Basics of Radiation Protection in Cardiac Imaging Studies

Cardiology is responsible for a large part of the radiation exposures that every person receives per year from all medical sources. Fluoroscopically guided and other cardiology procedures are increasing in number and complexity. Catheterization PCI, interventional electrophysiology procedures and repeated procedures can result in patient skin doses high enough to cause deterministic skin injuries. Cancer risk from a single NST is small, but projected on a population level, NSTs may result in thousands of radiation-attributable cancers annually. Several epidemiological studies involving various levels of radiation exposure all show increased cancer risk, and allow risk projection. The occupational radiation exposure of cardiologists and nuclear cardiology staff must be considered; exposure of interventional cardiologists and cardiac electrophysiologists can be two to three times higher than that of diagnostic radiologists. In recent years, intensive efforts have been initiated to reduce the radiation dose associated with cardiology. Staff radiation protection is related to patient protection, as radiation received is mainly the scattered radiation from patients. The correlation between occupational and patient doses is very dependent on equipment, the specialist, and protocols followed throughout the procedure. Radiation data collection and documentation procedures, QA programmes, application of Diagnostic Reference Levels (DRLs), research, training and education are among the very basic tools also to enhance radiation protection and exploit all the advantages of radiation imaging and therapy in Cardiology.

Keywords: Cancer risk, Deterministic effects, Dosimetry, Medical imaging, Occupational risk, Radiation biology, Radiation dose, Radiation exposure, Radiation protection, Stochastic effects.