Interventional Fluoroscopy Dosimetry Study

Estimation of annual doses for the US radiologists and US physicians performing fluoroscopically –guided procedures for the period 1977-2004

During the past few decades, there was dramatic growth in the numbers of higher-dose diagnostic x-ray examinations and fluoroscopically –guided (FG) procedures. These procedures use long and on-time radiological imaging, resulting in high radiation exposure not only to patients but also to physicians. However, exposure level and long-term adverse health risks to the radiologists and physicians performing FG procedures are not well known, especially in the US. The objective of our investigation is to advance knowledge of doses to radiologists and practitioners performing FG procedures. This dosimetry study is being performed in conjunction with mortality studies of radiologists and MDs performing FG procedures (http://dceg.cancer.gov/reb/research/ionizing/occupationalexposures/4).

REB investigators have performed a systematic literature review of dosimetry data for radiologists, and cardiologists and other specialists performing FG procedures. Annual doses to radiologists on a nationwide basis are available in several countries, but not in the U.S. For cardiologists and other specialists, we observed notable variation in radiation doses per procedure and underscored the absence of data to enable cumulative estimation of dose, which is relevant to health risk rather than dose during one procedure.

To estimate annual or lifetime doses, we will link the cohort of radiologists and physicians in the mortality study with the largest national dosimetry provider, Landauer, to obtain annual badge dose data for the period 1977-2004. Our proposed study would provide nationwide dose data for radiologists in the US and allow us to compare doses for radiologists who have been monitored on nationwide basis in other countries. Currently, a growing number of medical specialists other than radiologists perform FG procedures and likely receive high radiation doses, but the annual or cumulative dose to these specialists are not well known. We will estimate radiation doses and their temporal trend by medical specialty and compare the doses among different specialties.

As US radiologists and physicians performing FG procedures become aware of their annual doses and dose trends through our scientific reports, we anticipate that such information may have a clinical benefit to patients as well, because efforts to reduce occupational radiation doses will likely result in lower patient radiation doses.