Interventional Radiology (IR) procedures provide a safer, less invasive, less expensive, and shorter recovery option to surgery. They are performed under x-ray and like other Diagnostic Radiology procedures (ex. Upper GI, barium enema, mammography), the gravity of the medical situation justifies the exposure of the patient to radiation.
In June 2009, the American College of Radiology (ACR) and the Radiological Society of North America (RSNA) established the Joint Task Force on Adult Radiation Protection to address issues of radiation dose optimization in the adult population. Its mission was “to raise awareness of opportunities to eliminate unnecessary imaging examinations and to lower the amount of radiation used in necessary imaging examinations to only that needed to acquire appropriate medical images.”
The result was Image Wisely, a program to raise awareness for physicians and patients about x-ray exposure, emphasizing the use of the ALARA principle. ALARA (as low as reasonably achievable) is central to the medical use of x-ray radiation in patients. It is not only a sound safety principle, it is a requirement for everyone that uses x-ray equipment. Recognition of ALARA is applicable both to diagnostic and IR procedures done under x-ray.
The Image Wisely campaign plans to go beyond education by developing a stronger link between optimizing radiation exposure (dose) and accreditation. This would include a national dose registry, allowing comparison of an individual provider’s radiation doses (patient exposure times) to national benchmarks.
As part of a Quality Improvement Project, the Atlanta Interventional Institute (ATLII) looked at the fluoroscopic time for every patient who underwent Uterine Fibroid Embolization (UFE) at the hospital for the past two years. There are 2 IR groups of doctors that perform UFE at the hospital: Dr. Lipman (ATLII) is listed in blue & a competing IR group (Other) listed in orange.
The chart below clearly shows that the mean fluoroscopic x-ray time (and therefore patient x-ray exposure) is significantly lower with Dr. Lipman than the Other IR group. A number of the procedures performed with the Other IR group (and none with Dr. Lipman) are in the range of inciting radiation burns to the patients. The ovaries are also in the path of the x-ray beam during UFE and the long-term effects of this significantly higher exposure to Other IR Group’s patients should not be underestimated. The Other IR Group is exposing patients to radiation levels that are well beyond a reasonable limit and further proof that IR experience in performing UFE matters.
Dr. Lipman’s UFE experience is second to none. Dr. Lipman and ATLII welcomes Image Wisely, a National Dose Registry, and other similar initiatives to lower patient radiation dose. Our commitment to patient safety is one of the many reasons why we are leaders in the care of uterine fibroid patients.
