Radiation Protection in Interventional Radiology

Interventional procedures are used by a significant number of medical specialities. Radiation protection (RP) for patients and staff is one of the main issues in Interventional Radiology (IR). UNSCEAR, ICRP and IAEA have devoted significant time over the last years to improve radiation safety in IR. Several combined factors: prolonged localized fluoroscopy, multiple radiographic exposures, and repeated procedures can cause acute radiation injury to the skin. The values of dose-area product and effective dose for IR are typically larger than those used in common diagnostic x-ray examinations. The studies carried out among the Chernobyl survivors show that cataracts may appear after doses of less than 1 Gy and these are the doses interventionists are likely to receive after several years' work. ICRP recommends taking into account occupational risks to justify IR procedures. The diagnostic reference levels can also be a useful tool to optimize IR procedures. In this paper, we present some of the ICRP practical recommendations concerning training in RP, patient dose records, clinical follow-up when skin doses are estimated too high, the use of personal dosimeters, etc. We also include the actions of other international and national organizations as well as scientific societies on radiation safety in IR. We also discuss the influence on IR of the new radiation risk and tissue weighting factors proposed by the ICRP in 2007. We finally give some results on patient dose surveys and staff dose estimations in IR and conclude with a list of challenging topics for the years to come.