Name:

1. Ahmad Ardi Pratama

2. Muhammad Eri H

Radiation Sources in medicine

diagnostic Radiology

Interventional Radiology

IAEA
International Atomic Energy Agency

Objective

To become familiar with the technology and operation of

interventional radiology x-ray systems.
To become familiar with the specific radiation risks for
patients and staff associated with interventional radiology.

Contents

Description of interventional radiology x-ray systems.

Equipment malfunction affecting radiation protection.
Criteria of acceptability and quality control.

Interventional Radiology

Interventional radiology uses

x-ray imaging to guide the
placement of catheters, stents
etc. in blood vessels and
organs for the purpose of
correcting or treating a
particular condition.

Interventional Radiology (cont)

When contrast media is used to

outline blood vessels, the technique
of digital subtraction angiography
(DSA) may also be used.
During DSA, a negative digital
fluoroscopic image of the body part
under examination is digitally combined
with each frame of the subsequent
fluoroscopic image while a contrast
medium is injected into the blood
vessels.

Queensland Diagnostic Imaging

The resultant image (in

real time or recorded) is
displayed largely free of
anatomy that might
otherwise obscure the
6
blood vessels.

Interventional Radiology (cont)

A fluoroscopic
system that
can be used
for DSA and
interventional
radiology.
7

Interventional Radiology (cont)

Comprises fluoroscopically guided invasive procedures that

predominantly have a therapeutic objective. Access to the
organ or vessel of interest is usually percutaneous and
generally performed under local anesthesia and / or sedation.

Fluoroscopy is commonly used but computed tomography

and ultrasound may also be used.

Compared to other fluoroscopic procedures, fluoroscopic

exposure times can be long and may be combined with
extensive radiographic exposures.

Patient and staff radiation doses can be high.

Interventional Radiology (cont)

Fluoroscopic systems used for interventional radiology must
comply with the basic requirements that are applicable to
fluoroscopic equipment (Module 2.4).
Because the accumulated patient dose may be high, the
equipment shall incorporate a continuous indication of
patient dose such as a Dose-Area Product meter.
A device must indicate the total elapsed fluoroscopic
exposure time for each patient and provide an audible
warning to the fluoroscopist at a predetermined interval,
preferably not exceeding 5 minutes.

Malfunctions affecting radiation protection

The types of malfunctions that should be considered are:

generator, x-ray tube and imaging system deficiencies
listed in Modules 2.1 and 2.2, and
fluoroscopy system problems listed in Module 2.4.

10

Problems affecting radiation protection

Assuming appropriate dedicated equipment is used, it

functions correctly, is properly maintained and is subject to a
quality assurance programme, other causes of avoidable
patient and staff exposure during interventional radiology
might result from:
complex procedures which are not optimized (exposure
parameters, the number of images acquired, dose rate,
patient positioning, etc.);
inadequate radiation protection training received by
interventional physicians.

11