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AAPM Reports - Managing the Use of Fluoroscopy in Medical Institutions
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Report No. 058 - Managing the Use of Fluoroscopy in Medical Institutions (1998)

Category: Reports

The use of x-ray fluoroscopy has increased dramatically in recent years and is spreading beyond the radiology department. Although radiologists receive training in radiation safety and radiation biology, these topics are not part of most medical school or post graduate medical residency training for other medical specialists using fluoroscopy. Furthermore, improvements in radiologic technology have allowed more powerful x-ray sources to be incorporated into the standard and mobile fluoroscopy systems used by these specialists. The use of such equipment by personnel who have not received specialized training in the proper use of radiation creates the potential for excessive radiation exposure to personnel and patients. Inadequate training combined with increased radiation outputs, higher x-ray tube heat capacities, and real-time digital image acquisition and storage capability can produce patient doses that induce serious skin damage and other potentially deterministic effects. Deterministic effects are those for which the severity of the effect varies with the dose and for which a threshold usually exists. For these reasons it is necessary to develop procedures for managing the use of radiation from fluoroscopy to ensure that patients and personnel are not exposed to excessive levels of radiation. The purpose of this document is to provide medical physicists with resources that can be used in managing the use of radiation from fluoroscopic equipment in medical institutions. Managing fluoroscopic use is not limited only to radiation safety practices. It also involves equipment performance evaluation and quality control testing, monitoring of radiation doses to patients and personnel, and education and training of personnel. There are a number of resources to assist the practicing medical physicist with methods for evaluating performance of fluoroscopic equipment. Several such resources are listed at the end of this document (1-3). These issues will not be addressed here. It is also assumed that the reader is familiar with the basics of personnel radiation safety and personnel monitoring. A list 1 of several documents that deal with basic radiation safety and radiation bioeffects is also provided for completeness (4-11). Two aspects of management of radiation use that have not been dealt with in the past are: 1) a quality management program that monitors radiation usage in general, as well as radiation doses to individual patients and 2) the development of a training and credentialing process for users of fluoroscopy equipment. This document is designed to provide practicing medical physicists with information regarding these areas and resource materials that may be used in an education program for non-radiologists who use fluoroscopy.

ISBN: 978-1-888340-13-6

Keywords: Fluoroscopy, Dosimetry
Radiation Protection Committee Task Group #6

Richard A. Geise, Casimir Eubig, Stephanie Franz, Charles Kelsey, Ralph Lieto, Naimudding Shaikh, Marilyn Wexler, Morris Bank, Philip Judy, J. Thomas Payne, Thomas Shope, Jr., Gerald White

Committee Responsible: Radiography and Fluoroscopy Subcommittee
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