Main description:

This report provides guidance to assist the cardiologist with justification procedures and optimisation of protection in cardiac CT studies, cardiac nuclear medicine studies, and fluoroscopically guided cardiac interventions. It includes discussions of the biological effects of radiation, principles of radiological protection, protection of staff during fluoroscopically guided interventions, radiological protection training, and establishment of a quality assurance programme for cardiac imaging and intervention.

Contents:

PREFACE * EXECUTIVE SUMMARY * GLOSSARY * 1. INTRODUCTION * 1.1. Introduction * 1.2. Fluoroscopically guided procedures * 1.3. Cardiac CT * 1.4. Nuclear cardiology * 1.5. Occupational radiation risk * 1.6. Summary * 2. THE BIOLOGICAL EFFECTS OF RADIATION * 2.1. Types of radiation effects * 2.2. Background * 2.3. Radiation Effects and the Skin * 2.4. The Lens of the Eye and Radiation * 2.5. Cardiovascular effects of radiation exposure * 2.6. Occupational radiation exposure and intracranial neoplasms * 3. CLINICAL EXAMPLES OF TISSUE REACTIONS DUE TO FLUOROSCOPICALLY GUIDED CARDIOLOGY PROCEDURES * 3.1. Introduction * 3.2. Case 1 (Vliestra et al., 2004) * 3.3. Case 2 (Koenig et al., 2001) * 3.4. Case 3 (Wagner and Archer, 1997) * 3.5. Case 4 (Vliestra et al., 2004) * 3.6. Case 5 (Vano et al., 1998a) * 3.7. Case 6 (Courtesy of Dr. M. Portas, Buenos Aires, Argentina) * 4. PRINCIPLES OF RADIOLOGICAL PROTECTION IN MEDICINE * 4.1. Introduction * 4.2. Justification * 4.3. Optimization of protection * 4.4. Dose limits * 5. MANAGING PATIENT DOSE IN FLUOROSCOPICALLY GUIDED INTERVENTIONS * 5.1. Introduction * 5.2. Before the Procedure * 5.3. During the Procedure * 5.4. After the procedure * 5.5. Paediatric Patients * 6. PROTECTION OF STAFF DURING INTERVENTIONAL FLUOROSCOPY * 6.1. Introduction * 6.2. Comparison of radiation exposure with that of other staff * 6.3. The essentials of occupational radiological protection * 6.4. Personal protective devices * 6.5. Equipment-mounted shields * 6.6. Occupational exposure from fluoroscopy * 6.7. Personal dosimetry * 7. RADIOLOGICAL PROTECTION FOR NUCLEAR CARDIOLOGY * 7.1. Introduction * 7.2. Radiopharmaceuticals * 7.3. Dosimetry for nuclear cardiology * 7.4. Current dosimetry estimates * 7.5. Uncertainty in dosimetry * 7.6. Discrepancies between ICRP dosimetry and information from manufacturers * 7.7. Radiological protection of patients in nuclear cardiology * 7.8. Advice to patients * 7.9. Current research areas * 8. RADIOLOGICAL PROTECTION FOR CARDIAC CT * 8.1. Introduction * 8.2. Types of CT scanners * 8.3. Dosimetric Quantities * 8.4. Factors affecting patient dose * 8.5. Current Dosimetry Estimates * 8.6. Radiological Protection of Patients in Cardiac CT * 9. RADIOLOGICAL PROTECTION TRAINING FOR CARDIOLOGISTS * 9.1. Introduction * 9.2. Requirements on Radiological protection * 9.3. Interventional fluoroscopy * 10. QUALITY ASSURANCE PROGRAMMES * 10.1. Introduction * 10.2. Facilities * 10.3. Acceptance and constancy testing * 10.4. Staff * 10.5. Training * 10.6. Follow-up for possible radiation-induced skin injuries for interventional fluoroscopy procedures * 10.7. Dose audits * REFERENCES *