Reduction of Exposure of Patients and Staff to Radiation During Fluoroscopically Guided Interventional Procedures

Abstract

The increase in the frequency of interventional procedures and in the number of medical specialties using fluoroscopically guided procedures together with the reevaluation of radiation risks by the International Commission on Radiological Protection (ICRP) and their impact on safety regulations has promoted several international research programs, guidelines produced by professional and scientific societies, and many valuable research articles during the last few years. This review summarizes the most important new findings and brings readers up to date on the subject of radiation safety in interventional radiology. Several key points are highlighted in the sections on guidelines of scientific and professional societies, national and regional patient and staff dose surveys, interventional procedures in pediatrics, automatic patient dose registry and analysis, occupational and lens dose evaluation, lens injury surveys, and patient dose follow-up and hybrid rooms. As a conclusion, the most relevant aspects are summarized as follows: the ICRP recommendation on the use of diagnostic reference levels for interventional procedures and new radiation thresholds for some tissue reactions; a new occupational dose limit for the lens and changes in regulation; guidelines of several medical societies on radiation safety for interventional procedures; relevant international research programs on the topic; advances in radiology systems offering standardized patient dose reports and optimized imaging protocols; more interest and actions in radiological protection training; more interest in patient dose management for pediatric procedures; concern with lens and skin radiation injuries and actions to avoid them; better postprocedural care as part of the quality programs and better clinical follow-up of patients and automatic collection and processing of individual patient doses to help in the optimization and contribute to the tracking of patient procedures and doses.