Interventional procedures are increasing in developing countries, not only for adults but also for pediatric patients. The situation with respect to staff protection is considered generally acceptable, but this is not the case for patient protection. Many patients exceeded the dose threshold for erythema. A substantial number (62%) of percutaneous transluminal coronary angioplasty procedures performed in developing countries in this study are above the currently known dose reference level and thus could be optimized. Therefore, this study has significance in introducing the concept of patient dose estimation and dose management.
• The radiation dose imparted during fluoroscopically guided interventional procedures can be high • Understanding of reference levels might help optimise interventional cardiological procedures • Optimisation by changing the systems' settings seems feasible in some cases • Procedure complexity and the patient's clinical problem should be taken into account.
Reflecting a change in funding strategies for European research projects, and a commitment to the idea of responsible research and innovation in radiological protection (RP), a collective of research institutes and universities have developed a prospective Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiological protection. This is the first time such a research agenda has been proposed. This paper identifies six research lines of interest and concern: (1) Effects of social, psychological and economic aspects on RP behaviour; (2) Holistic approaches to the governance of radiological risks; (3) Responsible research and innovation in RP; (4) Stakeholder engagement and participatory processes in RP research, development, policy and practice; (5) Risk communication; and (6) RP cultures. These topics were developed through broad stakeholder consultation, in conjunction with activities carried out in the framework of various projects and initiatives (EU H2020 CONCERT programme, the EU FP7 projects OPERRA, PREPARE and EAGLE, the 2015–2018 RICOMET series of conferences, and the 2014 and 2016 International Symposia on Ethics of Environmental Health); as well as through dialogues with members of the European radiation protection research communities. The six research lines open opportunities to integrate a range of key social and ethical considerations into RP, thereby expanding research opportunities and programmes and fostering collaborative approaches to research and innovation.
The purpose of this study is to present a national survey that was performed in Greece for the establishment of national Dose Reference Levels (DRLs) for seven common adult Computed Tomography (CT) examinations. Volumetric computed tomography dose index and dose-length product values were collected from the post-data page of 65 'modern' systems that incorporate tube current modulation. Moreover, phantom dose measurements on 26 'older' systems were performed. Finally, the effective dose to the patient from a typical acquisition during these examinations was estimated. The suggested national DRLs are generally comparable with respective published values from similar European studies, with the exception of sinuses CT, which presents significantly higher values. This fact, along with the large variation of the systems' dose values that were observed even for scanners of the same type, indicates a need for further patient protection optimisation without compromising the clinical outcome.
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