PREFACE *
EXECUTIVE SUMMARY *
GLOSSARY *
1. INTRODUCTION *
1.1. Introduction *
1.2. Fluoroscopically guided procedures *
1.3. Cardiac CT *
1.4. Nuclear cardiology *
1.5. Occupational radiation risk *
1.6. Summary *
2. THE BIOLOGICAL EFFECTS OF RADIATION *
2.1. Types of radiation effects *
2.2. Background *
2.3. Radiation Effects and the Skin *
2.4. The Lens of the Eye and Radiation *
2.5. Cardiovascular effects of radiation exposure *
2.6. Occupational radiation exposure and intracranial neoplasms *
3. CLINICAL EXAMPLES OF TISSUE REACTIONS DUE TO FLUOROSCOPICALLY GUIDED CARDIOLOGY PROCEDURES *
3.1. Introduction *
3.2. Case 1 (Vliestra et al., 2004) *
3.3. Case 2 (Koenig et al., 2001) *
3.4. Case 3 (Wagner and Archer, 1997) *
3.5. Case 4 (Vliestra et al., 2004) *
3.6. Case 5 (Vaņķ et al., 1998a) *
3.7. Case 6 (Courtesy of Dr. M. Portas, Buenos Aires, Argentina) *
4. PRINCIPLES OF RADIOLOGICAL PROTECTION IN MEDICINE *
4.1. Introduction *
4.2. Justification *
4.3. Optimization of protection *
4.4. Dose limits *
5. MANAGING PATIENT DOSE IN FLUOROSCOPICALLY GUIDED INTERVENTIONS *
5.1. Introduction *
5.2. Before the Procedure *
5.3. During the Procedure *
5.4. After the procedure *
5.5. Paediatric Patients *
6. PROTECTION OF STAFF DURING INTERVENTIONAL FLUOROSCOPY *
6.1. Introduction *
6.2. Comparison of radiation exposure with that of other staff *
6.3. The essentials of occupational radiological protection *
6.4. Personal protective devices *
6.5. Equipment-mounted shields *
6.6. Occupational exposure from fluoroscopy *
6.7. Personal dosimetry *
7. RADIOLOGICAL PROTECTION FOR NUCLEAR CARDIOLOGY *
7.1. Introduction *
7.2. Radiopharmaceuticals *
7.3. Dosimetry for nuclear cardiology *
7.4. Current dosimetry estimates *
7.5. Uncertainty in dosimetry *
7.6. Discrepancies between ICRP dosimetry and information from manufacturers *
7.7. Radiological protection of patients in nuclear cardiology *
7.8. Advice to patients *
7.9. Current research areas *
8. RADIOLOGICAL PROTECTION FOR CARDIAC CT *
8.1. Introduction *
8.2. Types of CT scanners *
8.3. Dosimetric Quantities *
8.4. Factors affecting patient dose *
8.5. Current Dosimetry Estimates *
8.6. Radiological Protection of Patients in Cardiac CT *
9. RADIOLOGICAL PROTECTION TRAINING FOR CARDIOLOGISTS *
9.1. Introduction *
9.2. Requirements on Radiological protection *
9.3. Interventional fluoroscopy *
10. QUALITY ASSURANCE PROGRAMMES *
10.1. Introduction *
10.2. Facilities *
10.3. Acceptance and constancy testing *
10.4. Staff *
10.5. Training *
10.6. Follow-up for possible radiation-induced skin injuries for interventional fluoroscopy procedures *
10.7. Dose audits *
REFERENCES *