March 9, 2014
Notes: Cortese, Bernardo
Silva, Pedro Leon
Sgueglia, Gregory A
Catheter Cardiovasc Interv. 2014 Feb 15;83(3):427-35. doi: 10.1002/ccd.25149. Epub 2013 Sep 23.
Author Address: Interventional Cardiology, A.O. Fatebenefratelli Milano, Italy.
Reference Type: Journal Article
Record Number: 826Author: Cousins, C., Miller, D. L., Bernardi, G., Rehani, M. M., Schofield, P., Vano, E., Einstein, A. J., Geiger, B., Heintz, P., Padovani, R., Sim, K. H. and International Commission on Radiological, Protection
Title: ICRP PUBLICATION 120: Radiological protection in cardiology
Journal: Ann ICRP
Short Title: ICRP PUBLICATION 120: Radiological protection in cardiology
Alternate Journal: Annals of the ICRP
ISSN: 1872-969X (Electronic)
Accession Number: 23141687
Environmental Exposure/prevention & control
Occupational Exposure/*prevention & control
Abstract: Cardiac nuclear medicine, cardiac computed tomography (CT), interventional cardiology procedures, and electrophysiology procedures are increasing in number and account for an important share of patient radiation exposure in medicine. Complex percutaneous coronary interventions and cardiac electrophysiology procedures are associated with high radiation doses. These procedures can result in patient skin doses that are high enough to cause radiation injury and an increased risk of cancer. Treatment of congenital heart disease in children is of particular concern. Additionally, staff(1) in cardiac catheterisation laboratories may receive high doses of radiation if radiological protection tools are not used properly. The Commission provided recommendations for radiological protection during fluoroscopically guided interventions in Publication 85, for radiological protection in CT in Publications 87 and 102, and for training in radiological protection in Publication 113 (ICRP, 2000b,c, 2007a, 2009). This report is focused specifically on cardiology, and brings together information relevant to cardiology from the Commission’s published documents. There is emphasis on those imaging procedures and interventions specific to cardiology. The material and recommendations in the current document have been updated to reflect the most recent recommendations of the Commission. This report provides guidance to assist the cardiologist with justification procedures and optimisation of protection in cardiac CT studies, cardiac nuclear medicine studies, and fluoroscopically guided cardiac interventions. It includes discussions of the biological effects of radiation, principles of radiological protection, protection of staff during fluoroscopically guided interventions, radiological protection training, and establishment of a quality assurance programme for cardiac imaging and intervention. As tissue injury, principally skin injury, is a risk for fluoroscopically guided interventions, particular attention is devoted to clinical examples of radiation-related skin injuries from cardiac interventions, methods to reduce patient radiation dose, training recommendations, and quality assurance programmes for interventional fluoroscopy.