Radiation exposure to patients during interventional procedures in developing countries
In a recent IAEA study, the data collected from 55 hospitals in 20 countries (19 developing countries and one developed country) and published in August issue of AJR [Tsapaki et al., 2009], it has been shown that the interventional procedures are increasing in developing countries with 30% countries showing 100% increase in workload in last 3 years. The increase is also significant for paediatric patients. Staff protection is generally good, but patient radiation dose optimization is neglected. Many patients exceeded the dose threshold for erythema. A substantial number (62%) of percutaneous transluminal coronary angioplasty (PTCA) procedures performed in developing countries in this study are above the currently known dose reference level and thus could be optimized.
Interventional procedures using X rays are known to deliver higher radiation doses to patients as compared to common radiographic examinations. The effective doses to patients undergoing interventional procedures may be typically similar to those in computed tomography examinations but the major risk comes from skin dose that can be high enough to cause radiation injury to skin [Rehani, Ortiz-Lopez, 2006; Koenig et al., 2001 part1; Koenig et al., 2001 part2]. The need for training of interventional physician is recommended.
The IAEA has been active in conducting training programs for cardiologists [Rehani, 2007], link to RPOP at http://rpop.iaea.org/RPOP/RPoP/Content/AdditionalResources/Training/2_TrainingEvents/Cardiology.htm and in providing Free access to training material http://rpop.iaea.org/RPOP/RPoP/Content/AdditionalResources/Training/1_TrainingMaterial/Cardiology.htm that has been developed in cooperation with international organizations.
