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The cath lab scatter experience · UK

Stand where they stand. See what they take home.

An interactive cath lab. Change the projection, switch from fluoroscopy to cine, click on each member of the team to see where scatter reaches them, then equip them with Rothband protection and watch the numbers fall.

Enter the lab → Five staff positions · Three projections · Full Rothband kit · Protect the whole team to win
  • ×10Cine acquisition puts roughly ten times the dose rate of fluoroscopy into the patient, and the scatter follows1
  • 1 → ¼Double your distance from the patient and the scatter reaching you falls to a quarter2
  • >90%of scattered radiation is stopped by a protective apron, depending on kV and lead equivalence1

Interactive cath lab

Protect the team.

The heat map shows relative scatter around the patient for the current projection and mode. Click a person to see what reaches their eyes, thyroid, torso and legs, then switch on their kit. Get every member of the team into the green and the score turns green too.

0
Team protection scoreNobody is protected yet. Click a person to start.
Projection
Mode
Room kit
Cath lab during a procedure: operator and assistant at the table, scrub nurse at the trolley, anaesthetist at the head end, radiographer behind the control room glass
Relative scatterlow · high
Click a member of the team
Fluoroscopy · PA

Select a team member

Who do you want to protect?

Five people work around this patient. Each one stands somewhere different, so each one gets a different dose, and a different part of the body takes most of it.

Scatter at this position–/100
Eyes
–
Thyroid
–
Torso
–
Legs
–
UnprotectedWith current kitIn the green
Personal kit
Room kit affecting this position

The index is an indicative model built from published relationships (inverse square distance, tube-side scatter, cine versus fluoroscopy, typical attenuation of protective garments and shields). It is not a dosimetry measurement and not a substitute for a risk assessment with your Radiation Protection Adviser. Real doses depend on the room, the equipment, the procedure and the person.

Simulates a typical case: mostly fluoroscopy with short cine runs, current projection. Grey is the team's exposure with no protection at all; blue is with whatever kit they are wearing right now. Units are relative, not mSv.

Operator protected Every pair of eyes covered Every thyroid covered Legs covered at the table Whole team in the green

What the model is built on

Four rules of scatter every cath lab team should know.

The experience above is a teaching model. These are the relationships it is built from, and where they come from.

1/d²

Distance is the cheapest shield

Scatter falls with the square of the distance from the patient. Step from half a metre to one metre and the dose rate drops to a quarter. The assistant standing a step further back gets a fraction of the operator's dose.2

Tube side

Stand on the detector side when you can

Scatter is most intense on the side the beam enters the patient. Only around 1 to 5% of the beam comes out the exit side. With an under-table tube, that is why the legs take so much, and why steep LAO projections push scatter towards the operator.1

×10

Cine is where the dose is

Acquisition runs put roughly ten times the dose rate of fluoroscopy into the patient, so the scatter reaching the team jumps the same way. Step back during cine runs.1

0.5–5%

What gets through a 0.5 mm apron front

At 70 to 100 kVp, roughly 0.5 to 5% of scattered X-rays get through 0.5 mm lead equivalence, which is what a wraparound 0.25 mm garment gives at the front where it overlaps. Lead glasses roughly halve eye lens dose in everyday practice and do far better when the face is towards the patient.3,4

The Rothband cath lab kit

Everything the team wore in the lab above.

Made in Lancashire since 1911, NHS Supply Chain approved, core materials tested to IEC 61331.

Rothband TXRW wrap top

Torso · everyone at the table

TXRW Wrap Top

Lightweight two-piece wraparound top. Overlapping front panels give double protection where scatter hits first; weight is shared between shoulders and hips for long lists. Lightweight lead, Bilayer Earth or Bilayer Lead Free cores.

TXRW Wrap Top →
Rothband KXRW wrap kilt

Pelvis and upper legs

KXRW Wrap Kilt

The second half of the two-piece set. Wraparound kilt protecting the pelvis and upper legs, where under-table scatter arrives first for anyone standing at the table side.

KXRW Wrap Kilt →
Rothband PXR tabard apron

Alternative garment

PXR tabard

One-piece tabard with one- or two-shoulder clip options for staff who prefer a single garment, or for shorter cases.

PXR SC →
Rothband D-Type thyroid collar

Thyroid

D-Type Thyroid Collar (TPD / TPDM)

0.35 mm Pb lightweight lead collar covering the gland that sits exposed at the neckline of most aprons. Velcro or magnetic closure.

Thyroid collars →
Rothband Model 52 wraparound glasses

Eyes · 20 mSv annual lens limit

Model 52 wraparound glasses

Lead-equivalent lenses with side protection for the people closest to the patient. FitOver frames go over prescription glasses; Nike and Oakley frames for staff who want to actually wear them.

X-ray glasses →
Rothband lower body table shield

Legs · table side

Lower Body Table Shield

Overlapping lead panels that hang from the table rail and fold down for access. Six lengths from 78 to 162 cm, plus a multi-use shield and under-couch frame.

Table-mounted shields →
Rothband variable height mobile barrier

Anaesthetist · second operator

Variable Height Mobile Barrier

Wheeled lead barrier with a window adjustable from 115 to 188 cm, so the person behind it can see the patient and the monitors without standing in the scatter.

Mobile barrier →
Lead-lined walls
& lead glass

Control room · the whole department

Structural shielding

Lead-lined doors, partitions and viewing windows for the control area and the rooms next door. Rothband designs, supplies and installs.

Structural shielding →
Measure it

Dosimetry

Instadose

The model above is indicative. Real doses per person are measured, and Instadose personal dosimeters read out online so the team can see them.

Dosimetry →

Cath lab protection review

Now do it for your actual room.

Tell us about your lab and your team. A Rothband specialist will come back to you with garment, eyewear and shielding options for the positions people really stand in.

  • The kit you selected in the lab above is sent with your request, so we start from your picture.
  • Garment style, core material and lead equivalence options aligned to your RPA's guidance.
  • Sizing for the whole team, table shields for your table, and a fitting session on request.

Rothband (WSR Medical Solutions Ltd) will use these details to respond to your request. No newsletters, no lists.

Thank you. Your review request has been received.

A Rothband specialist will be in touch shortly. The kit you built in the lab has been attached.

Guidance

Cath lab radiation protection: the questions we are asked most

Direct answers with the research behind them. Where a decision belongs with your Radiation Protection Adviser, we say so.

Who gets the most dose in a cath lab?

Whoever stands closest to the patient on the tube side, for the longest. Usually the primary operator at the femoral or radial access site, then the assistant, then scrub staff. The anaesthetist at the head end is further from the beam but often unshielded, and the radiographer behind the lead glass gets almost nothing. Distance and position matter as much as what you wear.2

Why do the legs matter?

Because the tube is under the table, and the apron stops at the knee. Scatter from the beam entry side escapes below the table towards the legs of anyone at the table side. Table-mounted lower body shields have been shown to significantly reduce lower extremity dose to the operator.2

What lead equivalence does a cath lab apron need?

Wraparound 0.25 mm Pb garments are the common recommendation, giving 0.5 mm where the front panels overlap. At 70 to 100 kVp, roughly 0.5 to 5% of scatter gets through 0.5 mm. Two-piece sets share the weight between shoulders and hips for long cases.3

The lead equivalence for your room should be settled with your RPA; Rothband supplies certified attenuation data for every garment.

Do lead glasses really work?

Yes, and how well depends on where you look. In clinical practice lead glasses roughly halved eye lens dose; on a phantom facing the patient the reduction was eight to tenfold. Turning the head away from the patient opens the side, which is why wraparound frames and side shields matter. The UK annual eye lens limit is 20 mSv.4

Does LAO really push scatter towards the operator?

Yes. In a left anterior oblique projection the tube swings towards the patient's right, which is where the operator usually stands. Scatter is most intense on the beam entry side, so the operator's dose rises in LAO and falls in RAO. Steep cranial angulations raise patient entrance dose, and the scatter, further still.1

Is this model a dose calculation?

No. It is a teaching model built from published relationships: inverse square distance, tube-side scatter, cine versus fluoroscopy, and typical attenuation of garments and shields. Real doses are measured with personal dosimeters and depend on the room, the equipment and the procedure. Use it to understand where protection matters, then measure.

References

  1. International Atomic Energy Agency. Radiation protection of medical staff in interventional fluoroscopy (RPOP). iaea.org
  2. Radiation Protection in Interventional Radiology. Indian J Radiol Imaging. 2021 (PMC8817818). PMC
  3. Get Protected! Recommendations for Staff in IR. Cardiovasc Intervent Radiol. 2021 (PMC8034513). PMC
  4. van Rooijen BD, et al. Efficacy of radiation safety glasses in interventional radiology. Cardiovasc Intervent Radiol. 2014. springer.com

These answers are general guidance written by Rothband (WSR Medical Solutions Ltd), a UK radiation protection manufacturer since 1911. They are not a substitute for your local rules, risk assessment or the advice of your Radiation Protection Adviser.