Skip to main content

Challenges in Occupational Dosimetry for Interventional Radiologists

Abstract

This review presents the challenges met by interventional radiologists in occupational dosimetry. The issues mentioned are derived from the recommendations of the International Commission on Radiological Protection, the CIRSE guidelines on “Occupational radiation protection in interventional radiology" and the requirements of the European directive on Basic Safety Standards. The criteria for a proper use of personal dosimeters and the need to introduce optimization actions in some cases are set out in this review. The pros and cons of the electronic real-time dosimeters are outlined and the potential pitfalls associated with the use of personal dosimeters summarized. The electronic dosimeters, together with the appropriate software, allow an active optimization of the interventional procedures.

This is a preview of subscription content, access via your institution.

Fig. 1.

References

  1. UNSCEAR. Sources and Effects of Ionizing Radiation. UNSCEAR 2000 Report to the general assembly, with scientific annexes. Vol I, Annex E (Occupational Radiation Exposures). https://www.unscear.org/docs/publications/2000/UNSCEAR_2000_Annex-E-CORR.pdf (accessed 11 July 2020).

  2. ICRP Publication 139. Occupational radiological protection in interventional procedures ICRP Publication 139. Ann ICRP. 2018;47(2):1–112.

    Article  Google Scholar 

  3. ICRP Publication 85. Avoidance of radiation injuries from medical interventional procedures. Ann ICRP. 2000;30(2):7–67.

    Article  Google Scholar 

  4. Miller DL, Vano E, Bartal G, et al. 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(2):230–9. https://doi.org/10.1007/s00270-009-9756-7.

    Article  PubMed  Google Scholar 

  5. ICRP publication 118. ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs - Threshold doses for tissue reactions in a radiation protection context. Ann ICRP. 2012;41:1–322.

    Google Scholar 

  6. European Council Directive 2013/59/EURATOM on basic safety standards for protection against the dangers arising from exposure to ionising radiation (2014). Off J Eur Union L13;57:1-73 Available at https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2014:013:0001:0073:EN:PDF (accessed 5 Nov 2020).

  7. Ciraj-Bjelac O, Rehani M, Minamoto A, Sim KH, Liew HB, Vano E. Radiation-induced eye lens changes and risk for cataract in interventional cardiology. Cardiology. 2012;123(3):168–71. https://doi.org/10.1159/000342458.

    Article  CAS  PubMed  Google Scholar 

  8. Vano E, Kleiman NJ, Duran A, Romano-Miller M, Rehani MM. Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. J Vasc Interv Radiol. 2013;24(2):197–204. https://doi.org/10.1016/j.jvir.2012.10.016.

    Article  PubMed  Google Scholar 

  9. Domienik J, Brodecki M, Carinou E, et al. Extremity and eye lens doses in interventional radiology and cardiology procedures: first results of the ORAMED project. Radiat Prot Dosim. 2011;144(1–4):442–7. https://doi.org/10.1093/rpd/ncq508.

    Article  CAS  Google Scholar 

  10. Farah J, Struelens L, Auvinen A, et al. Application of the ELDO approach to assess cumulative eye lens doses for interventional cardiologists. Radiat Prot Dosim. 2015;164(1–2):84–8. https://doi.org/10.1093/rpd/ncu315.

    Article  CAS  Google Scholar 

  11. Domienik-Andrzejewska J, Ciraj-Bjelac O, Askounis P, et al. Past and present work practices of European interventional cardiologists in the context of radiation protection of the eye lens-results of the EURALOC study. J Radiol Prot. 2018;38(3):934–50. https://doi.org/10.1088/1361-6498/aac64b.

    Article  PubMed  Google Scholar 

  12. Martin CJ. A review of radiology staff doses and dose monitoring requirements. Radiat Prot Dosim. 2009;136(3):140–57.

    Article  CAS  Google Scholar 

  13. Principi S, Ginjaume M, Duch MA, et al. Influence of dosemeter position for the assessment of eye lens dose during interventional cardiology. Radiat Prot Dosim. 2015;164(1–2):79–83.

    Article  Google Scholar 

  14. Vano E, Sanchez RM, Fernandez JM. Strategies to optimise occupational radiation protection in interventional cardiology using simultaneous registration of patient and staff doses. J Radiol Prot. 2018;38(3):1077–88. https://doi.org/10.1088/1361-6498/aad429.

    Article  PubMed  Google Scholar 

  15. Sailer AM, Vergoossen L, Paulis L, van Zwam WH, Das M, Wildberger JE, Jeukens CRLPN. Personalized feedback on staff dose in fluoroscopy-guided interventions: a new era in radiation dose monitoring. Cardiovasc Intervent Radiol. 2017;40(11):1756–62.

    Article  Google Scholar 

  16. Sailer AM, Paulis L, Vergoossen L, Kovac AO, Wijnhoven G, Schurink GW, Mees B, Das M, Wildberger JE, de Haan MW, Jeukens CR. Real-time patient and staff radiation dose monitoring in IR practice. Cardiovasc Intervent Radiol. 2017;40(3):421–9.

    Article  Google Scholar 

  17. Baumann F, Katzen BT, Carelsen B, Diehm N, Benenati JF, Peña CS. The effect of realtime monitoring on dose exposure to staff within an interventional radiology setting. Cardiovasc Intervent Radiol. 2015;38(5):1105–11.

    Article  Google Scholar 

  18. NCRP. Radiation dose management for fluoroscopically guided interventional medical procedures. NCRP Report No. 168. National council on radiation protection and measurements. Maryland: Bethesda; 2010.

    Google Scholar 

  19. Koenig AM, Etzel R, Greger W, Viniol S, Fiebich M, Thomas RP, Mahnken AH. Protective efficacy of different ocular radiation protection devices: a phantom study. Cardiovasc Intervent Radiol. 2020;43(1):127–34.

    Article  CAS  Google Scholar 

  20. ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Ann ICRP. 2009;39(5):1–68.

    Article  Google Scholar 

  21. Vano E, Sanchez RM, Fernández JM. Helping to know if you are properly protected while working in interventional cardiology. J Radiol Prot. 2020. https://doi.org/10.1088/1361-6498/abc325.

    Article  PubMed  Google Scholar 

  22. Bartal G, Vano E, Paulo G, Miller DL. Management of patient and staff radiation dose in interventional radiology: current concepts. Cardiovasc Intervent Radiol. 2014;37(2):289–98.

    Article  Google Scholar 

  23. Sanchez R, Vano E, Fernandez JM, Gallego JJ. Staff radiation doses in a real-time display inside the angiography room. Cardiovasc Intervent Radiol. 2010;33(6):1210–4.

    Article  Google Scholar 

  24. Jaschke W, Bartal G, Martin CJ, Vano E. Unintended and accidental exposures, significant dose events and trigger levels in interventional radiology. Cardiovasc Intervent Radiol. 2020;43(8):1114–21.

    Article  Google Scholar 

  25. Vano E, Frija G, Stiller W, et al. Harmonisation of imaging dosimetry in clinical practice: practical approaches and guidance from the ESR EuroSafe Imaging initiative. Insights Imaging. 2020;11(1):54.

    Article  Google Scholar 

Download references

Funding

This work has been partially founded by the Spanish Nuclear Safety Council (Project EDOCI) and the Spanish Ministry of Economy and Competitiveness (Carlos III Health Institute) and the European Regional Development Fund (ERDF) under the Project MEDICI Number PI16/01413.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Vano.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Consent for Publication

For this type of paper, consent for publication is not required. All the authors have approved the submitted manuscript.

Ethical Approval

Not necessary for this paper (review).

Informed Consent

For this type of study, consent for publication is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vano, E., Sanchez Casanueva, R., Fernandez Soto, J.M. et al. Challenges in Occupational Dosimetry for Interventional Radiologists. Cardiovasc Intervent Radiol 44, 866–870 (2021). https://doi.org/10.1007/s00270-020-02725-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-020-02725-w

Keywords

  • Occupational radiation protection
  • Personal dosimetry
  • Real-time electronic dosimetry
  • Interventional radiology