Item 79] Item 79. The radiation shielding assembly or system of any one of items 62 to 78, wherein the support arm is capable of supporting approximately the entire weight of the radiation shielding assembly. [Item 80] 80. The radiation shielding assembly or system of any one of claims 62 to 79, wherein the support arm is capable of supporting a full weight of the radiation shielding assembly. [Item 81] 81. The radiation shielding assembly or system of any one of claims 62 to 80, wherein in operation, the support arm supports a full weight of the radiation shielding assembly. [Item 82] 82. The radiation shielding assembly or system of any one of claims 62-81, wherein the first generally flat vertical shield is configured for vertical translation. [Item 83] 83. The radiation shielding assembly or system of any one of claims 62 to 82, wherein the first generally flat vertical shielding and the first generally horizontal shielding are configured for vertical coordinated translation. [Item 84] 84. The radiation shielding assembly or system of any one of claims 62 to 83, wherein the first generally flat and vertical shield is configured to translate along the support arm. [Item 85] 85. The radiation shielding assembly or system of any one of claims 62 to 84, wherein the first generally flat and vertical shielding and the first generally horizontal shielding are configured to translate in unison along the support arm. [Item 86] 86. The radiation shielding assembly or system of any one of claims 62 to 85, wherein the first generally flat, vertical shielding is configured to translate along a generally vertical axis such that, in the first position, a top edge of the first generally flat, vertical shielding is at least about the height of an adult human above a floor. [Item 87] 87. The radiation shielding assembly or system of any one of claims 62 to 86, wherein the first generally flat, vertical shielding is configured to translate along a substantially vertical axis such that, in the first position, a top edge of the first generally flat, vertical shielding is about 2 m or more above the floor. [Item 88] 88. The radiation shielding assembly or system of any one of claims 62 to 87, wherein the first generally flat and vertical shielding has a height that is at least about the distance from the top of the operating table to the total body length of an average human. [Item 89] Item 89. The radiation shielding assembly or system of any one of items 62 to 88, wherein the first generally flat and vertical shielding has a height from a top surface of the operating table to a height of about 2 m above the floor when the operating table is on the floor. [Item 90] 90. The radiation shielding assembly or system of any one of claims 62 to 89, wherein at least one of the shields has a radiopacity of at least 0.5 mm lead equivalent. [Item 91] 91. The radiation shielding assembly or system of any one of claims 62-90, wherein all of the shields have a radiopacity of at least 0.5 mm lead equivalent. [Item 92] 92. The radiation shielding assembly or system of any one of claims 62-91, wherein at least one of the shields has a radiopacity of a minimum of 1 mm lead equivalent. [Item 93] 93. The radiation shielding assembly or system of any one of claims 62-92, wherein all of the shields have a radiopacity of a minimum of 1 mm lead equivalent. [Item 94] 94. The radiation shielding assembly or system of any one of claims 62-93, wherein at least one of the shields has a radiopacity of a minimum of 1.5 mm lead equivalent. [Item 95] 95. The radiation shielding assembly or system of any one of claims 62-94, wherein all of the shields have a radiopacity of a minimum of 1.5 mm lead equivalent. [Item 96] 96. The radiation shielding assembly or system of any one of claims 62-95, wherein at least one of the shields has a radiopacity of a minimum of 2 mm lead equivalent. [Item 97] 97. The radiation shielding assembly or system of any one of claims 62-96, wherein all of the shields have a radiopacity of a minimum of 2 mm lead equivalent. [Item 98] 98. The radiation shielding assembly or system of any one of claims 62-97, wherein at least one of the shields has a radiopacity of a minimum of 3 mm lead equivalent. [Item 99] 99. The radiation shielding assembly or system of any one of claims 62-98, wherein all of the shields have a radiopacity of a minimum of 3 mm lead equivalent. [Item 100] 99. The radiation shielding assembly or system of any one of claims 62 to 99, wherein at least one of the shields has a radiopacity of a minimum of 3.3 mm lead equivalent. [Item 101] 101. The radiation shielding assembly or system of any one of claims 62-100, wherein all of the shields have a radiopacity of a minimum of 3.3 mm lead equivalent. [Item 102] 102. The radiation shielding assembly or system of any one of items 62 to 101, wherein at least one of the shields reduces radiation exposure by at least 85% as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 103] 103. The radiation shielding assembly or system of any one of items 62 to 102, wherein all of the shields reduce radiation exposure by at least 85% as measured by modified ASTM F3094 / IEC 61331-1 protocol. [Item 104] 104. The radiation shielding assembly or system of any one of items 62 to 103, wherein at least one of the shields reduces radiation exposure to less than 2.5 mR / hr as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 105] 5. The radiation shielding assembly or system of any one of items 62 to 104, wherein all of the shields reduce radiation exposure to less than 2.5 mR / hr as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 106] 106. The radiation shielding assembly or system of any one of paragraphs 62 to 105, wherein at least one of the shields reduces radiation exposure to about 2.5 mR / hr or less as measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 107] 107. The radiation shielding assembly or system of any one of items 62 to 106, wherein all of the shields reduce radiation exposure to about 2.5 mR / hr or less when measured by modified ASTM F3094 / IEC 61331-1 protocols. [Item 108] Item 68. The radiation shielding assembly or system of any one of items 62-107, wherein the second generally flat and vertical shielding and the second generally horizontal shielding are configured to translate in unison along the support arm. [Item 109] Item 109. The radiation shielding assembly or system of any one of items 62 to 108, comprising a flexible radiopaque member positioned to at least partially cover the limb opening and configured to allow a human limb to pass through the limb opening. [Item 110] 110. The radiation shielding assembly or system of any one of claims 62 to 109, comprising a flexible radiopaque member positioned to at least partially cover the limb opening and configured to allow a human limb to pass through the limb opening, the flexible radiopaque member being selected from the group consisting of a curtain, an iris port leaf, and a sheath. [Item 111] Item 111. The radiation shielding assembly or system of any one of items 62 to 110, comprising means for raising and lowering at least one of the first generally flat and vertical shielding and the first generally horizontal shielding along the support arm. [Item 112] Item 112. The radiation shielding assembly or system of any one of items 62 to 111, further comprising a means for raising and lowering at least one of the first generally flat and vertical shielding and the first substantially horizontal shielding along the support arm, the means for raising and lowering being selected from the group consisting of a support mechanism, a counterweight system, an electric motor, a hydraulic system, a pneumatic system, and a manual system. [Item 113] Item 13. The radiation shielding assembly or system of any one of items 62 to 112, wherein the support arm comprises a mast supported by a floor stand. [Item 114] Item 114. The radiation shielding assembly or system of any one of items 62 to 113, wherein the support arm is a mast suspended by an overhead boom. [Item 115] 5. The radiation shielding assembly or system of any one of claims 62 to 114, wherein the support arm is a mast suspended by the overhead boom, the mast being capable of rotating about a longitudinal axis of the overhead boom. [Item 116] Item 6. A radiation shielding assembly or system as described in any one of items 62 to 115, wherein the support arm is a mast suspended by an overhead boom, the overhead boom being supported by a second mast. [Item 117] 17. The radiation shielding assembly or system of any one of claims 62 to 116, wherein the support arm is a mast suspended by an overhead boom and the second mast is supported by a rail mounted on a wall or ceiling, and the second mast is capable of translating along the rail mounted on the wall or ceiling. [Item 118] Item 68. The radiation shielding assembly or system of any one of items 62 to 117, wherein the support arm is a mast suspended by an overhead boom and the second mast is supported by a swing arm mounted to a wall or ceiling. [Item 119] Item 69. A radiation shielding assembly or system according to any one of items 62 to 118, wherein the support arm is a mast suspended by an overhead boom, the second mast being supported by a swing arm which in turn is supported by a rail mounted on a wall or ceiling, the swing arm being capable of translating along the rail mounted on the wall or ceiling. [Item 120] Item 120. The radiation shielding assembly or system of any one of items 62 to 119, wherein at least one of the shields is transparent to visible light. [Item 121] 121. The radiation shielding assembly or system of any one of claims 62 to 120, wherein all of the shields are transparent to visible light. [Item 122] 1. A radiography method comprising: (a) placing a radiation shielding assembly according to any one of items 1 to 121 between a patient and a user such that the patient's limb extends through an limb opening in the shielding assembly; (b) inserting a medical device into the vascular system of the limb; (c) irradiating the patient with radiation using a radiation generator positioned such that the radiation passes at least partially through the patient while being blocked from reaching a user by a shielding assembly.

Claims

1. 1. A radiation shielding assembly configured to shield radiation emitted from a radiation source located below a table supporting a patient, the assembly comprising: (a) a support arm configured to support at least a majority of the weight of the shield assembly; (b) a first generally planar vertical shield; (c) a second generally planar vertical shield; the first generally planar vertical shield is coupled to the second generally planar vertical shield to form a radiopaque barrier; the first generally planar vertical shield and the second generally planar vertical shield are positionable on the platform; the radiation shield assembly is configured such that at least one of the first generally planar vertical shield and the second generally planar vertical shield is rotatable relative to the other of the first generally planar vertical shield about a generally vertical axis; a radiation shielding assembly configured to position the first generally planar vertical shield and the second generally planar vertical shield to protect an upper body of a user from the radiation emitted from the radiation source.

2. 2. The radiation shielding assembly of claim 1, wherein the first generally planar vertical shield is configured such that a top edge of the first generally planar vertical shield is positioned at least 175 cm (±20%) from a floor.

3. 10. The radiation shielding assembly of claim 1, wherein a top end of the first generally planar vertical shield is configured to be placed at least about the height of an adult human above a floor surface.

4. 2. The radiation shielding assembly of claim 1, wherein the first generally planar vertical shield has a height at least as great as a distance from a top surface of the platform to an average human height.

5. the first generally planar vertical shield is fixed to the support arm; The radiation shielding assembly of claim 1 , wherein the second generally planar vertical shield is fixed to the support arm.

6. The radiation shielding assembly of claim 1 , wherein the support arm is configured to translate the radiation shielding assembly relative to the stage.

7. The radiation shield assembly of claim 1 , wherein the support arm is supported from overhead.

8. The radiation shielding assembly of claim 1 , wherein during operation, the support arm supports a full weight of the radiation shielding assembly.

9. 2. The radiation shielding assembly of claim 1, wherein at least one of the first generally planar vertical shield and the second generally planar vertical shield are configured to translate along the support arm.

10. 2. The radiation shielding assembly of claim 1, wherein the first and second generally planar vertical shields are configured to be positioned to shield the user's head from radiation emitted from the radiation source.

11. 2. The radiation shielding assembly of claim 1, wherein at least one of the first generally planar vertical shield and the second generally planar vertical shield are configured to translate along the support arm.

12. 2. The radiation shielding assembly of claim 1, wherein the support arm is configured to position the first and second generally planar vertical shields to shield an upper body of the user from radiation emitted by the radiation source.

13. 10. The radiation shielding assembly of claim 1, wherein one or both of the shields have a radiopacity of at least 0.5 mm lead equivalent.

14. The radiation shielding assembly of claim 1 , further comprising a third generally planar vertical shield secured to the first generally planar vertical shield.

15. The radiation shielding assembly of claim 14 , wherein the third generally planar vertical shield is translationally stationary relative to the first generally planar vertical shield.

16. 10. The radiation shielding assembly of claim 1, wherein both of the shields reduce radiation exposure to less than 2.5 mR / hr as measured by modified ASTM F3094 / IEC 61331-1 protocols.

17. 1. A radiation shielding assembly configured to shield radiation emitted from a radiation source located below a table supporting a patient, the assembly comprising: (a) a support arm suspended from overhead, the support arm configured to support substantially the entire weight of the shield assembly; (b) a first generally planar vertical shield having a radiopacity of at least 0.5 mm lead equivalent; (c) a second generally planar vertical shield having a radiopacity of at least 0.5 mm lead equivalent; the first generally planar vertical shield is coupled to the second generally planar vertical shield to form a radiopaque barrier; a support arm capable of positioning the first generally planar vertical shield and the second generally planar vertical shield above the platform; the radiation shield assembly is configured such that at least one of the first generally planar vertical shield and the second generally planar vertical shield is rotatable relative to the other of the first generally planar vertical shield about a generally vertical axis; a radiation shielding assembly configured to position the first generally planar vertical shield and the second generally planar vertical shield to protect an upper body of a user from the radiation emitted from the radiation source.

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