Radiation Protection Training Research Articles

The impact of radiation protection training on the radiological safety and the related culture of exposed workers in Greece

The safe use of radiation sources presupposes the engagement of personnel adequately educated and trained on radiation protection and with the necessary safety culture. This is necessary in order to understand their responsibilities and perform their duties in the safest way for themselves, the public and the patients, where appropriate. The Greek Atomic Energy Commission (EEAE) provides education and training on radiation protection to scientists, technical personnel and members of emergency response teams as well as the recognition of the related programs. To fulfil its role, EEAE implements a strategy on education and training in radiation protection through the development of appropriate programs which take into account the national needs, as well as the national capabilities and resources. In this respect, 65 one and two day training seminars were organised in the period 2011–2017 which were attended by 3126 radiation workers (i.e. medical radiology and nuclear medicine technologists, industrial radiographers and outside workers). The present work demonstrates a quantified assessment of the impact of EEAE training activities on particular categories of radiation workers. The study indicates a reduction in Hp(10) values as well as in the corresponding standard deviations of medical radiology technologists, nuclear medicine technologists, and industrial radiographers. A 48% decrease was also observed in the collective dose of medical radiology technologists with cumulative Hp(10) values higher than the investigation level. Moreover, an important improvement of specific safety culture indicators, such as the percentage of non-returned personal dosemeters was noticed and presented.

Awareness of Nurses to Radiation Protection in Medicine

Background: Nurses are vital in the management of patients for diagnostic imaging examinations. Some nurses work in radiology departments and others assist radiographers during mobile and theatre radiography. In recent years, some nurses working in the United Kingdom (UK) and Ireland are referring patients for radiological examinations, a role which was traditionally that of medical doctors. This work involves ionising radiation which is harmful to the human body. Therefore, it is essential that nurses understand the measures needed to protect patients, members of the public and themselves from ionising radiation. The aim of this study was to systematically review the awareness of nurses to radiation protection in medicine.Method: This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted in January 2020 in three databases: ScienceDirect, PubMed/MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as hand searching of journals and internet. Data were extracted from all included research studies and analysed thematically.Results: Ten primary research studies were identified, selected and included in this systematic review. Six themes were identified following data synthesis and analysis: sources of ionising radiation, benefits of ionising radiation in medicine, biological effects of ionising radiation to the human body, principles of radiation protection, control measures for external radiation exposure, populations most vulnerable to ionising radiation, and education and training in radiation protection. In general, this review found that nurses are not adequately aware of radiation protection.Conclusion: There is a need to integrate radiation protection into the nursing curriculum and to provide Continuing Professional Development (CPD) to nurses.

Current Sudan protective practice in diagnostic nuclear medicine and patient dose

Reflecting upon the influence of current diagnostic imaging radiation protection practices in Sudan, a sampling evaluation is made of administered activity across all five of the nuclear medicine departments in the country. Data were collected in respect of 423 patients, administered nuclide activities showing accord with international levels. For administered activity, four of the five departments use International Atomic Energy Agency (IAEA) Basic Safety Standard protocols, the other adopting UK Administration of Radioactive Substances Advisory Committee (ARSAC) practice. For national nuclear medicine diagnostic purposes overwhelming use is made of 99mTc. Thyroid and parathyroid scans account for 43% of the 423 investigations, while whole body bone and renal scans provide for the imaging needs of the respective 34% and 23% remaining patients. Of the acquired images, in excess of 80% of these were planar. The mean and standard deviation effective dose values were 2.26 ± 0.61, 4.70 ± 0.77 and 1.03 ± 0.29 mSv, for thyroid, bone and dynamic renal scans respectively, comparable with that of previous studies. While department designs are observed to comply with radiation protection regulations, the personal monitoring service is much less satisfactory, data frequently being found to be absent in all five departments. Moreover, only 60% of the medical physicists have been in receipt of regular radiation protection training, while other medical staff within the departments have not benefited from the relevant training at all, including physicians, nurses and nuclear medicine technologists. None have received regular specific medical checks. Accordingly, the Sudanese Nuclear & Radiological Regulatory Authority are now playing a major role in development of nuclear medicine practice and associated safety requirements, seeking accord with the principle of ALARA. Physician/medical physicist cooperation is needed in addressing optimization of radiation dose and image quality, also radiation protection awareness and training, as well as in medical surveillance.

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

We conducted a survey of doctors working in the cardiac catheterisation laboratories in Africa on their knowledge, attitude and practice with respect to radiation protection. Of seventy-two respondents contacted, 61 (84.7%) completed the questionnaire. Twenty-eight, (45.9%) were younger than 45 years. Thirty-seven, (60.6%) had less than 10 years of experience in the laboratory. Only 28 (45.9%) had undertaken radiation protection training. Fifty-eight, (95.1%) consistently used lead aprons. Forty-seven, (77%) reported consistently using thyroid shields. Ten (16.4%) consistently used radiation protection eyeglasses, whilst 36 (59%) never used them. Thermoluminescent Dosimeter badges were consistently used in 23 (37.7%). Forty-two, (68.9%) reported having ceiling mounted lead/acrylic shields. Level of radiation exposure in the most recent one year was ≤2 mSv in 14, between 2 and 20 mSv in 8 and between 20 and 30 mSv in 2, whilst 33 did not know their dose readings. The use of basic radiation protection tools as well as the knowledge and measurement of radiation exposure among interventional cardiologists working in Africa is low. The unavailability of some of the protective tools and a knowledge gap in terms of radiation protection and monitoring of self-exposure were some of the reasons for suboptimal self-protection against ionising radiation among our respondents. We suggest that initiatives be taken by all stakeholders to train this group of medical professionals in basic radiation protection to avoid unnecessary exposure to themselves, co-workers and patients.

La radioprotection en rhumatologie interventionnelle

Radiation protection is being re-evaluated by the nuclear safety authority (ASN) following an investigation of practices showing significant inadequacies in precautions, and in order to comply with the new European directives. Rheumatologists are less and less involved with the choice of the new generation of young rheumatologists to favor the ultrasound approach, both diagnostic and interventional. However, X-rays will still be required to visualize the bone tissue and to practice interventional gestures at this level, and absorptiometry, although extremely non-irradiating, is also concerned, as is the practice of isotopic synoviortheses. Finally, rheumatologists remain prescribers of exams or interventional procedures carried out under visual control with X-rays. Those who will be exposed to ionizing radiation will have to comply with the new regulations, acquire an adequate equipment, respect pre-established procedures, and validate radiation protection training for patients, 1 day every 7 years in France.

Surgical technologists' knowledge and performance about radiation protection in Zahedan educational hospitals. A descriptive-analytical study.

INTRODUCTION:The use of ionizing radiation in various sciences, especially in medical science, has played an important role in human health. As the use of radiology tests in medical centers, including the operating room ward, is increasing, increasing the level of awareness of the operating room staff can improve their performance in this area as well as reduce the risk of exposure to radiation. The aim of this study was to determine the knowledge and performance of surgical technologists about radiation protection in Zahedan educational hospitals.MATERIALS AND METHODS:The present study is a descriptive-analytical study that was performed on 80 surgical technologists of Zahedan teaching hospitals from January 2019 to December 2019. The Knowledge Questionnaire was used in this study, which was a researcher-made questionnaire. After filling out questionnaires and checklists, the data were analyzed by SPSS software using descriptive statistics and analytical, statistical tests, including independent t-test and Pearson correlation coefficient.RESULTS:The results showed that the mean age of participants was 31 ± 7.03 years . 27% were men, and 53% were women. The mean of work experience was 7 ± 7.56. The mean score of knowledge was 6 ± 3.02 and the performance score was 12 ± 7.38. There was a correlation between age, awareness and performance of the participants (P < 0.001), and there was a correlation between participants' radiation protection training and awareness and performance (P = 0.000). There is a direct relationship between staff knowledge and performance. No significant relationship was found between the other variables (P = 0.029).CONCLUSION:The results of the study showed that there is a relationship between radiation protection training courses so that the personnel who passed these courses are more aware and functioning. Given that action is needed to raise awareness through workshops.

Knowledge of radiation protection among radiology professionals and students: A medical college-based study

BACKGROUNDRadiation protection is the core of radiography for safe radiation-based imaging practice. This study aims to determine the knowledge of radiation protection among radiology professionals and students in a medical college of Nepal. MATERIAL AND METHODSA questionnaire survey was carried out among 35 radiology staff and students at Universal College of Medical Sciences (UCMS), Bhairahawa, Nepal. The questionnaire survey consisted of socio-demographic variables and 17 questions, 3 questions were related to general information regarding training, knowledge, and experience and the remaining 14 multiple choice questions (MCQ) were related to radiation protection. Data were analyzed in SPSS Statistics software, version 27. The p-value was set at 5% level of significance. Nonparametric tests were applied since the data did not follow normal distribution. The knowledge score were categorized into lesser than 60 % inadequate, 60–80 % adequate and greater than or equal to 80 % excellent. RESULTSOut of total 35 participants, 28 were male and 7 were female with mean age 26.09 ± 7.18 years, range 18–54. The average radiation level of awareness was 9.6 (68.57 %), which was adequate, maximum 13 and minimum 4. There was not statistical significance of knowledge score by gender, age groups, work experience and studentship. Taking academic qualification, the level of knowledge of diploma graduates was inadequate 7.76 (55.42 %), and lower than other higher academic qualifications. CONCLUSIONSAdequate radiation protection course materials and training should be introduced for diploma graduates. Continuing professional education (CME) should be organized regularly. Moreover, radiation protection law is a must in Nepal now.

Standardisation of Medical Physics training in Europe

Medical physics has done much to advance medicine. We can be proud of our collective accomplishments. The development of our profession in Europe has been driven by the regulatory requirements for radiation safety initially of staff and lately of patients. European legislation acknowledged the importance of physics in radiation protection of patients in the 1980s by requiring a “qualified expert in radiophysics” to be available to “sophisticated departments of radiotherapy and nuclear medicine”. In the 1990s the term “medical physics expert” (MPE) was introduced and the involvement of MPEs was foreseen also in “other radiological practices”. The new European Directive (59/2013) expanded the MPE’s role in patient radiation safety. It defines the roles and responsibilities of experts who should be involved in radiation protection. The role of the Radiation Protection Expert (RPE) and the Medical Physics Expert (MPE) is clearly defined. The requirements for information, training and education are also addressed in order to highlight the importance of education and training in radiation protection. According to article 14 member states must ensure the education training and retraining to allow the recognition of radiation protection experts and medical physics experts in the field. The new law which is now implemented in all Member States proves that medical physics has a lot more to offer and places our profession on a more profound ground and provides us with opportunities that we never had before. This is our big opportunity to evolve and make ourselves leaders in radiation protection within the hospital environment and beyond. In a number of European countries, binding regulations appear also on non ionizing radiation such as MRI, US and others. Artificial Intelligence and leaderships issues are also given a lot of attention. The presentation will provide the current information on education and training across Europe together with emerging challenges and opportunities.

Radiation Dose to the Eye Lens Through Radiological Imaging Procedures at the Surgical Workplace During Trauma Surgery.

Background: Due to the drastic reduction of the eye lens dose limit from 150 mSv per year to 20 mSv per year since 2018, the prospective investigation of the estimated dose of the eye lens by radiological imaging procedures at the surgical site during trauma surgery in the daily work process was carried out. This was also necessary because, as experience shows, with changes in surgical techniques, there are also changes in the use of radiological procedures, and thus an up-to-date inventory can provide valuable information for the assessment of occupationally induced radiation exposure of surgical personnel under the current conditions. Methods: The eye lens radiation exposure was measured over three months for five trauma surgeons, four hand surgeons and four surgical assistants with personalized LPS-TLD-TD 07 partial body dosimeters Hp (0.07). A reference dosimeter was deposited at the surgery changing room. The dosimeters were sent to the LPS (Landesanstalt für Personendosimetrie und Strahlenschutzausbildung) measuring institute (National Institute for Personal Dosimetry and Radiation Protection Training, Berlin) for evaluation after 3 months. The duration of the operation, occupation (assistant, surgeon, etc.), type of surgery (procedure, diagnosis), designation of the X-ray unit, total duration of radiation exposure per operation and dose area product per operation were recorded. Results: Both the evaluation of the dosimeters by the trauma surgeons and the evaluation of the dosimeters by the hand surgeons and the surgical assistants revealed no significant radiation exposure of the eye lens in comparison to the respective measured reference dosimeters. Conclusions: Despite the drastic reduction of the eye lens dose limit from 150 mSv per year to 20 mSv per year, the limit for orthopedic, trauma and hand surgery operations is well below the limit in this setting.

Assessment of radiation protection and awareness level among radiation workers and members of the public in Afghanistan—a pilot study

In this study, the level of radiation protection and awareness among radiation workers and members of the public in Afghanistan is assessed using two different survey mechanisms. The onsite survey conducted by the regulatory authorities covered 472 facilities while the online survey covering 1200 responses was conducted via the Survey Monkey online survey platform. Both the onsite and the online surveys show that more than 70% of radiation workers have insufficient knowledge of radiation safety and protection rules and regulations while more than 70% of the public just heard about radiation from one source or another. More than 50% of those members of the public, who have been through some sort of medical imaging using radiation were not given any instruction about the radiation hazards. The study is concluded with recommendations to the authorities for raising the knowledge of the radiation workers and general public awareness through launching regular radiation safety and protection training, TV spots and other means of mass media.

Use of fluoroscopy in endoscopy: indications, uses, and safety considerations

Historically, fluoroscopy was a tool of the radiologist. Interventional cardiologists and vascular surgeons have revolutionized their respective fields by adopting and adapting its use to their respective practice. The expansion of fluoroscopic utilization has also flourished within the field of endoscopy. While the indications for fluoroscopy during endoscopic procedures continue to expand, formal training in radiation exposure and protection is still not widely emphasized during advanced endoscopy training. This article presents current indications and uses of fluoroscopy in endoscopy along with a review of radiation exposure and safety tips for the endoscopist.

Current status of radiological protection in endourological procedures in Spain

ObjectiveTo know the degree of training in radiation protection (RP) of the Spanish urologists who perform endourological techniques, as well as to analyse the use of control and protection measures against ionizing radiation. Material and MethodsSurvey carried out, using the Multicentre Studies Platform (PIEM), among the 1,894 associates of the Spanish Association of Urology between April and October 2015. The questionnaire consisted of 21 questions that asked about the endourological activity performed, the degree of training in RP and the use of protective measures and personal dosimeters. A 17% of respondents was obtained, with 238 surveys finally being valid for analysis. Results63% of the respondents did not have any specific RP training, 25% had the first level accreditation and only 12% the second level one. A 57%, 27% and 2% of the urologists used chest, wrist and eye-lens dosimeter badges, respectively. The use of radiation protection measures proved to be insufficient. 53% of urologists at a higher risk of exposure had no RP training, 30% did not wear chest badges, and 40% did not use lead aprons or thyroid shields during endourological procedures. ConclusionRP training, dose control and the use of measures to protect against ionizing radiation is insufficient, even in those professionals most exposed to radiation. It is essential to correct these serious deficiencies in RP, working at an individual level, urology services, scientific societies and health authorities.

Young professionals in radiation protection: challenges and perspectives – Outcomes of an international survey

The Young Club of the French Society for Radiation Protection (SFRP), supported by the Rising Generations Group of the United Kingdom Society for Radiation Protection (SRP), teamed up to develop a survey targeted at the young professionals in radiation protection. Data about the background and training, current job and position was collected and provides an overview of the demographic of this group of professionals. The survey was also designed as a place where young people can express their views and opinions about initiatives set up by the employer and the national radiation protection society, and area they would like these organisations to develop further. Several key themes emerged from the answers of the respondents: notably, a high wish for more training in radiation protection – under different arrangements, ways to foster and secure future young professionals and a desire and mechanism for encouraging collaboration and networking between young professionals. Besides the statistical data, the messages from the survey will help to assess the effectiveness of initiatives in place, identify new ones and encourage future initiatives to foster and secure the young professionals in radiation protection.

Evaluation of radiation protection principles observance in radiology departments of Semnan University of medical sciences

Introduction: Most of people are exposed to ionizing radiation sources during their lifetime including background, cosmic or man-made beams like radiation used in nuclear medicine and radiology. Due to unavoidable use of ionizing radiation in diagnosis and treatment of diseases, designing and correct implementation of radiation protection principles in order to reducing its harmful effects for radiation workers, patients and patient's companions is necessary. Therefore the aim of this study is to assess the staff's observance level of radiation protection principles in radiology departments. Materials and MethodsIn this study, in order to evaluate the level of personnel awareness about the radiation protection principles and their observance as well as the protective equipment utility, a reliable and valid researcher-made checklist designed according to the radiation protection standards that have recommended by Atomic Energy Organization of Iran (AEOI) and then completed by personnel of radiology centers of semnan university of medical sciences. Acquired data were analyzed by SPSS software . Results: Based on the results, the awareness of personnel about protection standards was in the favorable level. The observance of the protection principles by the radiation workers of these centers was in accordance with recommended standards, the staff utilization level of radiation protection equipment is not acceptable. Generally the highest level of observance of protection measures was related to staff's protection and the lowest was for patient's companions Conclusion; The results show that the observance level of protective principles in the studied departments has been acceptable. However, radiation protection training courses with emphasis on the use of radiation protection devices are recommended to raise awareness of personnel, observance level of protection principles and ultimately, to meet AEOI standards

RADIATION PROTECTION LITERACY AND ITS ASSOCIATED FACTORS AMONG HEALTHCARE WORKERS IN NEGERI SEMBILAN

Background: Ionizing radiation can be an occupational hazard that need protection when in the form of particle which can produce biological changes to cells, tissues or organs. About 19.7% of worldwide average radiation dose is due to the medical use of radiation. In Malaysia, about 700,000 X-ray examinations were performed in 2014. The objective of this study is to assess the level and predictors for radiation protection literacy among healthcare workers in Negeri Sembilan. Materials and Methods: A cross-sectional study was conducted in health facilities in Negeri Sembilan from April 2018 to June 2018 among 151 healthcare workers. Respondents were selected based on their workplace using proportionate stratified random sampling method and data was obtained using validated self-administered questionnaire that focused on knowledge, attitude and practices on radiation protection. Data were analyzed using IBM SPSS version 23.0. Result: 52.3% of respondents had high knowledge, 80.8% had positive attitude and 56.3 % had good practice on radiation protection. Significant predictors for high knowledge were the use of radiation hazard monitoring device and being a radiation worker meanwhile for positive attitude was received medical surveillance. Significant predictors for good practice were the use of radiation hazard monitoring, being a radiation worker, being a health professional and being a health associate professional. Conclusion: Attitude on radiation protection among healthcare workers in Negeri Sembilan was still positive despite knowledge and practice was marginal. Future radiation protection awareness programme, education and training should be strengthen in order to improve radiation protection literacy among healthcare worker in Negeri Sembilan. Keywords: radiation protection literacy, healthcare worker, knowledge, attitude, practice,

OA224] Occupational radiation doses during interventional radiology residents training

This study aimed to evaluate and quantify differences in radiation doses to staff due to the participation of residents during interventional radiology procedures. The study presents dosimetric results for medical staff (experienced radiologist and residents) based on sixty six hepatic chemoembolization procedures conducted in five hemodynamic departments in Recife, Brazil. During each procedure, patient’s data (mass and height) and dosimetric parameters such as the air kerma-area product (KAP) and fluoroscopic time were registered. Occupational dosimetry was performed using thermoluminescent dosimeters and direct ion dosemeters (DIS) distributed over various regions of the physician’s body. The results showed that the mean accumulated KAP for procedure with residents was 16% greater than without (247.5 Gy*cm2 vs. 208.6 Gy*cm2). The Mean personal dose equivalent Hp(3) in the left eye and the effective dose for residents were 34% (491,3 μSv vs. 325.2 μSv) and 28% (23.4 μSv vs. 17.2 μSv) respectively higher than those received by the experienced radiologist. The results of the occupational dosimetry using DIS dosemeters showed that these devices can be used in a complementary way to estimate the occupational eye lens doses in interventional procedures. High variability of radiation doses to medical staff was observed among the five medical institutions, mainly because of the performance of X-ray equipments, complexity of the procedures, physical characteristics of the patients, and the resident’s lack of training in radiation protection.

I183] Guidelines for medical physics staffing requirements in diagnistic imaging and radionuclide therapy

Purpose Over the last decades, the rapid technological development of diagnostic and interventional radiology and nuclear medicine has made them major tools of modern medicine. However, at the same time, the involved risks, the growing number of procedures and the increasing complexity of the procedures require competent professional staff to ensure safe and effective patient diagnosis, treatment and management. Medical physicists have been recognized as vital health professionals with important and clear responsibilities related to quality and safety of applications of ionizing radiation in medicine. The aim of the IAEA Human Health Reports No. 15 is to provide guidance on appropriate staffing levels to support medical physics services in medical imaging and radionuclide therapy. Methods The roles and responsibilities of the medical physicist defined in international guidelines are the basis for different elements of the IAEA staffing algorithm. The components of the algorithm include input variables and weighting factors, with the output being the number of medical physicists (FTE) needed to deliver the service. To ensure the general applicability of the algorithm, a survey has been used to test it and obtain feedback from medical physicists throughout the world, representing different regions and different country health care levels. Results The IAEA staffing algorithm calculates the total number of medical physicists required by considering factor which are equipment dependent, patient dependent, radiation protection related, service related, training related and academic teaching and research related. This approach allows the needed flexibility to give appropriate staffing levels over a wide range of facility sizes and local conditions. Advantages of medical physics departments in terms of efficiencies gained are also explained and quantified. Conclusions The IAEA Human Health Reports No. 15 (endorsed by IOMP) contains a comprehensive method for the estimation of the number of medical physicists needed to ensure safe, effective and efficient diagnostic imaging and radionuclide treatment of patients. The algorithm described in this guidance document has been tested under a variety of field conditions. An accompanying spreadsheet is also available to facilitate calculations of the staffing needs following these recommendations.

OA117] Improvements and challenges in postgraduate radiation protection training for dental staff

Purpose Dental practitioners and other registered dental care professionals in the UK undergo regular update training on radiation protection matters as part of their CPD requirement. If assessments are not made as part of the update training session, it is difficult to demonstrate that real learning has taken place. It is also difficult to know whether there are areas of the training that prove difficult for participants to understand. The purpose of the study is to see whether this situation can be improved by the use of both pre-and post- training session testing. Methods Training sessions for dental practitioners and other registered dental care professionals were provided by the author as a series of 5, 1-h lectures designed to cover a defined syllabus. Prior to the start of the training session, participants completed a short 10-question multiple-choice questionnaire (MCQ). At the end of the session, participants then completed a longer 30-question MCQ. The questions on the pre-session test were a sub-set of the post-session test. Many questions on both tests were designed to have more than one correct answer, and participants were informed of this beforehand, both on the test sheets and by verbal reminder. No fixed time limit was given for the completion of the questionnaires. The pre- and post-training session MCQs have been used at eight training sessions with a total of approximately two hundred participants. Results > 85% of participants demonstrated an increase in their percentage test scores, with a mean increase in percentage score of 18%. Differences between pre- and post- course test scores were significant at p 0.01, assessed using the Wilcoxon Rank-sum test. Individual question scores were also analysed and demonstrated that certain questions generated more incorrect answers than others. Conclusions The use of both pre- and post-course testing for dental radiation training courses can demonstrate that learning has been effective. The analysis of individual question scores can shine a light on those areas where learning has not been as effective and thus help with the delivery of future courses.

Radiation dose during endovascular aneurysm repair (EVAR): upgrade of an angiographic system from standard to Eco mode.

To evaluate the radiation dose reduction during endovascular aneurysm repair (EVAR) after the reconfiguration of a Philips AlluraXper FD20 X-ray system. Between 2013 and 2015, we implemented a low-dose protocol (Eco dose) increasing the filtration with 1mm of Al and 0.1 of Cu on both fluoroscopy and fluorography and halving the frames per second in fluoroscopy. The switch was complemented by hybrid operating room staff education and training in radiation protection. We compared two samples of 50 patients treated before the switch (normal dose) with 50 patients treated after the switch (Eco dose). Procedures were categorized into two different grades of complexity, standard and complex, intended as fenestrated/chimney/snorkel and EVAR plus additional embolization to prevent endoleak type II. We evaluated patient demographics, Air Kerma (AK), dose area product (DAP), and procedural data (fluoroscopy time, number of fluorographies, and iodinated contrast). Staff radiation dose was measured with film badge dosimeter on C-arm. The Eco-dose protocol witnessed a DAP reduction of 53% in standard EVARs and of 57% in complex EVARs and an AK reduction of 45% in standard and 57% in complex EVAR. The image quality in 2016 was perceived acceptable, as proven by the fact that fluoroscopy time, number of fluorographies, and contrast medium volumes did not have to be increased. We achieved a reduction in staff dose of 25.6%. Optimized angiographic system setting significantly reduced the radiation dose both to the patients and to the staff assuring safe EVAR procedures.

Radiation Protection for Interventional Fluoroscopy: Results of a Survey Among Dutch Hospitals.

A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients.