Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine.

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Fluoroscopy

The 2009 National Council on Radiation Protection and Measurements, Report No. 160 — Ionizing Radiation Exposure of the Population of the United States — announced that medical exposure to patients had become one of the largest sources of radiation exposure to Americans, nearly equaling the exposure from background sources. Fluoroscopy is the third largest source of medical radiation exposure behind computed tomography and nuclear medicine.

The fluoroscopy articles presented here cover a broad array of topics including principles of radiation safety for patients and the teams performing these procedures, dose monitoring, teamwork, organizational culture, checklists and other tools from the process improvement perspective.

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This section provides a list of tasks promoting radiation-safety items during fluoroscopy. The checklist is divided into pre-procedure, intra-procedure and post-procedure items.

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Radiation injury during fluoroscopic procedures is influenced by many factors. Adequate pre-planning and attention to techniques to minimize radiation dose are integral components of mitigating the risk of radiation injury.

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Following these guidelines should reduce the incidence of adverse reactions to the patient due to excess radiation and improper technique.

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Careful planning and execution of fluoroscopically guided interventional procedures can reduce procedure risk as well as radiation exposure to the patient and hospital staff.

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Establishing a radiation safety-conscious environment in the cardiac catheterization laboratory for all procedures, diagnostic and therapeutic/interventional, should be a collaborative effort involving physicians, staff, medical physicists, quality assurance personnel and hospital administration.

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Physicians and ancillary professionals should be familiar with current recommendations on protocols and radiation management from professional organizations.

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As image quality improves, it begins providing more and more information that leads to increases in the probability of success. However, these increases eventually reach a point where further increases in image quality have little or no impact on the result.

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The general relationship between the number of incident photons entering the patient’s skin and exiting photons reaching the detector is described by the Beer-Lambert Law.

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The factors governing system performance are often divided into broad categories that can be used to begin cataloguing the numerous factors that govern radiation use during fluoroscopic procedures.

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Image Wisely encourages practitioners to optimize the amount of radiation used in
medically necessary imaging studies and to eliminate unnecessary procedures

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