Ionizing radiation management is among the most important safety issues in interventional cardiology. Multiple radiation protection measures allow the minimization of x-ray exposure during interventional procedures.Our purpose was to assess the utilization and effectiveness of radiation protection and optim ization techniques among interventional cardiologists in Lithuania.Interventional cardiologists of five cardiac centres were interviewed by anonymized questionnaire, addressing personal use of protective garments, shielding, table/detector positioning, frame rate (FR), resolution, field of view adjustment and collimation. Effective patient doses were compared between operators who work with and without x-ray optimization.Thirty one (68.9%) out of 45 Lithuanian interventional cardiologists participated in the survey. Protective aprons were universally used, but not the thyroid collars; 35.5% (n = 11) operators use protective eyewear and 12.9% (n = 4) wear radio-protective caps; 83.9% (n = 26) use overhanging shields, 58.1% (n = 18)-portable barriers; 12.9% (n = 4)-abdominal patient's shielding; 35.5% (n = 11) work at a high table position; 87.1% (n = 27) keep an image intensifier/receiver close to the patient; 58.1% (n = 18) reduce the fluoroscopy FR; 6.5% (n = 2) reduce the fluoro image detail resolution; 83.9% (n = 26) use a 'store fluoro' option; 41.9% (N = 13) reduce magnification for catheter transit; 51.6% (n = 16) limit image magnification; and 35.5% (n = 11) use image collimation. Median effective patient doses Practical Matter Society for Radiological ProtectionOriginal content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI. were significantly lower with x-ray optimization techniques in both diagnostic and therapeutic interventions. Many of the ionizing radiation exposure reduction tools and techniques are underused by a considerable proportion of interventional cardiology operators. The application of basic radiation protection tools and techniques effectively reduces ionizing radiation exposure and should be routinely used in practice.

Optimisation of medical X-ray examinations is very important for the enhancement of the reliability of the examination and for the reduction of the radiation dose to patients. Results of investigations of doses to patients during mammography using thermoluminescence dosemeters at different hospitals are presented together with a brief overview of the situation for mammography in Lithuania. It is shown that the entrance surface air kerma varies in a broad range and differed from hospital to hospital. Nevertheless the calculated values of average glandular dose (AGD) for a 'standard' breast being relatively high were comparable with those (3.2 mGy per exposure at net optical density 1.4) currently accepted by international authorities. Differences in AGD values evaluated at different hospitals demonstrate the existing potential for optimisation of the mammography screening procedures. The results of this investigation will be included in a database for patient doses in Lithuania and used for establishing a national reference dose level for mammography. Currently, reference levels recommended by international authorities are used in Lithuania.

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The entrance surface dose (ESD) (skin dose) and its variation due to overlapping radiation fields at mammography have been experimentally investigated on patients during two-view mammography screening examinations of both breasts and on phantoms of silicon gel. Measurements were done using multiple thermoluminescence dosemeters for mapping the variations in absorbed dose at the surface of the breast phantoms. It was found that the total resulting skin dose at the reference point on the breast surface, described in the European Protocol [Zoetelief, Fitzgerald, Leitz and Sabel (European protocol on dosimetry in mammography. EUR 16263 (Luxemburg: EC), 1996)] after multiple exposure of patient's breasts during two-view, four exposures mammography screening examinations is approximately 50 % higher as compared with the skin dose at the same point measured during one single (CC) exposure. The dose distributions on the breast phantom surface were non-uniform and indicated areas of higher doses, which were related to the regions of the superimposed fields on the surface during the examinations. The dosimetric importance of the superposition of X-ray fields on the ESD is discussed.

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