Techniques in Vascular & Interventional Radiology
Volume 13, Issue 3 , Pages 188-193 , September 2010

Measuring and Monitoring Radiation Dose During Fluoroscopically Guided Procedures

  • John W. Jaco, MD, CPT, MC, USAR

      Affiliations

    • Department of Radiology, National Capital Consortium, Washington, DC/Bethesda, MD
    • ,
  • Donald L. Miller, MD

      Affiliations

    • Department of Radiology, National Naval Medical Center, Bethesda, MD
    • Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, MD
    • Corresponding Author InformationAddress reprint requests to Donald L. Miller, MD, Department of Radiology, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600

References 

  1. Hall EJ. Radiation biology for pediatric radiologists. Pediatr Radiol. 2009;39(suppl 1):S57–S64
  2. Little MP. Risks associated with ionizing radiation. Br Med Bull. 2003;68:259–275
  3. Stecker MS, Balter S, Towbin RB, et al. Guidelines for patient radiation dose management. J Vasc Interv Radiol. 2009;20:S263–S273
  4. Koenig TR, Wolff D, Mettler FA, et al. Skin injuries from fluoroscopically guided procedures (Part 1, Characteristics of radiation injury). AJR Am J Roentgenol. 2001;177:3–11
  5. Balter S, Hopewell JW, Miller DL, et al. Fluoroscopically guided interventional procedures: A review of radiation effects on patients' skin and hair. Radiology. 2010;(in press)
  6. Monaco JL, Bowen K, Tadros PN, et al. Iatrogenic deep musculocutaneous radiation injury following percutaneous coronary intervention. J Invasive Cardiol. 2003;15:451–453
  7. Koenig TR, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures (Part 2, Review of 73 cases and recommendations for minimizing dose delivered to the patient). AJR Am J Roentgenol. 2001;177:13–20
  8. Padovani R, Bernardi G, Quai E, et al. Retrospective evaluation of occurrence of skin injuries in interventional cardiac procedures. Radiat Prot Dosim. 2005;117:247–250
  9. Fletcher DW, Miller DL, Balter S, et al. Comparison of four techniques to estimate radiation dose to skin during angiographic and interventional radiology procedures. J Vasc Interv Radiol. 2002;13:391–397
  10. Miller DL, Balter S, Cole PE, et al. Radiation doses in interventional radiology procedures: The RAD-IR study (Part II. Skin dose). J Vasc Interv Radiol. 2003;14:977–990
  11. den Boer A, de Feijter PJ, Serruys PW, et al. Real-time quantification and display of skin radiation during coronary angiography and intervention. Circulation. 2001;104:1779–1784
  12. Miller DL, Balter S, Noonan PT, et al. Minimizing radiation-induced skin injury in interventional radiology procedures. Radiology. 2002;225:329–336
  13. International Electrotechnical Commission. Report 60601 Medical electrical equipment—Part 2-43: Particular requirements for the safety of X-ray equipment for interventional procedures. Geneva, Switzerland: IEC; 2000;
  14. Electronic products; performance standard for diagnostic X-ray systems and their major components; final rule. Fed Regist. 2005;70:111:33998–34042
  15. Miller DL, Balter S, Wagner LK, et al. Quality improvement guidelines for recording patient radiation dose in the medical record. J Vasc Interv Radiol. 2004;15:423–429
  16. Vano E, Järvinen H, Kosunen A, et al. Patient dose in interventional radiology: A European survey. Radiat Prot Dosim. 2008;129:39–45
  17. International Commission on Radiological Protection. The 2007 Recommendations of the International Commission on Radiological Protection (ICRP Publication 103). Ann ICRP. 2007;37:1–332
  18. International Commission on Radiological Protection. Radiation Protection in Medicine (ICRP Publication 105). Ann ICRP. 2007;37:1–63
  19. Food and Drug Administration. Public Health Advisory: Avoidance of Serious x-ray-Induced Skin Injuries to Patients During Fluoroscopically-Guided Procedures. Rockville, MD: Center for Devices and Radiological Health; 1994;
  20. Food and Drug Administration. Important Information for Physicians and Other Health Care Professionals: Avoidance of Serious X-ray Induced Skin Injuries to Patients During Fluoroscopically-Guided Procedures. Rockville, MD: Center for Devices and Radiological Health; 1994;
  21. American College of Radiology. ACR Technical Standard for Management of the Use of Radiation in Fluoroscopic Procedures: Practice Guidelines and Technical Standards 2008. In: Reston, VA: American, College of Radiology; 2008;p. 1143–1149
  22. Hirshfeld JW, Balter S, Brinker JA, et al. ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: A report of the American College of Cardiology foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. J Am Coll Cardiol. 2004;44:2259–2282
  23. International Commission on Radiological Protection. Avoidance of Radiation Injuries from Medical Interventional Procedures (ICRP Publication 85). Ann ICRP. 2000;30:7–67
  24. National Cancer Institute. Interventional fluoroscopy: Reducing radiation risks for patients and staff (NIH Publication No. 05-5286). Bethesda, MD: National Cancer Institute; 2005;
  25. Miller DL. Overview of contemporary interventional fluoroscopy procedures. Health Phys. 2008;95:638–644

 Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Army, Navy, Department of Defense, or the US Government.

PII: S1089-2516(10)00018-1

doi: 10.1053/j.tvir.2010.03.009

Techniques in Vascular & Interventional Radiology
Volume 13, Issue 3 , Pages 188-193 , September 2010

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