ICRP Publication 120

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 *