Evaluation of Composite Lead-Free Shield for Clinical Use in C-Arm Fluoroscopy

C-arm fluoroscopy provides essential real-time imaging for various interventional procedures but entails radiation exposure risks for both patients and medical staff. Conventional lead and lead-free shields offer high attenuation yet remain limited in clinical use due to weight, image artifacts, and procedural constraints. This study evaluated a lead-free composite shield composed of tungsten, tungsten carbide, bismuth, aluminum, and polyurethane, focusing on dose reduction, scatter shielding performance, image quality, and interactions with Automatic Brightness Control (ABC) in a C-arm environment. PHITS-based Monte Carlo simulations demonstrated strong attenuation in the low-to-mid energy range across 60–120 kVp. Experimental measurements showed attenuation rates of 59.6–70.8% (no filter), 45.4–55.4% (Al 2.5 mm), and 37.5–49.5% (Cu 0.25 mm), corresponding to 0.04 mmPb. Scattered radiation shielding efficiency ranged from 36–58% (1 layer) and 61– 80% (1.5 layers). Phantom tests confirmed an average 29% dose reduction without significant ABC-driven parameter increases, and SNR/CNR changes were not statistically significant (p > 0.05).