Management of Patient and Staff Radiation Dose in Interventional Radiology: Current Concepts

Abstract

The increasing complexity and numbers of interventional fluoroscopy procedures have led to increasing patient doses of radiation and to increasing concern over staff doses. Hybrid rooms incorporate multiple imaging modalities and are used by multidisciplinary teams in interventional fluoroscopy suites and operating theaters. These rooms present additional radiation protection challenges. The new low annual exposure limit for the lens of the eye also requires specific measures to prevent cataracts in operators. The traditional attitude of radiation protection must be changed to one of proactive management of radiation dose and image quality. Incorporation of a comprehensive dose management program into the departmental quality assurance program is now essential. Physicians, radiographers, and medical physicists play an essential role in the safe use of fluoroscopy in medical practice. Efficient use of all imaging modalities (e.g., fluoroscopy, digital subtraction angiography, cone-beam CT) requires knowledge of the effects of different equipment settings on patient and staff doses as well as the skill and competence to optimize these settings for each procedure and patient. Updates and recommendations on radiation protection and dose management programs, including aspects of education and training, are presented.

Occupational Radiation Exposure During Endovascular Aortic Repair

“…There was a stronger correlation with iodinated contrast volume compared to fluoroscopy time. A potential explanation might be that procedural contrast usage serves as an indirect measure for the amount of DSA runs which mainly contributes to the total procedural DAP while fluoroscopy contributes a relatively small fraction for the total radiation dose [8]. For EVAR procedures, patient's body weight was furthermore significantly correlated to FO dose; group analyses for FEVAR and TEVAR did however not show a strong correlation for body weight, which might be influenced by the limited number of procedures in these subgroups.…”

A Systematic Review of the Efficiency of Radiation Protection Training in Raising Awareness of Medical Staff Working in Catheterisation Laboratory

“…This includes justifying the requested procedure with the referring physician and explaining all benefits and possible risks before acquiring the consent of the patient [1]. However, routine planning usually does not include particular aspects of radiation dose management and protection for patients and staff [22].…”

“…The use of minimally invasive, image-guided procedures in interventional radiology (IR) and cardiology has widely increased due to the benefits demonstrated by these procedures [1].…”

Knowledge of Radiation Protection and the Recognition and Performance of Radiation Protection Behavior among Perioperative Nurses

“…중재적 시술이 전문화되면서 중재적 방사선 적용범위도 계 속 확대되었으며 (Chon, 2007;Persliden, 2005), 의료환경에 서 방사선 투시법을 이용해 시행되는 중재적 시술이 증가하고 있다 (Bartal., Vano, Paulo, & Miller, 2013). X-선이 중재적 시술에 집중적으로 사용되면서 장기간 소량의 피폭에 의해 만 성적으로 나타나는 신체적 증상과 단기간 대량의 방사선 피폭 으로 인한 신체적 손상의 위험이 증가하였다 (Bor et al, 2004).…”