Get Protected! Recommendations for Staff in IR

Abstract

Purpose Evaluation and registration of patient and staff doses are mandatory under the current European legislation, and the occupational dose limits recommended by the ICRP have been adopted by most of the countries in the world. Methods Relevant documents and guidelines published by international organisations and interventional radiology societies are referred. Any potential reduction of patient and staff doses should be compatible with the clinical outcomes of the procedures. Results The review summarises the most common protective measures and the needed quality control for them, the criteria to select the appropriate protection devices, and how to avoid unnecessary occupational radiation exposures. Moreover, the current and future advancements in personnel radiation protection using medical simulation with virtual and augmented reality, robotics, and artificial intelligence (AI) are commented. A section on the personnel radiation protection in the era of COVID-19 is introduced, showing the expanding role of the interventional radiology during the pandemic. Conclusion The review is completed with a summary of the main factors to be considered in the selection of the appropriate radiation protection tools and practical advices to improve the protection of the staff.

The Impact of COVID-19 on Interventional Radiology Practice Worldwide: Results from a Global Survey

“…In order to be able to provide COVID-positive and COVID-negative patients with IR services, structural organisations regarding procedural and transfer logistics were put in place. These included establishing separate routes and rooms for transfer when treating COVID-positive patients, performing bed-side ultrasound-guided procedures and increasing telehealth for outpatient clinics [3,4,10,11,[31][32][33]. Our data captured differences in how the second wave of the pandemic (September 2020 onwards) was handled compared to the first wave (March 2020-June 2020).…”

“…Based on key publications, CIRSE has published a checklist for preparing interventional radiology services (IR services) for COVID-19 [1]. Recommendations also suggested the postponement of both non-urgent and elective procedures [2][3][4][5][6][7]. The published literature showed that during the first wave, the overall number of procedures performed by interventional radiologists (IRs) decreased by 16-62%, out-of-clinics hours and stress increased, and the number of outpatient cases was affected [8][9][10][11][12].…”

Clinical application of percutaneous left atrial appendage occlusion guided only by transesophageal echocardiography without fluoroscopy and angiography in the patients with nonvalvular atrial fibrillation

“…Radiation for patients and medical staff in fluoroscopy and angiography operation is considered the highest in medical imaging 21 . Occupational dose limits are applied to the staff.…”

Reducing stray radiation with a novel detachable lead arm support in percutaneous coronary intervention

“…6 Several PCI-related techniques that reduce occupational radiation doses to cardiologists have been reported in the literature. 7 The most common strategies are to use a lead curtain suspended from the table side rail and a ceiling-suspended lead shield. Because these protectors cannot sufficiently reduce stray radiation (scattered X-rays from interactions with the patient and/or examination table) to negligible levels, cardiologists should wear radioprotective gear, such as protective apron, thyroid collar, and lead glasses, during PCI.…”

“…Several PCI‐related techniques that reduce occupational radiation doses to cardiologists have been reported in the literature 7 . The most common strategies are to use a lead curtain suspended from the table side rail and a ceiling‐suspended lead shield.…”