[ RadSafe ] ICRP Publication 117

[Fred Dawson]

ICRP News: Now available: ICRP Publication 117 Radiological Protection in
Fluoroscopically Guided Procedures outside the Imaging Department 

ICRP Publication 117
Ann ICRP 40(6), 2010

M.M. Rehani, O. Ciraj-Bjelac, E. Vaño, D.L. Miller, S. Walsh, B.D. Giordano,
J. Persliden

Abstract - An increasing number of medical specialists are using fluoroscopy
outside imaging departments, but there has been general neglect of
radiological protection coverage of fluoroscopy machines used outside
imaging departments. Lack of radiological protection training of those
working with fluoroscopy outside imaging departments can increase the
radiation risk to workers1 and patients. Procedures such as endovascular
aneurysm repair, renal angioplasty, iliac angioplasty, ureteric stent
placement, therapeutic endoscopic retrograde cholangio-pancreatography, and
bile duct stenting and drainage have the potential to impart skin doses
exceeding 1 Gy. Although tissue reactions among patients and workers from
fluoroscopy procedures have, to date, only been reported in interventional
radiology and cardiology, the level of fluoroscopy use outside imaging
departments creates potential for such injuries.

A brief account of the health effects of ionising radiation and protection
principles is presented in Section 2. Section 3 deals with general aspects
of the protection of workers and patients that are common to all, whereas
specific aspects are covered in Section 4 for vascular surgery, urology,
orthopaedic surgery, obstetrics and gynaecology, gastroenterology and
hepatobiliary system, and anaesthetics and pain management. Although
sentinel lymph node biopsy involves the use of radio-isotopic methods rather
than fluoroscopy, performance of this procedure in operating theatres is
covered in this report as it is unlikely that this topic will be addressed
in another ICRP publication in coming years. Information on radiation dose
levels to patients and workers, and dose management is presented for each
speciality.

Issues connected with pregnant patients and pregnant workers are covered in
Section 5. Although ICRP has recently published a report on training,
specific needs for the target groups in terms of orientation of training,
competency of those who conduct and assess specialists, and guidelines on
the curriculum are provided in Section 6.

This report emphasises that patient dose monitoring is essential whenever
fluoroscopy is used.

It is recommended that manufacturers should develop systems to indicate
patient dose indices with the possibility of producing patient dose reports
that can be transferred to the hospital network, and shielding screens that
can be effectively used for the protection of workers using fluoroscopy
machines in operating theatres without hindering the clinical task.

Recommended reference format for citations
ICRP, 2010. Radiological Protection in Fluoroscopically Guided Procedures
outside the Imaging Department. ICRP Publication 117. Ann. ICRP 40(6)

http://www.icrp.org/publication.asp?id=ICRP%20Publication%20117

http://www.icrp.org


Fred Dawson
New Malden
England