Ionizing radiation exposure in interventional cardiology: current radiation protection practice of invasive cardiology operators in Lithuania

Abstract

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.

Radiation protection knowledge and practices in interventional cardiologists practicing in Africa: a cross sectional survey

“…Our study found out that prior training on basic radiation protection measures, basic knowledge regarding exposure to ionising radiation and the use of the most basic radiation protection tools are lower than that expected to ensure the safety of the operators themselves and their co-workers. This is alarming because ionising radiation exposure in cardiac catheterisation laboratories is primarily reduced or prevented by the application of basic x-ray optimisation tools and techniques [2,8,14] and all involved personnel should receive adequate training and knowledge of them [10]. Though it has been reported in another study that interventional cardiologists generally tend to underutilise radiation protection tools [14], the major reason in our study was unavailability of the protective tools or the lack of knowledge/ training, rather than preference or carelessness.…”

“…Young and enthusiastic professionals have joined and will continue to join interventional cardiology practice in these and future centers. Therefore, it is mandatory that the safety of such practitioners, co-workers and their patients be ensured to avoid adverse outcomes and also tackle an irrational fear of radiation [4,14] that would ultimately hamper practice, should adverse outcomes occur in this population. We sought to determine the current existing knowledge and practice of radiation protection among interventional cardiologists working in some of these centers in Africa.…”

Investigation of radiation protection and safety measures in Rwandan public hospitals: Readiness for the implementation of the new regulations

“…Furthermore, in a study conducted in a large facility in Iran, it was found that a lead rubber apron was the most available form of protection, with lead equivalent barriers being equipped in 62.5% of the radiography rooms again in line with the findings in Rwanda. 12,13 Lead rubber shielding has until recently been the accepted form of radiation protection for the patient, MIT, and staff. However, new research with the implementation of digital radiography has discouraged the use of lead rubber shielding on a patient as a primary method of reducing dose.…”

Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation

“…This is consistent with low use of protective lead eyewear in other settings. 31 Table 2 illustrates that there were no risk factors that were statistically significantly associated with any risk factor for cortical or PSC cataracts for all the participants.…”