Rehani MM, et al. ICRP Publication 117. Radiological Protection In Fluoroscopically Guided Procedures Performed Outside The Imaging Department. Ann ICRP. 2010 Dec;40(6):1-102.

A brief account of the health effects of ionising radiation and protection principles is presented in Section 2. Section 3 deals with general aspects of the protection of workers and patients that are common to all, whereas specific aspects are covered in Section 4 for vascular surgery, urology, orthopaedic surgery, obstetrics and gynaecology, gastroenterology and hepatobiliary system, and anaesthetics and pain management.

Rehani MM, et al. ICRP Publication 117. Radiological Protection In Fluoroscopically Guided Procedures Performed Outside The Imaging Department. Ann ICRP. 2010 Dec;40(6):1-102.

A brief account of the health effects of ionising radiation and protection principles is presented in Section 2. Section 3 deals with general aspects of the protection of workers and patients that are common to all, whereas specific aspects are covered in Section 4 for vascular surgery, urology, orthopaedic surgery, obstetrics and gynaecology, gastroenterology and hepatobiliary system, and anaesthetics and pain management.

Weyland CS, Hemmerich F, Möhlenbruch MA, et al. Radiation exposure and fluoroscopy time in mechanical thrombectomy of anterior circulation ischemic stroke depending on the interventionalist’s experience-a retrospective single center experience. Eur Radiol. 2019 Nov 11. doi: 10.1007/s00330-019-06482-4. [Epub ahead of print]

To quantify the influence of interventionalist’s experience on procedure time, radiation exposure, and fluoroscopy time during mechanical thrombectomy (MT) in the anterior circulation.Retrospective analysis of an institutional review board-approved stroke database of a comprehensive stroke center focusing on radiation exposure (as per dose area product in Gy × cm2, median [IQR]), procedure, and fluoroscopy time (in minutes, median [IQR]) in patients receiving MT in anterior circulation ischemic stroke. Procedures have been assigned according to the interventionalist’s experience in MT into three sequential groups: A = 1-25 procedures, B = 26-50 procedures, and C = more than 50 procedures.

van der Marel K, et al. Reduced Patient Radiation Exposure During Neurodiagnostic And Interventional X-Ray Angiography With A New Imaging Platform. AJNR Am J Neuroradiol. 2017 Mar;38(3):442-449.

We evaluated patient doses from an x-ray imaging platform with radiation dose–reduction technology, which combined image noise reduction, motion correction, and contrast-dependent temporal averaging with optimized x-ray exposure settings. A total of 1238 neurointerventional cases were included, of which 914 and 324 were performed on the reference and dose-reduction platforms, respectively. Over all diagnostic and neurointerventional procedures, the cumulative dose-area product was significantly reduced by 53.2% (mean reduction, 160.3 Gy × cm2; P < .0001), fluoroscopy duration was marginally significantly increased (mean increase, 5.2 minutes; P = .0491), and contrast volume was nonsignificantly increased (mean increase, 15.3 mL; P = .1616) with the dose-reduction platform.

Stewart FA, Akleyev AV, Hauer-Jensen M, et al. ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context. Ann ICRP. 2012 Feb;41(1-2):1–322.

This report provides a review of early and late effects in normal tissue and organs with respect to radiation protection. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin;and the eye.

Simon SL, Linet MS. Radiation-Exposed Populations: Who, Why, and How to Study. Health Phys. 2014 Feb;106(2):182-195.

This paper describes a wide range of populations exposed to radiation and the motivation and key methodological criteria that drive the rationale and priority of studying such populations. Also, discussed are alternative methods for evaluating radiation-related health risks in these populations, with a major focus on epidemiologic approaches. This paper concludes with a short summary of major highlights from radiation epidemiologic research and important unanswered questions.Introduction of Exposed Populations (Video 1:29, http://links.lww.com/HP/A22)

Sarti G, Busca F, Carpano L, et al. DOSE MEASUREMENTS TO THE LENS IN NUCLEAR MEDICINE AND IN FLUOROSCOPY-GUIDED INTERVENTIONAL PROCEDURES: ANALYSIS OF THE RESULTS AND ASSESSMENT OF THE EFFECTIVENESS OF PROTECTIVE EYEWEAR ANTI-X. Radiat Prot Dosimetry. 2016 Sep;170(1-4):181-6.

The new limit of 20 mSv to the lens raises the need for further assessment of the equivalent dose to the lens for nuclear medicine and interventional radiology operators. (a) A measurement campaign was performed in nuclear medicine, (b) a routine monitoring was organised in interventional procedures and (c) the effectiveness of protective eyewear was assessed. In nuclear medicine, for photon fields, the adequacy of Hp(0.07) of dosemeter worn on the trunk is confirmed; with (90)Y, the annual values of Hp(3) measured in therapeutic session are <5 mSv. In interventional procedures, routine monitoring of the dose to the lens must be maintained where the values of Hp(0.07) dosemeter worn on the trunk are higher than one-third of the new limits. The measures carried out have shown that the attenuation factor mean of the protective glasses is equal to ∼4 (range 1.7-11.4).

Rola R, Otsuka S, Obenaus A, et al. Indicators Of Hippocampal Neurogenesis Are Altered By56fe-Particle Irradiation In A Dose-Dependent Manner. Radiat Res. 2004 Oct;162(4):442-446.

The health risks to astronauts exposed to high-LET radiation include possible cognitive deficits. The pathogenesis of radiation-induced cognitive injury is unknown but may involve loss of neural precursor cells from the subgranular zone (SGZ) of the hippocampal dentate gyrus. To address this hypothesis, adult female C57BL/6 mice received whole-body irradiation with a 1 GeV/nucleon iron-particle beam in a single fraction of 0, 1, 2 and 3 Gy. The present data provide the first evidence that high-LET radiation has deleterious effects on cells associated with hippocampal neurogenesis.

Rogits B, Jungnickel K, Lowenthal D, et al. Prospective Evaluation Of The Radiologist’s Hand Dose In CT-Guided Interventions. Röfo. 2013 Nov;185(11):1081-1088.

Assessment of radiologist’s hand dose in CT-guided interventions and determination of influencing factors. 138 CT-guided interventions (biopsy n = 99, drainage n = 23, pain therapy n = 16) at different locations (lung n = 41, retroperitoneum n = 53, liver n = 25, spine n = 19) were included. The lesion size was 4 – 240 mm (median: 23 mm). The fluoroscopy time per intervention was 4.6 – 140.2 s (median: 24.2 s). The measured hand dose ranged from 0.001 – 3.02 mSv (median: 0.22 mSv). The median hand dose for lung puncture (n = 41) was slightly higher (median: 0.32 mSv, p = 0.01) compared to that for the liver, retroperitoneum and other.