Radioprotection In 2018: An Update

Vincenzo D Palumbo, Antonio Bruno, Benedetto Di Trapani, Simone Tomasini, Antonello Basile, Giovanni Tomasello

Abstract

Fluoroscopically-guided interventional procedures are performed in large numbers in Europe and in the United States. Radiation doses received by interventional radiologists can vary for the same type of procedure and for similar patient doses. Occupational radiation protection is a necessity whenever radiation is used in the practice of medicine. The International Commission on Radiological Protection is engaging against occupational radiation damages, publishing regular recommendations on dose limits. These limits are expressed as effective doses for the whole body and also as equivalent doses for particular regions or tissues of practitioners’ bodies. Shielding and personal protective clothes are the most common tools for radiation protection employed up to now. Radiation protection is a dynamic field. It has undergone a significant evolutionary period during the past few decades and general improvement of protection techniques and technology is expected to continue. Further progress in the application of protection principles and concepts will contribute to balanced protection.

References

1. Miller DL. Overview of contemporary interventional fluoroscopy procedures. Health Phys 2008;95:638-644.
2. Vañó E, Gonzalez L, Fernández JM, Haskal ZJ. Eye lens exposure to radiation in interventional suites: caution is warranted. Radiology 2008;248:945-953.
3. Stecker MS, Balter S, Towbin RB, Miller DL, Vañó E, Bartal G, Angle JF, Chao CP, Cohen AM, Dixon RG, Gross K, Hartnell GG, Schueler B, Statler JD, de Baère T, Cardella JF; SIR Safety and Health Committee; CIRSE Standards of Practice Committee. Guidelines for patient radiation dose management. J Vasc Interv Radiol 2009;20:S263-S273.
4. Kim KP, Miller DL, Balter S, Kleinerman RA, Linet MS, Kwon D, Simon SL. Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys 2008;94:211-227.
5. Kleiman NJ. Radiation cataract. In: Working party on research implications on health and safety standards of the article 31 group of experts. Radiation Protection 145 EU Scientific Seminar 2006. New insights in radiation risk and basic safety standards. European Commission, Brussels, 2007; pp 81-95.
6. Worgul BV, Kundiyev YI, Sergiyenko NM, Chumak VV, Vitte PM, Medvedovsky C, Bakhanova EV, Junk AK, Kyrychenko OY, Musijachenko NV, Shylo SA, Vitte OP, Xu S, Xue X, Shore RE. Cataracts among Chernobyl clean-up workers: implications regarding permissible eye exposures. Radiat Res 2007;167:233-243.
7. Nakashima E, Neriishi K, Minamoto A. A reanalysis of atomic-bomb cataract data, 2000–2002: a threshold analysis. Health Phys 2006;90:154-160.
8. Neriishi K, Nakashima E, Minamoto A, Fujiwara S, Akahoshi M, Mishima HK, Kitaoka T, Shore RE. Postoperative cataract cases among atomic bomb survivors: radiation dose response and threshold. Radiat Res 2007;168:404-408.
9. World Health Organization (2000). Efficacy and radiation safety in interventional radiology. Geneva.
10. Valentin J. Avoidance of radiation injuries from medical interventional procedures. Ann ICRP 2000;30:7-67.
11. Vañó E, González L, Guibelalde E, Fernández JM, Ten JI. Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 1998;71:954-960.
12. Stoeckelhuber BM, Leibecke T, Schulz E, Melchert UH, Bergmann-Koester CU, Helmberger T, Gellissen J. Radiation dose to the radiologist’s hand during continuous CT fluoroscopy-guided interventions. Cardiovasc Interv Radiol 2005;28:589-594.
13. Hohl C, Suess C, Wildberger JE, Honnef D, Das M, Mühlenbruch G, Schaller A, Günther RW, Mahnken AH. Dose reduction during CT fluoroscopy: phantom study of angular beam modulation. Radiology 2008;246:519-525.
14. European Commission. Directorate-General for the Environment, European Commission (2000). Radiation protection 116. Guidelines on education and training in radiation protection for medical exposures. Luxembourg.
15. The 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP 2007;37:1-332.
16. National Council on Radiation Protection and Measurements (1995). Use of personal monitors to estimate effective dose equivalent and effective dose to workers for external exposure to low-LET radiation. NCRP Report No. 122. Bethesda.
17. Balter S. Radiation safety in the cardiac catheterization laboratory: basic principles. Catheter Cardiovasc Interv 1999;47:229-236.
18. Balter S, Sones FM Jr, Brancato R. Radiation exposure to the operator performing cardiac angiography with U-arm systems. Circulation 1978;58:925-932.
19. Geijer H. Radiation dose and image quality in diagnostic radiology. Optimization of the dose-image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector. Acta Radiol Suppl 2002;43:1-43.
20. Crane GD, Abbott PV. Radiation shielding in dentistry: an update. Aust Dent J 2016;61:277-281.
21. Kim KP, Miller DL, Berrington de Gonzalez A, Balter S, Kleinerman RA, Ostroumova E, Simon SL, Linet MS. Occupational radiation doses to operators performing fluoroscopically-guided procedures. Health Phys 2012;103:80-99.
22. Whitby M, Martin CJ. A study of the distribution of dose across the hands of interventional radiologists and cardiologists. Br J Radiol 2005;78:219-229.
23. Comissão Nacional de Energia Nuclear – CNEN (2011). CNEN-NN-3.01: diretrizes básicas de proteção radiológica. Brasilia.
24. Miller DL, Vañó E, Bartal G, Balter S, Dixon R, Padovani R, Schueler B, Cardella JF, de Baère T. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovasc Intervent Radiol 2010;33:230-239.
25. Le Heron J, Padovani R, Smith I, Czarwinski R. Radiation protection of medical staff. Eur J Radiol 2010;76:20-23.
26. Maeder M, Brunner-La Rocca HP, Wolber T, Ammann P, Roelli H, Rohner F, Rickli H. Impact of a lead glass screen on scatter radiation to eyes and hands in interventional cardiologists. Cath Cardiovasc Interv 2006;67:18-23.
27. Thornton RH, Altamirano J, Dauer L. Comparing strategies for IR eye protection. J Vasc Interv Radiol 2009;20:S52-S53.
28. King JN, Champlin AM, Kelsey CA, Tripp DA. Using a sterile disposable protective surgical drape for reduction of radiation exposure to interventionalists. Am J Roentgenol 2002;178:153-157.
29. Wagner LK, Mulhern OR. Radiation-attenuating surgical gloves: effects of scatter and secondary electron production. Radiology 1996;200:45-48.
30. Zeinali-Rafsanjani B, Rasekhi A, Saeedi-Moghadam M, Zarei F, Jalli R, Sefidbakht S, Pishdad P. A useful gadget to reduce the radiation dose of interventionist’s hands. Health physics 2017;112:494-497.