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

The primary goal of radiation management in interventional radiology is to minimize the unnecessary use of radiation. Skilled radiation management minimizes radiation risk to the patient without increasing other risks, such as procedural risks. The increasing complexity and widespread use of interventional fluoroscopy has led to increasing patient doses and concern over staff doses. Time has come to change the paradigm from the traditional radiation protection attitude to proactive dose and image quality management. Dose management principles apply not only to patients, but also to staff. The International Commission on Radiological Protection (ICRP) and the new European directive on Basic Safety includes staff radiological risk as part of the justification and optimization of medical exposures. The justification of imaging in IR is primarily concerned with image-guided interventional procedures, rather than purely diagnostic imaging. Comprehensive Radiation protection (RP) programs as part of the quality assurance became essential and interventional radiologists have to take a lead. Efficient use of different imaging modalities (fluoroscopy, DSA, cone-beam CT, etc.) requires the knowledge, skills and competences about the impact on patient and staff doses. The new established annual limit exposure to eye lens requires specific measures to avoid cataracts in operators. Medical doctors, radiographers and medical physicists play an essential role in the safe use of fluoroscopy in medical practice. Advices on RP programs for patients and personnel including aspects of education and training will be presented.