Medical interventional procedures-reducing the radiation risks.

Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up.