Knowledge and practices of interventional radiology staff regarding radiation protection

Naoual Elmorabit; Asmaa Marrakchi; Fatima Zahra Chelh; Safae Zaizoune; Mohamed Azougagh; Oumkeltoum Ennibi

doi:10.31893/multirev.2025062

Keywords:

radiological safety

healthcare personnel

occupational exposure

radiation protection devices

Abstract

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.
References
1. Abdulkadir, M.K., Piersson, A.D., Musa, G.M., Audu, S. A., Abubakar, A., Muftaudeen, B., & Umana, J. E. (2021). Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers. Egyptian Journal of Radiology and Nuclear Medicine 52, 67
2. Alahmari, M., & Sun, Z. (2015). A systematic review of the efficiency of radiation protection training in raising awareness of medical staff working in catheterisation laboratory. Current Medical Imaging Reviews, 11(3), 200-206.
3. Alahmari, MAS, Sun, Z, Bartlett, A. (2016). Radiation protection in an interventional laboratory: a comparative study of Australian and Saudi Arabian hospitals. Radiation Protection Dosimetry;172:453–65. https://doi.org/10.1093/rpd/ncv547.
4. Behr-Meenen, C., von Boetticher, H., Kersten, J.F., & Nienhaus, A. (2021). Radiation Protection in Interventional Radiology/Cardiology—Is State-of-the-Art Equipment Used? International Journal of Environmental Research and Public Health, 18(24), 13131. https://doi.org/10.3390/ijerph182413131
5. Brun, A., Mor, R. A., Bourrelly, M., Dalivoust, G., Gazazian, G., Boufercha, R., Gazazian, G., Boufercha, R., Lehucher-Michel, M. P., & Sari-Minodier, I. (2018). Radiation protection for surgeons and anesthetists: practices and knowledge before and after training. Journal of Radiological Protection, 38(1), 175
6. Chida, K., Kaga, Y., Haga, Y., Kataoka, N., Kumasaka, E., Meguro, T., & Zuguchi, M. ( 2013). Occupational dose in interventional radiology procedures. American Journal of Roentgenology, 200(1), 138-141.
7. Cousins, C., Miller, D. L., Bernardi, G., Rehani, M. M., Schofield, P., Vañó, E., Einstein, A. J., Geiger, B., Heintz, P., Padovani, R., Sim, K. H., & International Commission on Radiological Protection. (2013). ICRP PUBLICATION 120: Radiological protection in cardiology. Annals of the ICRP, 42(1), 1–125. https://doi.org/10.1016/j.icrp.2012.09.001
8. Darina, Budošová., Martina, Horvathova., Zuzana, Bárdyová., Tibor, Balázs. (2022). Current trends of radiation protection equipment in interventional radiology.. Radiation Protection Dosimetry, 198 9-11(9-11):554-559. doi: 10.1093/rpd/ncac098
9. Duncan, J. R., Balter, S., Becker, G. J., Brady, J., Brink, J. A., Bulas, D., Chatfield, M. B., Choi, S., Connolly, B. L., Dixon, R. G., Gray, J. E., Kee, S. T., Miller, D. L., Robinson, D. W., Sands, M. J., Schauer, D. A., Steele, J. R., Street, M., Thornton, R. H. & Wise, R. A., 2011, Optimizing radiation use during fluoroscopic procedures: proceedings from a multidisciplinary consensus panel. Journal of Vascular and Interventional Radiology, 22(4), 425-429.
10. Faj, D., Edyvean, S., Lajunen, A., Katukhov, A., & Vassileva, J. (2023). Establishment and utilization of diagnostic reference levels in medical imaging: Results from a survey and consultation under the IAEA technical cooperation programme in Europe and Central Asia. Physica medica, 108, 102565.
11. Faulkner, K. Vano, E. (2001) Deterministic Effects in Interventional Radiology, Radiation Protection Dosimetry, 94(1-2): 95–98, https://doi.org/10.1093/oxfordjournals.rpd.a006489
12. Faulkner, K., Vano, A., Ortiz, P., & Ruiz, R. (2000). Practical aspects of radiation protection in interventional radiology. In The 10th International Congress of the International Radiation Protection Association. Hiroshima, Japan: The International Radiation Protection Association.
13. Fernando, R., Mazuim, D.C.B., Souza, A.D., & D’Agostini, A.Z. (2022). Management of doses from medical exposures in interventional radiology: an integrative review. Brazilian Journal of Radiation Sciences, 10(3B). doi: 10.15392/2319-0612.2022.1858.
14. Friedman, A. A., Ghani, K. R., Peabody, J. O., Jackson, A., Trinh, Q. D., & Elder, J. S. (2013). Radiation safety knowledge and practices among urology residents and fellows: results of a nationwide survey. Journal of surgical education, 70(2), 224-231.
15. International Atomic Energy Agency. (2010), Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures, IAEA-TECDOC-1641, IAEA, Vienna
16. Jentzsch, T., Pietsch, C. M., Stigler, B., Ramseier, L. E., Seifert, B., & Werner, C. M. (2015) The compliance with and knowledge about radiation protection in operating room personnel: a cross-sectional study with a questionnaire. Archives of orthopaedic and trauma surgery, 135, 1233-1240
17. Kim, C., Vasaiwala, S., Haque, F., Pratap, K., & Vidovich, M. I. (2010) Radiation safety among cardiology fellows. The American journal of cardiology, 106(1), 125-128.
18. Lynskey III, G. E., Powell, D. K., Dixon, R. G., & Silberzweig, J. E. (2013).Radiation protection in interventional radiology: survey results of attitudes and use. Journal of Vascular and Interventional Radiology, 24(10), 1547-1551.
19. Miller, D. L., Vañó, E., Bartal, G., Balter, S., Dixon, R., Padovani, R., Schueler, B., Cardella, J. F. & De Baère, T. (2010) Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovascular and interventional radiology, 33, 230-239.
20. Moshfegh, S., Hasanzadeh, H., Jadidi, M., Mirmohammadkhani, M., Bitarafan-Rajabi, A., Abedelahi, A., Emadi, A., Bokharaeian, M., Shabani, F., Masoumi, H., Seifi, D., Khani, T., Sanchooli, M. Ehtiati, A. Amin, S., Vali, M. H., Maziar, A., Vali, S.,& Pashaei, M. B. (2017) Evaluation of knowledge, attitude and practice of personnel in operating room, ERCP, and ESWL towards radiation hazards and protection. Middle East Journal of Rehabilitation and Health Studies, 4(3).
21. O'Connor, U., Walsh, C., Gallagher, A., Dowling, A., Guiney, M., Ryan, J. M., McEniff, N., & O'Reilly, G. (2015). Occupational radiation dose to eyes from interventional radiology procedures in light of the new eye lens dose limit from the International Commission on Radiological Protection. The British journal of radiology, 88(1049), 20140627. https://doi.org/10.1259/bjr.20140627
22. O'Rourke, M., Moore, N., Young, R., Svetlic, S., Bucknall, H., McEntee, M. F., & England, A. (2024). An investigation into the knowledge, attitudes, and practice of radiation protection in interventional radiology and cardiac catheter-laboratories. Journal of Medical Imaging and Radiation Sciences, 55(3).
23. Ou-Saada, I., Boujemaa, S., Campoleoni, M., Brambilla, R., & Bentayeb, F. (2020). Local diagnostic reference levels in interventional radiology. Journal of Medical Imaging and Radiation Sciences, 51(2), 307-311
24. Paulo, G., Bartal, G., & Vano, E. (2021). Radiation dose of patients in fluoroscopically guided interventions: an update. CardioVascular and Interventional Radiology, 44, 842-848.
25. Rose, A., Uebel, K. E., & Rae, W. I. (2018). Interventionalists’ perceptions on a culture of radiation protection. SA journal of radiology, 22(1), 1-10.
26. Rusch, F. M., Bornstein, M. M., & Dagassan-Berndt, D. (2023) The use of protection measures in dento-maxillofacial radiology in Europe: a survey among experts. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 133(1), 12–20. https://doi.org/10.61872/sdj-2023-01-01
27. Schueler, B. A., Vrieze, T. J., Bjarnason, H., & Stanson, A. W,( 2006). An investigation of operator exposure in interventional radiology. Radiographics, 26(5), 1533-1541
28. Sebastião, L.M., de Cássia Flôr, R., & Jorge, T.A. (2023). The practice of radiation protection in an interventional neuroradiology service. Revista Brasileira de Medicina do Trabalho, 20(03), 430-437. doi: 10.47626/1679-4435-2022-748.
29. Shabani, F., Hasanzadeh, H., Emadi, A., Mirmohammadkhani, M., Bitarafan-Rajabi, A., Abedelahi, A., Bokharaeian, M., Masoumi, H., Seifi, D., Khani, T., Sanchooli, M., Moshfegh, S., & Ziari, A. (2018). Radiation protection knowledge, attitude, and practice (KAP) in interventional radiology. Oman medical journal, 33(2), 141.
30. Shafiee, M., Rashidfar, R., Abdolmohammadi, J., Borzoueisileh, S., Salehi, Z., & Dashtian, K. (2020). A study to assess the knowledge and practice of medical professionals on radiation protection in interventional radiology. Indian Journal of Radiology and Imaging, 30(01), 64-69.
31. Sheena, Patel., Bmbs, Frcr., P., Jenkins., Jim, Zhong., Katrina, Harborne., Sidibe, Modi., C., Joy., R, Williams., P, Haslam. (2023). Better safe than so ray: national survey of radiation protection amongst interventional radiology trainees in the United Kingdom. British Journal of Radiology, 96 doi: 10.1259/bjr.20230071
32. Tefera, E., Qureshi, S. A., Gezmu, A. M., & Mazhani, L. (2020). Radiation protection knowledge and practices in interventional cardiologists practicing in Africa: a cross sectional survey. Journal of Radiological Protection, 40(1), 311.
33. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). (2022). SOURCES, EFFECTS AND RISKS OF IONIZING RADIATION. VOLUME I: Sources: Report to the General Assembly, Scientific Annexes A. UNSCEAR 2020/2021 Report. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations sales publication E.22.IX.1. United Nations, New York
34. Vano, E., & Faulkner, K. (2005). ICRP special radiation protection issues in interventional radiology, digital and cardiac imaging. Radiation protection dosimetry, 117(1-3), 13-17.
35. Vano, E., Goicolea, J., Galvan, C., Gonzalez, L., Meiggs, L., Ten, J. I., & Macaya, C. (2001). Skin radiation injuries in patients following repeated coronary angioplasty procedures. The British journal of radiology, 74(887), 1023-1031
36. Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz-López, P., Mattsson, S., Padovani, R., Rogers, A., & Authors on behalf of ICRP (2017). ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging. Annals of the ICRP, 46(1), 1–144. https://doi.org/10.1177/0146645317717209
37. Vañó, E., Rosenstein, M., Liniecki, J., Rehani, M. M., Martin, C. J., & Vetter, R. J. (2009) ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Annals of the ICRP, 39(5), 7–68. https://doi.org/10.1016/j.icrp.2011.01.002
38. Vu, C. T., & Elder, D. H. (2013) Pregnancy and the working interventional radiologist. Seminars in interventional radiology, 30(4), 403–407. https://doi.org/10.1055/s-0033-1359735
39. Wagner, L. K., Eifel, P. J., & Geise, R. A. (1994) Potential biological effects following high X-ray dose interventional procedures. Journal of Vascular and Interventional Radiology, 5(1), 71-84.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Elmorabit, N., Marrakchi, A., Chelh, F. Z., Zaizoune, S., Azougagh, M., & Ennibi, O. (2024). Knowledge and practices of interventional radiology staff regarding radiation protection. Multidisciplinary Reviews, 8(2), 2025062. https://doi.org/10.31893/multirev.2025062

[1] Abdulkadir, M.K., Piersson, A.D., Musa, G.M., Audu, S. A., Abubakar, A., Muftaudeen, B., & Umana, J. E. (2021). Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers. Egyptian Journal of Radiology and Nuclear Medicine 52, 67

[2] Alahmari, M., & Sun, Z. (2015). A systematic review of the efficiency of radiation protection training in raising awareness of medical staff working in catheterisation laboratory. Current Medical Imaging Reviews, 11(3), 200-206.

[3] Alahmari, MAS, Sun, Z, Bartlett, A. (2016). Radiation protection in an interventional laboratory: a comparative study of Australian and Saudi Arabian hospitals. Radiation Protection Dosimetry;172:453–65. https://doi.org/10.1093/rpd/ncv547.

[4] Behr-Meenen, C., von Boetticher, H., Kersten, J.F., & Nienhaus, A. (2021). Radiation Protection in Interventional Radiology/Cardiology—Is State-of-the-Art Equipment Used? International Journal of Environmental Research and Public Health, 18(24), 13131. https://doi.org/10.3390/ijerph182413131

[5] Brun, A., Mor, R. A., Bourrelly, M., Dalivoust, G., Gazazian, G., Boufercha, R., Gazazian, G., Boufercha, R., Lehucher-Michel, M. P., & Sari-Minodier, I. (2018). Radiation protection for surgeons and anesthetists: practices and knowledge before and after training. Journal of Radiological Protection, 38(1), 175

[6] Chida, K., Kaga, Y., Haga, Y., Kataoka, N., Kumasaka, E., Meguro, T., & Zuguchi, M. ( 2013). Occupational dose in interventional radiology procedures. American Journal of Roentgenology, 200(1), 138-141.

[7] Cousins, C., Miller, D. L., Bernardi, G., Rehani, M. M., Schofield, P., Vañó, E., Einstein, A. J., Geiger, B., Heintz, P., Padovani, R., Sim, K. H., & International Commission on Radiological Protection. (2013). ICRP PUBLICATION 120: Radiological protection in cardiology. Annals of the ICRP, 42(1), 1–125. https://doi.org/10.1016/j.icrp.2012.09.001

[8] Darina, Budošová., Martina, Horvathova., Zuzana, Bárdyová., Tibor, Balázs. (2022). Current trends of radiation protection equipment in interventional radiology.. Radiation Protection Dosimetry, 198 9-11(9-11):554-559. doi: 10.1093/rpd/ncac098

[9] Duncan, J. R., Balter, S., Becker, G. J., Brady, J., Brink, J. A., Bulas, D., Chatfield, M. B., Choi, S., Connolly, B. L., Dixon, R. G., Gray, J. E., Kee, S. T., Miller, D. L., Robinson, D. W., Sands, M. J., Schauer, D. A., Steele, J. R., Street, M., Thornton, R. H. & Wise, R. A., 2011, Optimizing radiation use during fluoroscopic procedures: proceedings from a multidisciplinary consensus panel. Journal of Vascular and Interventional Radiology, 22(4), 425-429.

[10] Faj, D., Edyvean, S., Lajunen, A., Katukhov, A., & Vassileva, J. (2023). Establishment and utilization of diagnostic reference levels in medical imaging: Results from a survey and consultation under the IAEA technical cooperation programme in Europe and Central Asia. Physica medica, 108, 102565.

[11] Faulkner, K. Vano, E. (2001) Deterministic Effects in Interventional Radiology, Radiation Protection Dosimetry, 94(1-2): 95–98, https://doi.org/10.1093/oxfordjournals.rpd.a006489

[12] Faulkner, K., Vano, A., Ortiz, P., & Ruiz, R. (2000). Practical aspects of radiation protection in interventional radiology. In The 10th International Congress of the International Radiation Protection Association. Hiroshima, Japan: The International Radiation Protection Association.

[13] Fernando, R., Mazuim, D.C.B., Souza, A.D., & D’Agostini, A.Z. (2022). Management of doses from medical exposures in interventional radiology: an integrative review. Brazilian Journal of Radiation Sciences, 10(3B). doi: 10.15392/2319-0612.2022.1858.

[14] Friedman, A. A., Ghani, K. R., Peabody, J. O., Jackson, A., Trinh, Q. D., & Elder, J. S. (2013). Radiation safety knowledge and practices among urology residents and fellows: results of a nationwide survey. Journal of surgical education, 70(2), 224-231.

[15] International Atomic Energy Agency. (2010), Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures, IAEA-TECDOC-1641, IAEA, Vienna

[16] Jentzsch, T., Pietsch, C. M., Stigler, B., Ramseier, L. E., Seifert, B., & Werner, C. M. (2015) The compliance with and knowledge about radiation protection in operating room personnel: a cross-sectional study with a questionnaire. Archives of orthopaedic and trauma surgery, 135, 1233-1240

[17] Kim, C., Vasaiwala, S., Haque, F., Pratap, K., & Vidovich, M. I. (2010) Radiation safety among cardiology fellows. The American journal of cardiology, 106(1), 125-128.

[18] Lynskey III, G. E., Powell, D. K., Dixon, R. G., & Silberzweig, J. E. (2013).Radiation protection in interventional radiology: survey results of attitudes and use. Journal of Vascular and Interventional Radiology, 24(10), 1547-1551.

[19] Miller, D. L., Vañó, E., Bartal, G., Balter, S., Dixon, R., Padovani, R., Schueler, B., Cardella, J. F. & De Baère, T. (2010) Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovascular and interventional radiology, 33, 230-239.

[20] Moshfegh, S., Hasanzadeh, H., Jadidi, M., Mirmohammadkhani, M., Bitarafan-Rajabi, A., Abedelahi, A., Emadi, A., Bokharaeian, M., Shabani, F., Masoumi, H., Seifi, D., Khani, T., Sanchooli, M. Ehtiati, A. Amin, S., Vali, M. H., Maziar, A., Vali, S.,& Pashaei, M. B. (2017) Evaluation of knowledge, attitude and practice of personnel in operating room, ERCP, and ESWL towards radiation hazards and protection. Middle East Journal of Rehabilitation and Health Studies, 4(3).

[21] O'Connor, U., Walsh, C., Gallagher, A., Dowling, A., Guiney, M., Ryan, J. M., McEniff, N., & O'Reilly, G. (2015). Occupational radiation dose to eyes from interventional radiology procedures in light of the new eye lens dose limit from the International Commission on Radiological Protection. The British journal of radiology, 88(1049), 20140627. https://doi.org/10.1259/bjr.20140627

[22] O'Rourke, M., Moore, N., Young, R., Svetlic, S., Bucknall, H., McEntee, M. F., & England, A. (2024). An investigation into the knowledge, attitudes, and practice of radiation protection in interventional radiology and cardiac catheter-laboratories. Journal of Medical Imaging and Radiation Sciences, 55(3).

[23] Ou-Saada, I., Boujemaa, S., Campoleoni, M., Brambilla, R., & Bentayeb, F. (2020). Local diagnostic reference levels in interventional radiology. Journal of Medical Imaging and Radiation Sciences, 51(2), 307-311

[24] Paulo, G., Bartal, G., & Vano, E. (2021). Radiation dose of patients in fluoroscopically guided interventions: an update. CardioVascular and Interventional Radiology, 44, 842-848.

[25] Rose, A., Uebel, K. E., & Rae, W. I. (2018). Interventionalists’ perceptions on a culture of radiation protection. SA journal of radiology, 22(1), 1-10.

[26] Rusch, F. M., Bornstein, M. M., & Dagassan-Berndt, D. (2023) The use of protection measures in dento-maxillofacial radiology in Europe: a survey among experts. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 133(1), 12–20. https://doi.org/10.61872/sdj-2023-01-01

[27] Schueler, B. A., Vrieze, T. J., Bjarnason, H., & Stanson, A. W,( 2006). An investigation of operator exposure in interventional radiology. Radiographics, 26(5), 1533-1541

[28] Sebastião, L.M., de Cássia Flôr, R., & Jorge, T.A. (2023). The practice of radiation protection in an interventional neuroradiology service. Revista Brasileira de Medicina do Trabalho, 20(03), 430-437. doi: 10.47626/1679-4435-2022-748.

[29] Shabani, F., Hasanzadeh, H., Emadi, A., Mirmohammadkhani, M., Bitarafan-Rajabi, A., Abedelahi, A., Bokharaeian, M., Masoumi, H., Seifi, D., Khani, T., Sanchooli, M., Moshfegh, S., & Ziari, A. (2018). Radiation protection knowledge, attitude, and practice (KAP) in interventional radiology. Oman medical journal, 33(2), 141.

[30] Shafiee, M., Rashidfar, R., Abdolmohammadi, J., Borzoueisileh, S., Salehi, Z., & Dashtian, K. (2020). A study to assess the knowledge and practice of medical professionals on radiation protection in interventional radiology. Indian Journal of Radiology and Imaging, 30(01), 64-69.

[31] Sheena, Patel., Bmbs, Frcr., P., Jenkins., Jim, Zhong., Katrina, Harborne., Sidibe, Modi., C., Joy., R, Williams., P, Haslam. (2023). Better safe than so ray: national survey of radiation protection amongst interventional radiology trainees in the United Kingdom. British Journal of Radiology, 96 doi: 10.1259/bjr.20230071

[32] Tefera, E., Qureshi, S. A., Gezmu, A. M., & Mazhani, L. (2020). Radiation protection knowledge and practices in interventional cardiologists practicing in Africa: a cross sectional survey. Journal of Radiological Protection, 40(1), 311.

[33] United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). (2022). SOURCES, EFFECTS AND RISKS OF IONIZING RADIATION. VOLUME I: Sources: Report to the General Assembly, Scientific Annexes A. UNSCEAR 2020/2021 Report. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations sales publication E.22.IX.1. United Nations, New York

[34] Vano, E., & Faulkner, K. (2005). ICRP special radiation protection issues in interventional radiology, digital and cardiac imaging. Radiation protection dosimetry, 117(1-3), 13-17.

[35] Vano, E., Goicolea, J., Galvan, C., Gonzalez, L., Meiggs, L., Ten, J. I., & Macaya, C. (2001). Skin radiation injuries in patients following repeated coronary angioplasty procedures. The British journal of radiology, 74(887), 1023-1031

[36] Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz-López, P., Mattsson, S., Padovani, R., Rogers, A., & Authors on behalf of ICRP (2017). ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging. Annals of the ICRP, 46(1), 1–144. https://doi.org/10.1177/0146645317717209

[37] Vañó, E., Rosenstein, M., Liniecki, J., Rehani, M. M., Martin, C. J., & Vetter, R. J. (2009) ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Annals of the ICRP, 39(5), 7–68. https://doi.org/10.1016/j.icrp.2011.01.002

[38] Vu, C. T., & Elder, D. H. (2013) Pregnancy and the working interventional radiologist. Seminars in interventional radiology, 30(4), 403–407. https://doi.org/10.1055/s-0033-1359735

[39] Wagner, L. K., Eifel, P. J., & Geise, R. A. (1994) Potential biological effects following high X-ray dose interventional procedures. Journal of Vascular and Interventional Radiology, 5(1), 71-84.

Abstract

References

How to cite