Occupational Radiation Doses to Operators Performing Fluoroscopically-Guided Procedures

At a glance

Type of study

Systematic review or meta-analysis, Systematic review

Who was studied

Interventional radiologists, Urologists, Orthopedic surgeons, Gastroenterologists, Other surgeons, Other physicians, Trainees

Topics

Dosimetry and monitoringEye lens and cataractsThyroidBrain tumorsPersonal protective equipmentRoom shielding and protective devicesDose reduction techniquesTraining and educationPatient dose

Summary based on

the full text

What it found

• Operators performing non-cardiac fluoroscopically guided procedures received per-case effective doses comparable to interventional cardiologists, varying widely by procedure.

  Key figures: 1.7-56 μSv percutaneous nephrolithotomy (PCNL); 0.1-101 μSv vertebroplasty; 2.5-88 μSv nailing; 2.0-46 μSv biliary; 2.5-74 μSv transjugular intrahepatic portosystemic shunt (TIPS); 1.8-53 μSv head/neck; 0.2-49 μSv endoscopic retrograde cholangiopancreatography (ERCP)

• Doses measured over protective devices at eye, neck and trunk had wide ranges; hand doses were notably higher.

  Key figures: eye 19-800 (median 113) μSv; neck 6-1,180 (median 75) μSv; trunk 2-1,600 (median 302) μSv; hand 30-5800 (median 450) μSv

• Reported operator doses varied by one to three orders of magnitude between studies for the same procedure, even after normalizing to patient dose, suggesting room for improved protection.

  Key figures: 0.02 to 73 μSv/min normalized effective dose

• Lens of eye and thyroid doses were much greater than effective dose; brain dose about 5 times lower than lens but still an order of magnitude above effective dose.

  Key figures: 1.5 to 1300 μSv per case

• Protective measures in included studies substantially reduced dose: leaded screen cut forehead dose 70%, leaded gloves 75%, under-couch shield 8-fold at abdomen, and multiple practice changes cut vertebroplasty whole-body dose from 1440 to 4 μSv.

  Key figures: 70%; 75%; 8-fold; 1440 μSv to 4 μSv

Limits to keep in mind

Literature review of small heterogeneous dosimetry studies (2-136 cases each) with inconsistent dosimetry methods and sparse kerma-area product (KAP) data; effective doses were estimated assuming no thyroid shield, and no cumulative or annual doses could be derived.

Related research summaries

• Radiation Exposure, Training, and Safety in Cardiology (2024, Narrative review)
• AST Standards for Ionizing Radiation Exposure (Guideline or consensus statement)
• ICRP Draft - Radiological Protection in Fluoroscopically Guided Procedures (Guideline or consensus statement)
• IU Health Handbook of Fluoroscopy Safety (Guideline or consensus statement)
• Radiation exposure in interventional cardiology: a narrative review of health effects and novel approaches to ensure radiation safety (2025, Narrative review)