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Presenter: Prof. Hilde Bosmans
Date of broadcast: 6 September 2018, 3 pm CEST
The importance of radiation protection in the cathlab has long been stressed due to the potential for high exposures to both the patient and the medical personnel compared to other fields of radiology. Interventional radiologists and cardiologists experience the highest amount of radiation exposure of any medical professional. Studies show increased prevalence of left-sided brain tumors, cataract, thyroid disease, and more, for interventionalists. The collective effective dose to the population due to interventional procedures is approximately 10% even though they account for only 1% of the number of procedures, making interventional procedures a significant contributor to the stochastic risk of patients. Additionally, skin burn is a well-documented radiation induced (deterministic) effect of prolonged high exposures in the cathlab. Today, new tools are available to predict these tissue effects and/or start specific actions.
Because of these risks, understanding how to avoid or minimize their effects is an important responsibility of everyone involved in the medical process. The key basic principles in understanding radiation protection are: justification, optimization and dose limits. Doctors must assure the right test is done on the right patient for the right reason. Critically, is also knowing how to optimize the medical procedure in terms of dose to the patient and personnel. In order to ensure this, adequate training of the medical staff is of great importance. Several important practical tips will be discussed dealing with optimizing the three main dose reduction techniques: time, distance and shielding. However, radiation protection doesn’t stop after the training step. Implementing a quality assurance program will make sure that your facility consistently produces diagnostic images of sufficient high quality such that they provide adequate diagnostic information with the least possible exposure. We will also discuss the potential advantages of other system designs.
Understanding all parts of radiation protection will in the end not only benefit the patient, but all the medical staff as well.
1. Understand the radiation induced risks to the patient and medical staff in the cathlab
2. Understand skin dose mapping
3. Understand how to minimize radiation risks through optimizing: time, distance and shielding (the basic principles of radiation protection)
4. Appreciate the need for implementing a strong quality assurance program
5. Understand radiation protection issues of new system designs
Hilde Bosmans is professor in medical physics in radiology at the KU Leuven. Her medical physics activities include all modalities in x-ray imaging and more in particular also interventional radiology and cardiology. Next to clinical medical physics activities she also guides PhD students in medical physics, of which one student specifically focuses on improved quality and use of X ray dose in the cath lab. She was involved on several EC supported projects dealing with interventional radiology such as FP5 Dimond III, FP6 Sentinel and more recently Horizon2020 P3 Stroke, an EIT Health project. In this project, a new angio suit is being developed in which an x-ray tube and MRI system are combined into a single unit for stroke and other procedures. In the frame of this project, basic radiation protection measures have been reviewed.