Abstract
Dose optimization in fluoroscopy and angiography can be seen as a difficult task to accomplish because it involves many operator and device-dependent variables. A balance is required between achieving the goal of the fluoroscopic procedure, minimizing the dose, and providing adequate diagnostic image quality. In any fluoroscopic and angiographic diagnostic/interventional procedure, patient dose largely parallels the operator exposure time. Optimization protocols are important to reduce the radiation exposure of the patient and operator.
Keywords: Optimization, radiation, dose
References
Loose R, Wucherer M. How to measure/calculate radiation dose in patients?Cardiovasc Intervent Radiol. 2021; 44: 835-41.
Fisher RF, Applegate KE, Berkowitz LK, Christianson O, Dave JK, DeWeese L, et al AAPM Medical Physics Practice guideline12.a: fluoroscopy dose management.J Appl Clin Med Phys. 2022; 23: e13526.
Leibovic SJ, Caldicott WJ. Gastrointestinal fluoroscopy: patient dose and methods for its reduction.Br J Radiol. 1983; 56: 715-9.
McParland BJ. Entrance skin dose estimate derived from dose-area product measurements in interventional radiological proceduresBr J Radiol. 1998; 71: 1288-95.
McParland BJ. A study of patient radiation doses in interventional radiological procedures.Br J Radiol.1998; 71: 175-85.
O’Dea TJ, Geise RA, Ritenour ER. The potential for radiation-induced skin damage in interventional neuroradiological procedures: a review of 522 cases using automated dosimetry.Med Phys. 1999; 26: 2027-33.
Rosenthal LS, Mahesh M, Beck TJ, Saul JP, Miller JM, Kay N, et al. Predictors of fluoroscopy time and estimated radiation exposure during radiofrequency catheter ablation procedures: a multicenter experience.Am J Cardiol. 1998; 82: 451-8.
Mahesh M. Fluoroscopy: patient radiation exposure issues.Radiographics. 2001; 21: 1033-45.
Ruiz-Cruces R, Pérez-Martínez M, Martín-Palanca A, Flores A, Cristófol J, Martínez-Morillo M, et al. Patient dose in radiologically guided interventional vascular procedures conventional versus digital systems.Radiology. 1997; 205: 385-93.
Shrimpton PC, Wall BF, Jones DG, Fisher ES. The measurement of energy imparted to patients during diagnostic x-ray examinations using the Diamentor exposure-area product meter.Phys Med Biol. 1984; 29: 1199-208.
Le Heron JC. Estimation of effective dose to the patient during medical X-ray examinations from measurements of the dose-area product.Phys Med Biol. 1992; 37: 2117-26.
Strauss KJ. Clinica radiation dose monitoring. In: Batler S, Shope TR, editors. Syllabus: a categorical course in physics - physical and technical aspects of angiography and interventional radiology Oak book III: Radiologic Society of North America 1995: 171-87.
Geise RA, O’Dea TJ. Radiation dose in interventional fluoroscopic procedures.Appl Radiat Isot. 1999; 50: 173-84.
Wagner LK, Eifel PJ, Geise RA. Potential biological effects following high X-ray dose interventional procedures.J Vasc Interv Radiol. 1994; 5: 71-84.
Padovani R, Bernardi G, Quai E, Signor M, Toh HS, Morocutti G, et al. Retrospective evaluation of occurrence of skin injuries in interventional cardiac procedures.Radiat Prot Dosimetry. 2005; 117: 247-50.
Lee WJ, Bang YJ, Cha ES et al Lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments.Int Arch Occup Environ Health. 2021; 94: 139-45.
ACR-AAPM technical standard for management of the use of radiation in fluoroscopic procedures. 2023.
Nicholson R, Tuffee F, Uthappa MC. Skin sparing in interventional radiology: the effect of copper filtration.Br J Radiol. 2000; 73: 36-42.
International Atomic Energy Agency (IAEA). Last Accessed Date: 20.02.2025
Miller DL, Balter S, Dixon RG, Nikolic B, Bartal G, Cardella JF, et al. Quality improvement guidelines for recording patient radiation dose in the medical record for fluoroscopically guided procedures.J Vasc Interv Radiol.2012; 23: 11-8.
Garg T, Shrigiriwar A. Radiation protection in interventional radiology.Indian J Radiol Imaging. 2021; 31: 939-45.
Jasieniak J, Kuchcińska A, Podgórska J, Cieszanowski A. Summary of radiation dose management and optimization: comparison of radiation protection measures between Poland and other countries.Pol J Radiol. 2023; 88: 12-21.
