Practical approaches to dosimetry for the patient and staff for fluoroscopic procedures

Three recent developments that provide practical information on radiation dosimetry for patients or clinical staff for diagnostic or interventional fluoroscopy are presented. They are: (i) a Handbook for determining absorbed doses in tissues (for patients) from coronary artery procedures; (ii) recommendations on avoiding radiation-induced skin injuries (to patients) during fluoroscopically-guided interventional procedures: and (iii) a method for determining effective dose (to staff wearing protective aprons) from fluoroscopic procedures, using the results of personal monitors. The simulated examinations of the coronary arteries are based on a series of distinct X-ray fields commonly used in coronary interventional radiology, derived from analyses of practice at the Institut de Cardiologie de Montreal. The views and arterial projections represented are generally applicable to a broad range of examinations following a variety of clinical protocols. For each arterial projection, a separate Monte Carlo calculation was made with ADAM and EVA for the relevant complex oblique X-ray field in divergent-beam geometry, with specific X-ray spectra representative of clinical practice. (author)