Evolving operator practices reduced patient radiation dose in interventional cardiology: Trends in a single center.

Background: This retrospective study addresses the role of operator and fluoroscopy equipment in reducing patient radiation exposure in the Cath lab.

Methods: Data from 99,400 procedures performed in our institution between 2007 and 2019 were reviewed. Dosimetric parameters included reference point air kerma (K), Kerma Area Product (P), fluoroscopic time, and contrast volume.

NCRP commentary no. 33-recommendations for stratification of equipment use and radiation safety training for fluoroscopy.

National Council on Radiation Protection and Measurements Commentary No. 33 'Recommendations for Stratification of Equipment Use and Radiation Safety Training for Fluoroscopy' defines an evidence-based, radiation risk classification for fluoroscopically guided procedures (FGPs), provides radiation-related recommendations for the types of fluoroscopes suitable for each class of procedure, and indicates the extent and content of training that ought to be provided to different categories of facility staff who might enter a room where fluoroscopy is or may be performed. For FGP, radiation risk is defined by the type and likelihood of radiation hazards that could be incurred by a patient undergoing a FGP.

Cause-Specific Mortality in Patients With Advanced Chronic Kidney Disease in the ISCHEMIA-CKD Trial.

Background: In ISCHEMIA-CKD, 777 patients with advanced chronic kidney disease and chronic coronary disease had similar all-cause mortality with either an initial invasive or conservative strategy (27.2% vs 27.8%, respectively).

AAPM Task Group Report 272: Comprehensive acceptance testing and evaluation of fluoroscopy imaging systems.

Modern fluoroscopes used for image guidance have become quite complex. Adding to this complexity are the many regulatory and accreditation requirements that must be fulfilled during acceptance testing of a new unit. Further, some of these acceptance tests have pass/fail criteria, whereas others do not, making acceptance testing a subjective and time-consuming task.

Collar Badge Lens Dose Equivalent Values among United States Physicians Performing Fluoroscopically Guided Interventional Procedures.

Purpose: To describe the range of occupational badge dose readings and annualized dose records among physicians performing fluoroscopically guided interventional (FGI) procedures using job title information provided by the same 3 major medical institutions in 2009, 2012, and 2015.

Materials And Methods: The Radiation Safety Office of selected hospitals was contacted to request assistance with identifying physicians in a large commercial dosimetry database. All entries judged to be uninformative of occupational doses to FGI procedure staff were excluded.

Microbial Contamination Risk and Disinfection of Radiation Protective Garments.

Healthcare-associated infections are a major public health concern for both patients and medical personnel. This has taken on greater urgency during the current COVID-19 pandemic. Radiation Personal Protective Equipment (RPPE) may contribute to risks of microbial contamination.

Preventing Harm From Fluoroscopically Guided Interventional Procedures With a Risk-Based Analysis Approach.

Purpose: Fluoroscopically guided interventional (FGI) procedures often have lower complication rates compared with alternative surgical procedures, providing an option for patients with a high risk of perioperative mortality. Although severe radiation injuries are rare, patients receiving peak skin doses exceeding 3 Gy can suffer from radiation-induced tissue injuries, ranging from transient erythema to nonhealing wounds. As these iatrogenic injuries may manifest weeks to months postprocedure, proper diagnosis and timely medical intervention are less likely.

Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study.

Objectives: To assess radiation exposure-related work history and risk of cataract and cataract surgery among radiologic technologists assisting with fluoroscopically guided interventional procedures (FGIP).

Methods: This retrospective study included 35 751 radiologic technologists who reported being cataract-free at baseline (1994-1998) and completed a follow-up questionnaire (2013-2014). Frequencies of assisting with 21 types of FGIP and use of radiation protection equipment during five time periods (before 1970, 1970-1979, 1980-1989, 1990-1999, 2000-2009) were derived from an additional self-administered questionnaire in 2013-2014.

Dosimetry for the study of medical radiation workers with a focus on the mean absorbed dose to the lung, brain and other organs.

Background: The reconstruction of lifetime radiation doses for medical workers presents special challenges not commonly encountered for the other worker cohorts comprising the Million Worker Study.

Methods: The selection of approximately 175,000 medical radiation workers relies on using estimates of lifetime and annual personal monitoring results collected since 1977. Approaches have been created to adjust the monitoring results so that mean organ absorbed doses can be estimated.

Caution: Predictors ahead.

Radiation dose data can be used as a starting point to establish local TAVR reference levels. Cancer risk is of concern but is very low in the context of TAVR patients. Improvements in clinical radiation management will reduce both patient and staff risk for all procedures.

Occupational health hazards in the interventional laboratory: Time for a safer environment.

Over the past 30 years, the advent of fluoroscopically guided interventional procedures has resulted in dramatic increments in both X-ray exposure and physical demands that predispose interventionists to distinct occupational health hazards. The hazards of accumulated radiation exposure have been known for years, but until recently the other potential risks have been ill-defined and under-appreciated. The physical stresses inherent in this career choice appear to be associated with a predilection to orthopedic injuries, attributable in great part to the cumulative adverse effects of bearing the weight and design of personal protective apparel worn to reduce radiation risk and to the poor ergonomic design of interventional suites.

Always on My Mind.

This article is focused on occupational radiogenic brain tumors and some radioprotective techniques used to manage this risk. Published case reports have stimulated concern among operators. The anatomical pattern of tumor locations is not consistent with measured radiation dose distributions at operators' heads.

Novel radiation dose reduction fluoroscopic technology facilitates chronic total occlusion percutaneous coronary interventions.

Aims: Radiation exposure and prolonged procedure time continue to limit the complexity of CTO-PCI procedures attempted. This study aimed to assess the impact of radiation dose-limiting equipment on radiation dosage and fluoroscopic time in chronic total occlusion (CTO) percutaneous coronary interventions (PCI).

Methods And Results: Retrospective clinical and dosimetric data from diagnostic catheterisations (DXC) and CTO-PCI procedures performed on one of three variants of interventional fluoroscopic equipment were collected.

A hybrid phantom system for patient skin and organ dosimetry in fluoroscopically guided interventions.

Purpose: The purpose of this study was to investigate calibrations for improved estimates of skin dose and to develop software for computing absorbed organ doses for fluoroscopically guided interventions (FGIs) with the use of radiation dose structured reports (RDSR) and the UF/NCI family of hybrid computational phantoms.

Methods And Materials: Institutional review board approval was obtained for this retrospective study in which ten RDSRs were selected for their high cumulative reference air kerma values. Skin doses were computed using the University of Florida's rapid in-clinic peak skin dose algorithm (or UF-RIPSA).

Report of IRPA task group on the impact of the eye lens dose limits.

In 2012 IRPA established a task group (TG) to identify key issues in the implementation of the revised eye lens dose limit. The TG reported its conclusions in 2013. In January 2015, IRPA asked the TG to review progress with the implementation of the recommendations from the early report and to collate current practitioner experience.