ICRP publication 120: Radiological Protection in Cardiology

Annals of the ICRP

Volumn 42, Issue 1, 2013, Pages 1-125

  Cousins, C ^a   Miller, D L ^a   Bernardi, G ^a   Rehani, M M ^a   Schofield, P ^a   VaAfA+/ AfA E ^a   Einstein, A J ^a   Geiger, B ^a   Heintz, P ^a   Padovani, R ^a   Sim, K H ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; CARDIOLOGY; CHILD; ENVIRONMENTAL EXPOSURE; FEMALE; FLUOROSCOPY; HUMAN; MALE; METHODOLOGY; OCCUPATIONAL EXPOSURE; PRACTICE GUIDELINE; RADIATION DOSE; RADIATION MONITORING; RADIATION PROTECTION; RADIOLOGY; REVIEW; STANDARD;

ADOLESCENT; ADULT; CARDIOLOGY; CHILD; ENVIRONMENTAL EXPOSURE; FEMALE; FLUOROSCOPY; HUMANS; MALE; OCCUPATIONAL EXPOSURE; RADIATION DOSAGE; RADIATION MONITORING; RADIATION PROTECTION; RADIOLOGY;

EID: 84874999824     PISSN: 01466453     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.icrp.2012.09.001     Document Type: Article

References (278)

1. Abada, H.T., Larchez, C., Daoud, B., et al., 2006. MDCT of the coronary arteries: feasibility of low-dose CT with ECG-pulsed tube current modulation to reduce radiation dose. AJR Am. J. Roentgenol. 186, S387–S390.
2. Abdulla, J., Abildstrom, S.Z., Gotzsche, O., et al., 2007. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur. Heart J. 28, 3042–3050.
3. Achenbach, S., Marwan, M., Ropers, D., et al., 2010. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur. Heart J. 31, 340–346.
4. Acosta, R., Hoffmeister, L., Roman, R., et al., 2006. Systematic review of population-based studies of the prevalence of cataracts. Arch. Soc. Esp. Oftalmol. 81, 509–516.
5. ACR, 1992. Proceedings of the ACR/FDA Workshop on Fluoroscopy. Strategies for Improvement in Performance, Radiation Safety and Control. American College of Radiology, Reston, VA.
6. ACR, 2008. ACR Practice Guideline for Imaging Pregnant or Potentially Pregnant Adolescents and Women with Ionizing Radiation. Practice Guidelines and Technical Standards 2008. American College of Radiology, Reston, VA, pp. 23–37. Available at: (last accessed 11 August 2010).
7. ACR, 2009. ACR-SNM-SPR Practice Guideline for the Performance of Cardiac Scintigraphy. American College of Radiology, Reston, VA. Available at: (last accessed 16 September 2011).
8. ACR, 2010. American College of Radiology ACR Appropriateness Criteria. Clinical Condition: Chronic Chest Pain — High Probability of Coronary Artery Disease. American College of Radiology, Reston, VA. Available at: (last accessed 2 January 2011).
9. Allan, J.M., 2008. Genetic susceptibility to radiogenic cancer in humans. Health Phys. 95, 677–686.
10. American College of Cardiology/American Heart Association Ad Hoc Task Force on Cardiac Catheterization (ACC/AHA), 1991. ACC/AHA guidelines for cardiac catheterization and cardiac catheterization laboratories. J. Am. Coll. Cardiol. 18, 1149–1182.
11. American College of Cardiology Cardiac Catheterization Committee, 1995. Use of radiographic devices by cardiologists. J. Am. Coll. Cardiol. 25, 1738–1739.
12. Anderson, H.V., Shaw, R.E., Brindis, R.G., et al., 2002. A contemporary overview of percutaneous coronary interventions. The American College of Cardiology–National Cardiovascular Data Registry (ACC–NCDR). J. Am. Coll. Cardiol. 39, 1096–1103.
13. Andreassi, M.G., 2009. Radiation risk from pediatric cardiac catheterization: friendly fire on children with congenital heart disease. Circulation 120, 1847–1849.
14. Andreassi, M.G., Ait-Ali, L., Botto, N., et al., 2006. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur. Heart J. 27, 2703–2708.
15. Bacher, K., Bogaert, E., Lapere, R., et al., 2005. Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation 111, 83–89.
16. Balter, S., 2001a. Interventional Fluoroscopy. Physics, Technology and Safety. Wiley-Liss, New York.
17. Balter, S., 2001b. Stray radiation in the cardiac catheterization laboratory. Radiat. Prot. Dosimetry 94, 183–188.
18. Balter, S., Miller, D.L., Vañó, E., et al., 2008. A pilot study exploring the possibility of establishing guidance levels in x-ray directed interventional procedures. Med. Phys. 35, 673–680.
19. Balter, S., Hopewell, J.W., Miller, D.L., et al., 2010. Fluoroscopically guided interventional procedures: a review of radiation effects on patients' skin and hair. Radiology 254, 326–341.
20. Bernardi, G., Padovani, R., Morocutti, G., et al., 2000. Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: analysis in relation to radiation exposure parameters. Catheter Cardiovasc. Interv. 51, 1–9, discussion 10.
21. Bernardi, G., Padovani, R., Morocutti, G., et al., 2001a. A method based on DIMOND quality criteria to evaluate imaging in diagnostic and interventional cardiology. Radiat. Prot. Dosimetry 94, 167–172.
22. Bernardi, G., Padovani, R., Morocutti, G., et al., 2001b. Quality criteria for cardiac images in diagnostic and interventional cardiology. Br. J. Radiol. 74, 852–855.
23. Bernardi, G., Padovani, R., Trianni, A., et al., 2008. The effect of fellows' training in invasive cardiology on radiological exposure of patients. Radiat. Prot. Dosimetry 128, 72–76.
24. Bhatti, P., Sigurdson, A.J., Mabuchi, K., 2008. Can low-dose radiation increase risk of cardiovascular disease? Lancet 372, 697–699.
25. Bischoff, B., Hein, F., Meyer, T., et al., 2009. Impact of a reduced tube voltage on CT angiography and radiation dose: results of the PROTECTION I study. JACC Cardiovasc. Imag. 2, 940–946.
26. Blettner, M., Schlehofer, B., Samkange-Zeeb, F., et al., 2007. Medical exposure to ionising radiation and the risk of brain tumours: Interphone study group, Germany. Eur. J. Cancer 43, 1990–1998.
27. Block, M., Bove, A.A., Ritman, E.L., 1984. Coronary angiographic examination with the dynamic spatial reconstructor. Circulation 70, 209–216.
28. Boden, W.E., O'Rourke, R.A., Teo, K.K., et al., 2007. Optimal medical therapy with or without PCI for stable coronary disease. N. Engl. J. Med. 356, 1503–1516.
29. Bogaert, E., Bacher, K., Thierens, H., 2008. A large-scale multicentre study in Belgium of dose area product values and effective doses in interventional cardiology using contemporary x-ray equipment. Radiat. Prot. Dosimetry 128, 312–323.
30. Bogaert, E., Bacher, K., Lemmens, K., et al., 2009. A large-scale multicentre study of patient skin doses in interventional cardiology: dose-area product action levels and dose reference levels. Br. J. Radiol. 82, 303–312.
31. Bongartz, G., Golding, S.J., Jurik, A.G., et al., 2000. European Guidelines on Quality Criteria for Computed Tomography. EUR 16262. The European Commission's Study Group on Development of Quality Criteria for Computed Tomography. Available at: (last accessed 4 October 2012).
32. Bongartz, G., Golding, S.J., Jurik, A.G., et al., 2004. CT Quality Criteria. European Commission. Available at:
33. Bonhoeffer, P., Boudjemline, Y., Qureshi, S.A., et al., 2002. Percutaneous insertion of the pulmonary valve. J. Am. Coll. Cardiol. 39, 1664–1669.
34. Bor, D., Sancak, T., Toklu, T., et al., 2008. Effects of radiologists' skill and experience on patient doses in interventional examinations. Radiat. Prot. Dosimetry 129, 32–35.
35. Bor, D., Olgar, T., Toklu, T., et al., 2009. Patient doses and dosimetric evaluations in interventional cardiology. Phys. Med. 25, 31–42.
36. Brindis, R.G., Douglas, P.S., Hendel, R.C., et al., 2005. ACCF/ASNC appropriateness criteria for singlephoton emission computed tomography myocardial perfusion imaging (SPECT MPI): a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association. J. Am. Coll. Cardiol. 46, 1587–1605.
37. Bryk, S.G., Censullo, M.L., Wagner, L.K., et al., 2006. Endovascular and interventional procedures in obese patients: a review of procedural technique modifications and radiation management. J. Vasc. Interv. Radiol. 17, 27–33.
38. Carozza, S.E., Wrensch, M., Müke, R., et al., 2000. Occupation and adult gliomas. Am. J. Epidemiol. 152, 838–846.
39. Chambers, C.E., Fetterly, K.A., Holzer, R., et al., 2011. Radiation safety program for the cardiac catheterization laboratory. Catheter. Cardiovasc. Interv. 77, 546–556.
40. Cheng, T.O., 2004. The current state of cardiology in China. Int. J. Cardiol. 96, 425–439.
41. Chida, K., Saito, H., Otani, H., et al., 2006. Relationship between fluoroscopic time, dose-area product, body weight, and maximum radiation skin dose in cardiac interventional procedures. AJR Am. J. Roentgenol. 186, 774–778.
42. Chida, K., Ohno, T., Kakizaki, S., et al., 2010. Radiation dose to the pediatric cardiac catheterization and intervention patient. AJR Am. J. Roentgenol. 195, 1175–1179.
43. Christner, J.A., Kofler, J.M., McCollough, C.H., 2010. Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection Publication 103 or dual-energy scanning. AJR Am. J. Roentgenol. 194, 881– 889.
44. Ciraj-Bjelac, O., Rehani, M.M., Sim, K.H., et al., 2010. Risk for radiation induced cataract for staff in interventional cardiology: is there reason for concern? Catheter Cardiovasc Interv. 76, 826–834.
45. Codman, E.A., 1896. The cause of burns from x-rays. Bos. Med. Surg. J. 136, 610–611.
46. Daniel, J., 1896. The x-rays. Science 3, 562.
47. Dauer, L.T., Williamson, M.J., St. Germain, J., et al., 2007a. Nuclear granny – reply. J. Nucl. Cardiol. 14, 904–905.
48. Dauer, L.T., Williamson, M.J., St. Germain, J., et al., 2007b. Tl-201 stress tests and homeland security. J. Nucl. Cardiol. 14, 582–588.
49. Dauer, L.T., Thornton, R.H., Solomon, S.B., et al., 2010a. Unprotected operator eye lens doses in oncologic interventional radiology are clinically significant: estimation from patient kerma-areaproduct data. J. Vasc. Interv. Radiol. 21, 1859–1861.
50. Dauer, L.T., Brooks, A.L., Hoel, D.G., et al., 2010b. Review and evaluation of updated research on the health effects associated with low-dose ionising radiation. Radiat. Prot. Dosimetry 140, 103–136.
51. Dauer, L.T., Thornton, R.H., Miller, D.L., et al., 2012. Radiation management for interventions using fluoroscopic or computed tomographic guidance during pregnancy: a joint guideline of the Society of Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe with endorsement by the Canadian Interventional Radiology Association. J. Vasc. Interv. Radiol. 23, 19–32.
52. Davis, W., 2006. Mapping improvements in molecular imaging. Med. Imag. Available at: (last accessed 31 December 2010).
53. Dendy, P.P., 2008. Radiation risks in interventional radiology. Br. J. Radiol. 81, 1–7.
54. DePuey, E.G., 2006. Imaging guidelines for nuclear cardiology procedures: a report of the American Society of Nuclear Cardiology Quality Assurance Committee. J. Nucl. Cardiol. 13, e21–e171.
55. D'Helft, C.J., Brennan, P.C., McGee, A.M., et al., 2009. Potential Irish dose reference levels for cardiac interventional examinations. Br. J. Radiol. 82, 296–302.
56. Douglas, P.S., Khandheria, B., Stainback, R.F., et al., 2008. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine. J. Am. Coll. Cardiol. 51, 1127–1147. Available at: (last accessed 1 January 2011).
57. Douglas, P.S., Carr, J.J., Cerqueira, M.D., et al., 2012. Developing an action plan for patient radiation safety in adult cardiovascular medicine: Proceedings from the Duke University Clinical Research Institute/American College of Cardiology Foundation/American Heart Association think tank held on February 28, 2011. J. Am. Coll. Cardiol. 59, 1833–1847.
58. Dromi, S., Wood, B.J., Oberoi, J., et al., 2006. Heavy metal pad shielding during fluoroscopic interventions. J. Vasc. Interv. Radiol. 17, 1201–1206.
59. Earls, J.P., Schrack, E.C., 2009. Prospectively gated low-dose CCTA: 24 months experience in more than 2,000 clinical cases. Int. J. Cardiovasc. Imag. 25, 177–187.
60. EC, 2000. Guidelines on Education and Training in Radiation Protection for Medical Exposures. Radiation Protection 116. European Commission, Directorate General Environment, Nuclear Safety and Civil Protection, Luxembourg. Available at: (last accessed 2 January 2011).
61. Efstathopoulos, E., Makrygiannis, S.S., Kottou, S., et al., 2003. Medical personnel and patient dosimetry during coronary angiography and intervention. Phys. Med. Biol. 48, 3059–3068.
62. Einstein, A.J., 2009. Medical imaging: the radiation issue. Nat. Rev. Cardiol. 6, 436–438.
63. Einstein, A.J., Moser, K.W., Thompson, R.C., et al., 2007a. Radiation dose to patients from cardiac diagnostic imaging. Circulation 116, 1290–1305.
64. Einstein, A.J., Henzlova, M.J., Rajagopalan, S., 2007b. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298, 317–323.
65. Einstein, A.J., Sanz, J., Dellegrottaglie, S., et al., 2008. Radiation dose and cancer risk estimates in 16- slice computed tomography coronary angiography. J. Nucl. Cardiol. 15, 232–240.
66. Einstein, A.J., Elliston, C.D., Arai, A.E., et al., 2010. Radiation dose from single heartbeat coronary CT angiography performed using a 320 detector-row volume scanner. Radiology 254, 698–704.
67. EU, 1997. Council Directive 97/43 Euratom, on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466 Euratom. Official Journal of the European Communities L180, 22–27.
68. Faulkner, K., Werduch, A., 2008a. An estimate of the collective dose to the European population from cardiac x-ray procedures. Br. J. Radiol. 81, 955–962.
69. Faulkner, K., Werduch, A., 2008b. Analysis of the frequency of interventional cardiology in various European countries. Rad. Prot. Dosimetry 129, 74–76.
70. FDA, 1994. Public Health Advisory. Avoidance of Serious X-ray Induced Skin Injuries to Patients during Fluoroscopically Guided Procedures. Center for Devices and Radiological Health, US Food and Drug Administration, Rockville, MD.
71. Finkelstein, M.M., 1998. Is brain cancer an occupational disease of cardiologists? Can. J. Cardiol. 14, 1385–1388.
72. Fletcher, D.W., Miller, D.L., Balter, S., et al., 2002. Comparison of four techniques to estimate radiation dose to skin during angiographic and interventional radiology procedures. J. Vasc. Interv. Radiol. 13, 391–397.
73. Frazier, T.H., Richardson, J.B., Fabre, V.C., et al., 2007. Fluoroscopy-induced chronic radiation skin injury: a disease perhaps often overlooked. Arch. Dermatol. 143, 637–640.
74. Gerber, T.C., Stratmann, B.P., Kuzo, R.S., et al., 2005. Effect of acquisition technique on radiation dose and image quality in multidetector row computed tomography coronary angiography with submillimeter collimation. Invest. Radiol. 40, 556–563.
75. Gerber, T.C., Carr, J.J., Arai, A.E., et al., 2009. Ionizing radiation in cardiac imaging. A Science Advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation 119, 1056–1065.
76. Germano, J.J., Day, G., Gregorious, D., et al., 2005. A novel radiation protection drape reduces radiation exposure during fluoroscopy guided electrophysiology procedures. J. Invasive Cardiol. 17, 469–472.
77. Gibson, P.B., Demus, D., Noto, R., et al., 2002. Low event rate for stress-only perfusion imaging in patients evaluated for chest pain. J. Am. Coll. Cardiol. 39, 999–1004.
78. Goldstein, J.A., Balter, S., Cowley, M., et al., 2004. Occupational hazards of interventional cardiologists: prevalence of orthopedic health problems in contemporary practice. Catheter Cardiovasc. Interv. 63, 407–411.
79. Guibelalde, E., Vañó, E., Gonzalez, L., et al., 2003. Practical aspects for the evaluation of skin doses in interventional cardiology using a new slow film. Br. J. Radiol. 76, 332–336.
80. Hall, E.J., 2009. Radiation biology for pediatric radiologists. Pediatr. Radiol. 39 (Suppl. 1), S57–S64.
81. Hardell, L., Mild, K.H., Påhlson, A., et al., 2001. Ionizing radiation, cellular telephones and the risk for brain tumours. Eur. J. Cancer Prev. 10, 523–529.
82. Hausleiter, J., Meyer, T., Hermann, F., et al., 2009. Estimated radiation dose associated with cardiac CT angiography. JAMA 301, 500–507.
83. Hausleiter, J., Martinoff, S., Hadamitzky, M., et al., 2010. Image quality and radiation exposure with a low tube voltage protocol for coronary CT angiography. Results of the PROTECTION II Trial. JACC Cardiovasc. Imaging 3, 1113–1123.
84. Hendel, R.C., Berman, D.S., Di, C.M.F., et al., 2009a. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. Circulation 119, 561–587.
85. Hendel, R.C., Berman, D.S., Di, C.M.F., et al., 2009b. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J. Am. Coll. Cardiol. 53, 2201–2229.
86. Hendel, R.C., Cerqueira, M., Douglas, P.S., et al., 2010. A multicenter assessment of the use of singlephoton emission computed tomography myocardial perfusion imaging with appropriateness criteria. J. Am. Coll. Cardiol. 55, 156–162.
87. Henzlova, M.J., Cerqueira, M.D., Hansen, C.L., et al., 2009. ASNC Imaging Guidelines for Nuclear Cardiology Procedures. Stress Protocols and Tracers. American Society of Nuclear Cardiology, Bethesda, Maryland.
88. Hernanz-Schulman, M., Goske, M.J., Bercha, I.H., et al., 2011. Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR Am. J. Roentgenol. 197, 475–481.
89. Herold, D.M., Hanlon, A.L., Hanks, G.E., 1999. Diabetes mellitus: a predictor for late radiation morbidity. Int. J. Radiat. Oncol. Biol. Phys. 43, 475–479.
90. Hesse, B., Tagil, K., Cuocolo, A., et al., 2005. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur. J. Nucl. Med. Mol. Imaging 32, 855–897.
91. Hidajat, N., Wust, P., Felix, R., et al., 2006. Radiation exposure to patient and staff in hepatic chemoembolization: risk estimation of cancer and deterministic effects. Cardiovasc. Intervent. Radiol. 29, 791–796.
92. Hirshfeld Jr., J.W., Balter, S., Brinker, J.A., et al., 2004. ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. J. Am. Coll. Cardiol. 44, 2259–2282.
93. Hirshfeld Jr., J.W., Balter, S., Brinker, J.A., et al., 2005. ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Circulation 111, 511–532.
94. Hounsfield, G.N., 1979. Computed Medical Imaging.
95. Huang, B., Li, J., Law, M.W., et al., 2010. Radiation dose and cancer risk in retrospectively and prospectively ECG-gated coronary angiography using 64-slice multidetector CT. Br. J. Radiol. 83, 152–158.
96. Hunter, C., Ziadi, M., Etele, J., et al., 2010. New effective dose estimates for rubidium-82 based on dynamic PET/CT imaging in humans. J. Nucl. Med. 51 (Suppl. 2), 1429.
97. Hymes, S.R., Strom, E.A., Fife, C., 2006. Radiation dermatitis: clinical presentation, pathophysiology, and treatment. J. Am. Acad. Dermatol. 54, 28–46.
98. IAEA, 1996. International Basic Safety Standards against Ionizing Radiation and for the Safety of Radiation Sources. Safety Series No. 115. International Atomic Energy Agency, Vienna.
99. IAEA, 2001. Training in Radiation Protection and the Safe Use of Radiation Sources. Safety Report Series No. 20. International Atomic Energy Agency, Vienna.
100. IAEA, 2009. Establishing Guidance Levels in X-ray Guided Medical Interventional Procedures: a Pilot Study. Safety Reports Series No. 59. International Atomic Energy Agency, Vienna.
101. IAEA, 2010. Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures. IAEATECDOC- 1641. International Atomic Energy Agency, Vienna.
102. ICRP, 1977. Recommendations of the ICRP. ICRP Publication 26. Ann. ICRP 1(3).
103. ICRP, 1979. Limits for intakes of radionuclides by workers. ICRP Publication 30 (Part 1). Ann. ICRP 2(3/4).
104. ICRP, 1988. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53. Ann. ICRP 18(1–4).
105. ICRP, 1991. 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann. ICRP 21(1–3).
106. ICRP, 1996. Radiological protection and safety in medicine. ICRP Publication 73. Ann. ICRP 26(2).
107. ICRP, 1998. Radiation dose to patients from radiopharmaceuticals (Addendum to ICRP Publication 53). ICRP Publication 80. Ann. ICRP 28(3).
108. ICRP, 2000a. Pregnancy and medical radiation. ICRP Publication 84. Ann. ICRP 30(1).
109. ICRP, 2000b. Avoidance of radiation injuries from medical interventional procedures. ICRP Publication 85. Ann. ICRP 30(2).
110. ICRP, 2000c. Managing patient dose in computed tomography. ICRP Publication 87. Ann. ICRP 30(4).
111. ICRP, 2001. Radiation and your patient – a guide for medical practitioners. ICRP Supporting Guidance 2. Ann. ICRP 31(4).
112. ICRP, 2007a. Managing patient dose in multi-detector computed tomography (MDCT). ICRP Publication 102. Ann. ICRP 37(1).
113. ICRP, 2007b. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP 37(2–4).
114. ICRP, 2007c. Radiological protection in medicine. ICRP Publication 105. Ann. ICRP 37(6).
115. ICRP, 2008. Radiation dose to patients from radiopharmaceuticals – Addendum 3 to ICRP Publication 53. ICRP Publication 106. Ann. ICRP 38(1/2).
116. ICRP, 2009. Education and training in radiological protection for diagnostic and interventional procedures. ICRP Publication 113. Ann. ICRP 39(5).
117. ICRP, 2010. Radiological protection in fluoroscopically guided procedures outside the imaging department. ICRP Publication 117, Ann. ICRP 40(6).
118. ICRP, 2011. Statement on Tissue Reactions. ICRP. Seoul, Korea.
119. ICRP, 2012. ICRP statement on tissue reactions/early and late effects of radiation in normal tissues and organs – threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann. ICRP 41(1/2).
120. ICRP, forthcoming. Radiological protection in pediatric and diagnostic interventional radiology. ICRP Publication 121. Ann. ICRP.
121. ICRU, 2005. Patient dosimetry for X rays used in medical imaging. ICRU Report 74. J. ICRU 5, 1–113.
122. IEC, 1993. Medical Electrical Equipment. Part 1-61223. Evaluation and Routine Testing in Medical Imaging Departments. International Electrotechnical Commission, Geneva.
123. IEC, 2000. Medical Electrical Equipment. Part 2-43. Particular Requirements for the Safety of X-ray Equipment for Interventional Procedures. IEC 60601-2-43. International Electrotechnical Commission, Geneva.
124. IEC, 2004. Medical Electrical Equipment. Technical Report 60788. Glossary of Defined Terms. IEC TR 60788, second ed. International Electrotechnical Commission, Geneva.
125. IEC, 2009. Medical Electrical Equipment. Part 2-44. Particular Requirements for the Safety of X-ray Equipment for Computed Tomography. International Standard IEC 60601-2-44, third ed. International Electrotechnical Commission, Geneva.
126. IEC, 2010. Medical Electrical Equipment. Part 2-43: Particular Requirements for the Safety of X-ray Equipment for Interventional Procedures. IEC 60601-2-43, second ed. International Electrotechnical Commission, Geneva.
127. Jakobs, T.F., Becker, C.R., Ohnesorge, B., et al., 2002. Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur. Radiol. 12, 1081–1086.
128. Justino, H., 2006. The ALARA concept in pediatric cardiac catheterization: techniques and tactics for managing radiation dose. Pediatr. Radiol. 36, 146–153.
129. Kahn, H.A., Liebowitz, H.M., Ganley, J.P., et al., 1977. The Framingham Eye Study. I. Outline and major prevalence findings. Am. J. Epidemiol. 106, 17–32.
130. Karipidis, K.K., Benke, G., Sim, M.R., et al., 2007. Occupational exposure to ionizing and non-ionizing radiation and the risk of glioma. Occup. Med. (Lond.) 57, 518–524.
131. Khodadadegan, Y., Zhang, M., Pavlicek, W., et al., 2010. Automatic monitoring of localized skin dose with fluoroscopic and interventional procedures. J. Digit. Imaging 24, 626–639.
132. Kim, K.P., Miller, D.L., Balter, S., et al., 2008. Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys. 94, 211–227.
133. Kim, K.P., Miller, D.L., 2009. Minimising radiation exposure to physicians performing fluoroscopically guided cardiac catheterisation procedures: a review. Radiat. Prot. Dosimetry 133, 227–233.
134. Kim, K.P., Einstein, A.J., Berrington de Gonzalez, A., 2009. Coronary artery calcification screening: estimated radiation dose and cancer risk. Arch. Intern. Med. 169, 1188–1194.
135. Kim, C., Vasaiwala, S., Haque, F., Pratap, K., Vidovich, M.I., 2010. Radiation safety among cardiology fellows. Am. J. Cardiol. 106, 125–128.
136. King, J.N., Champlin, A.M., Kelsey, C.A., et al., 2002. Using a sterile disposable protective surgical drape for reduction of radiation exposure to interventionalists. AJR Am. J. Roentgenol. 178, 153–157.
137. Kleiman, N.J., 2007. Radiation Cataract. Working Party on Research Implications on Health and Safety Standards of the Article 31 Group of Experts. Radiation Protection 145 EU Scientific Seminar 2006. New Insights in Radiation Risk and Basic Safety Standards. European Commission, Brussels, pp. 81– 95.
138. Klein, L.W., Miller, D.L., Balter, S., et al., 2009. Occupational health hazards in the interventional laboratory: time for a safer environment. Heart Rhythm 6, 439–444.
139. Koenig, T.R., Wolff, D., Mettler, F.A., et al., 2001a. Skin injuries from fluoroscopically guided procedures. Part 1. Characteristics of radiation injury. AJR Am. J. Roentgenol. 177, 3–11.
140. Koenig, T.R., Mettler, F.A., Wagner, L.K., 2001b. Skin injuries from fluoroscopically guided procedures. Part 2. Review of 73 cases and recommendations for minimizing dose delivered to patient. AJR Am. J. Roentgenol. 177, 13–20.
141. Kuon, E., Schmitt, M., Dahm, J.B., 2002. Significant reduction of radiation exposure to operator and staff during cardiac interventions by analysis of radiation leakage and improved lead shielding. Am. J. Cardiol. 89, 44–49.
142. Kuon, E., Birkel, J., Schmitt, M., et al., 2003. Radiation exposure benefit of a lead cap in invasive cardiology. Heart 89, 1205–1210.
143. Kuon, E., Dahm, J., Empen, K., et al., 2004. Identification of less-irradiating tube angulations in invasive cardiology. J. Am. Coll. Cardiol. 44, 1420–1428.
144. Laskey, W.K., Kimmel, S., Krone, R.J., 2000. Contemporary trends in coronary intervention: a report from the Registry of the Society for Cardiac Angiography and Interventions. Cathet. Cardiovasc. Intervent. 49, 19–22.
145. Laskey, W.K., Williams, D.O., Vlachos, H.A., et al., 2001. Changes in the practice of percutaneous coronary intervention: a comparison of enrollment waves in the National Heart, Lung, and Blood Institute (NHLBI) Dynamic Registry. Am. J. Cardiol. 87, 964–969.
146. Levi, D.S., Alejos, J.C., Moore, J.W., 2003. Future of interventional cardiology in pediatrics. Curr. Opin. Cardiol. 18, 79–90.
147. Limacher, M.C., Douglas, P.S., Germano, G., et al., 1998. ACC expert consensus document. Radiation safety in the practice of cardiology. J. Am. Coll. Cardiol. 31, 892–913.
148. Linet, M.S., Slovis, T.L., Miller, D.L., et al., 2012. Cancer risks associated with external radiation from diagnostic imaging procedures. CA Cancer J. Clin. 62, 75–100.
149. Loevinger, R., Budinger, T., Watson, E., 1988. MIRD Primer for Absorbed Dose Calculations. Society of Nuclear Medicine, New York.
150. Lundberg, T.M., Gray, P.J., Bartlett, M.L., 2002. Measuring and minimizing the radiation dose to nuclear medicine technologists. J. Nucl. Med. Technol. 30, 25–30.
151. Maeder, M., Verdun, F.R., Stauffer, J.C., et al., 2005. Radiation exposure and radiation protection in interventional cardiology. Kardiovaskuläre Medizin. 8, 124–132.
152. Maeder, M., Brunner-La Rocca, H.P., Wolber, T., et al., 2006. Impact of a lead glass screen on scatter radiation to eyes and hands in interventional cardiologists. Catheter Cardiovasc. Interv. 67, 18–23.
153. Mahmarian, J.J., 2010. Stress only myocardial perfusion imaging: is it time for a change? J. Nucl. Cardiol. 17, 529–535.
154. Martin, C.J., 2009. A review of radiology staff doses and dose monitoring requirements. Radiat. Prot. Dosimetry 136, 140–157.
155. Martinez, L.C., Vañó, E., Gutierrez, F., et al., 2007. Patient doses from fluoroscopically guided cardiac procedures in pediatrics. Phys. Med. Biol. 52, 4749–4759.
156. MARTIR (Multimedia and Audiovisual Radiation Protection Training in Interventional Radiology), 2002. CD-ROM. Radiation Protection 119. European Commission. Directorate General Environment, Nuclear Safety and Civil Protection, Luxembourg.
157. Matanoski, G.M., Seltser, R., Sartwell, P.E., et al., 1975. The current mortality rates of radiologists and other physician specialists: specific causes of death. Am. J. Epidemiol. 101, 199–210.
158. McCollough, C.H., 2008. CT dose: how to measure, how to reduce. Health Phys. 95, 508–517.
159. McCollough, C.H., Schueler, B.A., Atwell, T.D., et al., 2007. Radiation exposure and pregnancy: when should we be concerned? Radiographics 27, 909–918.
160. McCormick, V.A., Schultz, C.C., Hollingsworth-Schuler, V., et al., 2002. Reducing radiation dose in the cardiac catheterization laboratory by design alterations and staff education. Am. J. Cardiol. 90, 903– 905.
161. McFadden, S.L., Mooney, R.B., Shepherd, P.H., 2002. X-ray dose and associated risks from radiofrequency catheter ablation procedures. Br. J. Radiol. 75, 253–265.
162. McGale, P., Darby, S.C., 2008. Commentary: a dose-response relationship for radiation-induced heart disease - current issues and future prospects. Int. J. Epidemiol. 37, 518–523.
163. McGeoghegan, D., Binks, K., Gillies, M., et al., 2008. The non-cancer mortality experience of male workers at British Nuclear Fuels plc, 1946–2005. Int. J. Epidemiol. 37, 506–518.
164. Meier, B., 2010. Cardiac Catheterization Interventions: European Statistics 2007/2008. Presented at Euro PCR, Paris, France. May 25–28, 2010.
165. Miller, D.L., 2008. Overview of contemporary interventional fluoroscopy procedures. Health Phys. 95, 638–644.
166. Miller, D.L., Balter, S., Noonan, P.T., et al., 2002. Minimizing radiation-induced skin injury in interventional radiology procedures. Radiology 225, 329–336.
167. Miller, D.L., Balter, S., Schueler, B.A., et al., 2010a. Clinical radiation management for fluoroscopically guided interventional procedures. Radiology 257, 321–332.
168. Miller, D.L., Van˜ó, E., Bartal, G., et al., 2010b. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovasc. Interv. Radiol. 33, 230–239.
169. Miller, J.A., Raichlin, E., Williamson, E.E., et al., 2010c. Evaluation of coronary CTA appropriateness criteria in an academic medical center. J. Am. Coll. Radiol. 7, 125–131.
170. Miller, D.L., Balter, S., Dixon, R.G., et al., 2012. Quality improvement guidelines for recording patient radiation dose in the medical record for fluoroscopically guided procedures. J. Vasc. Interv. Radiol. 23, 11–18.
171. Monaco, J.L., Bowen, K., Tadros, P.N., et al., 2003. Iatrogenic deep musculocutaneous radiation injury following percutaneous coronary intervention. J. Invasive Cardiol. 15, 451–453.
172. Mond, H.G., Irwin, M., Morillo, C., et al., 2004. The world survey of cardiac pacing and cardioverter defibrillators: calendar year 2001. Pacing Clin. Electrophysiol. 27, 955–964.
173. Moore, W.E., Ferguson, G., Rohrmann, C., 1980. Physical factors determining the utility of radiation safety glasses. Med. Phys. 7, 8–12.
174. Moran, A., Gu, D., Zhao, D., et al., 2010. Future cardiovascular disease in China: Markov model and risk factor scenario projections from the coronary heart disease policy model - China. Circ. Cardiovasc. Qual. Outcomes 3, 243–252.
175. Morin, R.L., Gerber, T.C., McCollough, C.H., 2003. Radiation dose in computed tomography of the heart. Circulation 107, 917–922.
176. Moss, A.J., Zareba, W., Hall, W.J., et al., 2002. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N. Engl. J. Med. 346, 877–883.
177. NCI, 2005. Interventional Fluoroscopy: Reducing Radiation Risks for Patients and Staff. NIH Publication No. 05-5286. National Cancer Institute, Bethesda, MD.
178. NCRP, 1993. Limitation of Exposure to Ionizing Radiation. NCRP Report No. 116. National Council on Radiation Protection and Measurements, Bethesda, MD.
179. NCRP, 1995. Use of Personal Monitors to Estimate Effective Dose Equivalent and Effective Dose to Workers for External Exposure to Low-LET Radiation. NCRP Report No. 122. National Council on Radiation Protection and Measurements, Bethesda, MD.
180. NCRP, 2000. Radiation Protection for Procedures Performed Outside the Radiology Department. NCRP Report No. 133. National Council on Radiation Protection and Measurements, Bethesda, MD.
181. NCRP, 2009. Ionizing Radiation Exposure of the Population of the United States. NCRP Report No. 160. National Council on Radiation Protection and Measurements, Bethesda, MD.
182. NCRP, 2010. Radiation Dose Management for Fluoroscopically Guided Interventional Medical Procedures. NCRP Report No. 168. National Council on Radiation Protection and Measurements, Bethesda, MD.
183. Neofotistou, V., Vañó, E., Padovani, R., et al., 2003. Preliminary reference levels in interventional cardiology. Eur. Radiol. 13, 2259–2263.
184. NHS, 1993. What do we mean by appropriate health care? Report of a working group prepared for the Director of Research and Development of the NHS Management Executive. Qual. Health Care 2, 117– 123.
185. NRC, 2006. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR-VII Phase 2. National Academy Press, Washington, DC.
186. Ortiz, P., Van˜ó, E., Padovani, R., et al., 2004. Influence of the Interventional Equipment Performance on Patient Dose and Image Quality. Results of a Survey under the IAEA International Action Plan for the Radiological Protection of Patients. ECR (European Congress of Radiology), Vienna.
187. Padovani, R., Rodella, C.A., 2001. Staff dosimetry in interventional cardiology. Radiat. Prot. Dosimetry 94, 99–103.
188. Padovani, R., Bernardi, G., Quai, E., et al., 2005. Retrospective evaluation of occurrence of skin injuries in interventional cardiac procedures. Radiat. Prot. Dosimetry 117, 247–250.
189. Padovani, R., Vano, E., Trianni, et al., 2008. Reference levels at European level for cardiac interventional procedures. Radiat. Prot. Dosimetry 129, 104–107.
190. Padovani, R., Le Heron, J., Cruz-Suarez, R., et al., 2011. International project on individual monitoring and radiation exposure levels in interventional cardiology. Radiat. Prot. Dosimetry 144, 437–441.
191. Pages, J., 2000. Effective dose and dose to the crystalline lens during angiographic procedures. JBR-BTR: Organe de la Societe Royale Belge de Radiologie 83, 108–110.
192. Pasciak, A.S., Jones, A.K., 2011. Does ‘spreading’ skin dose by rotating the C-arm during an intervention work? J. Vasc. Interv. Radiol. 22, 443–452.
193. Patel, M.R., Spertus, J.A., Brindis, R.G., et al., 2005. ACCF proposed method for evaluating the appropriateness of cardiovascular imaging. J. Am. Coll. Cardiol. 46, 1606–1613.
194. Patel, M.R., Dehmer, G.J., Hirshfeld, J.W., et al., 2009. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 appropriateness criteria for coronary revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography. J. Am. Coll. Cardiol. 53, 530–553.
195. Patton, J.A., Slomka, P.J., Germano, G., et al., 2007. Recent technologic advances in nuclear cardiology. J. Nucl. Cardiol. 14, 501–513.
196. Peterzol, A., Quai, E., Padovani, R., et al., 2005. Reference levels in PTCA as a function of procedure complexity. Radiat. Prot. Dosimetry 117, 54–58.
197. Preston, D.L., Ron, E., Yonehara, S., et al., 2002. Tumors of the nervous system and pituitary gland associated with atomic bomb radiation exposure. J. Natl. Cancer Inst. 94, 1555–1563.
198. Preston, D.L., Ron, E., Tokuoka, S., et al., 2007. Solid cancer incidence in atomic bomb survivors: 1958– 1998. Radiat. Res. 168, 1–64.
199. Raff, G.L., Chinnaiyan, K.M., Share, D.A., et al., 2009. Radiation dose from cardiac computed tomography before and after implementation of radiation dose-reduction techniques. JAMA 301, 2340–2348.
200. RCR, 2007. Making the Best Use of Clinical Radiology Services: Referral Guidelines, sixth ed. Royal College of Radiologists, London.
201. Rehani, M.M., 2007. Training of interventional cardiologists in radiation protection – the IAEA's initiatives. Int. J. Cardiol. 114, 256–260.
202. Rehani, M.M., Ortiz-Lopez, P., 2006. Radiation effects in fluoroscopically guided cardiac interventions – keeping them under control. Int. J. Cardiol. 109, 147–151.
203. Renaud, L., 1992. A 5-y follow-up of the radiation exposure to in-room personnel during cardiac catheterization. Health Phys. 62, 10–15.
204. Rice, M.J., McDonald, R.W., Li, X., et al., 2002. New technology and methodologies for intraoperative, perioperative, and intraprocedural monitoring of surgical and catheter interventions for congenital heart disease. Echocardiography 19, 725–734.
205. Roedler, H.D., 1981. Accuracy of Internal Dose Calculations with Special Consideration of Radiopharmaceutical Biokinetics, Third International Radiopharmaceutical Dosimetry Symposium, HHS Publication FDA 81-8166. Department of Health and Human Welfare, Bureau of Radiological Health, Rockville, MD.
206. Rosenthal, L.S., Mahesh, M., Beck, T.J., et al., 1998. Predictors of fluoroscopy time and estimated radiation exposure during radiofrequency catheter ablation procedures. Am. J. Cardiol. 82, 451–458.
207. Salukhe, T.V., Dimopoulos, K., Francis, D., 2004. Cardiac resynchronisation may reduce all-cause mortality: meta-analysis of preliminary COMPANION data with CONTAK-CD, InSync ICD, MIRACLE and MUSTIC. Int. J. Cardiol. 93, 101–103.
208. Sanz, J., Rius, T., Kuschnir, P., et al., 2005. The importance of end-systole for optimal reconstruction protocol of coronary angiography with 16-slice multidetector computed tomography. Invest. Radiol. 40, 155–163.
209. Sawdy, J.M., Gocha, M.D., Olshove, V., et al., 2009. Radiation protection during hybrid procedures: innovation creates new challenges. J. Invasive Cardiol. 21, 437–440.
210. Schroeder, S., Achenbach, S., Bengel, F., et al., 2008. Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group on Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur. Heart J. 29, 531–556.
211. Schueler, B.A., Vrieze, T.J., Bjarnason, H., et al., 2006. An investigation of operator exposure in interventional radiology. RadioGraphics 26, 1533–1541.
212. Schueler, B.A., Sturchio, G., Landsworth, R., et al., 2009. Does new lightweight leaded eyewear provide adequate radiation protection for fluoroscopists? Med. Phys. 36, 2747–2748.
213. Senthamizhchelvan, S., Bravo, P.E., Esaias, C., et al., 2010. Human biodistribution and radiation dosimetry of 82Rb. J. Nucl. Med. 51, 1592–1599.
214. Shack, R.B., Lynch, J.B., 1987. Radiation dermatitis. Clin. Plast. Surg. 14, 391–401.
215. Shimizu, Y., Kodama, K., Nishi, N., et al., 2010. Radiation exposure and circulatory disease risk: Hiroshima and Nagaski atomic bomb survivor data, 1950–2003. BMJ 340, b5349.
216. Shope, T.B., 1996. Radiation-induced skin injuries from fluoroscopy. Radiographics 16, 1195–1199.
217. Shore, R.E., Moseson, M., Xue, X., et al., 2002. Skin cancer after x-ray treatment for scalp ringworm. Radiat. Res. 157, 410–418.
218. Shore, R.E., Neriishi, K., Nakashima, E., 2010. Epidemiological studies of cataract risk at low to moderate radiation doses: (not) seeing is believing. Radiat. Res. 174, 889–894.
219. Sidhu, M.K., Goske, M.J., Coley, B.J., et al., 2009. Image gently, step lightly: increasing radiation dose awareness in pediatric interventions through an international social marketing campaign. J. Vasc. Interv. Radiol. 20, 1115–1119.
220. Sistrom, C.L., 2008. In support of the ACR appropriateness criteria. J. Am. Coll. Radiol. 5, 630–635.
221. Smart, R., 2004. Task-specific monitoring of nuclear medicine technologists' radiation exposure. Radiat. Prot. Dosimetry 109, 201–209.
222. Smith-Bindman, R., Lipson, J., Marcus, R., et al., 2009. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch. Intern. Med. 169, 2078–2086.
223. Stabin, M., 2006. Nuclear medicine dosimetry. Phys. Med. Biol. 51, R187–R202.
224. Stabin, M.G., 2008a. Uncertainties in internal dose calculations for radiopharmaceuticals. J. Nucl. Med. 49, 853–860.
225. Stabin, M.G., 2008b. Radiopharmaceuticals for nuclear cardiology: radiation dosimetry, uncertainties, and risk. J. Nucl. Med. 49, 1555–1563.
226. Stabin, M.G., 2010. Proposed revision to the radiation dosimetry of 82Rb. Health Phys. 99, 811–813.
227. Stabin, M., Siegel, J., Hunt, J., et al., 2001. RADAR: the radiation dose assessment resource – an online source of dose information for nuclear medicine and occupational radiation safety. J. Nucl. Med. 42 (Suppl.), 243.
228. Stecker, M.S., Balter, S., Towbin, R.B., et al., 2009. Guidelines for patient radiation dose management. J. Vasc. Interv. Radiol. 20, S263–S273.
229. Stern, S.H., Renaud, L., Zankl, M., 1995. Handbook of Selected Tissue Doses for Fluoroscopic and Cineangiographic Examination of the Coronary Arteries (in SI Units). HHS Publication FDA 95-8288. Food and Drug Administration, Rockville, MD.
230. Stifter, E., Sacu, S., Thaler, A., et al., 2006. Contrast acuity in cataracts of different morphology and association to self-reported visual function. Invest. Ophthalmol. Vis. Sci. 47, 5412–5422.
231. Stratakis, J., Damilakis, J., Hatzidakis, A., et al., 2006. Occupational radiation exposure from fluoroscopically guided percutaneous transhepatic biliary procedures. J. Vasc. Interv. Radiol. 17, 863–871.
232. Sun, Z., Ng, K.H., 2011. Prospective versus retrospective ECG-gated multislice CT coronary angiography: a systematic review of radiation dose and diagnostic accuracy. Eur. J. Radiol. 81, e94–100.
233. Suzuki, S., Furui, S., Isshiki, T., et al., 2008. Patients' skin dose during percutaneous coronary intervention for chronic total occlusion. Catheter. Cardiovasc. Interv. 71, 160–164.
234. Taylor, A.J., Cerqueira, M., Hodgson, J.M., et al., 2010. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J. Am. Coll. Cardiol. 56, 1864–1894.
235. Thornton, R.H., Dauer, L.T., Altamirano, J.P., et al., 2010. Comparing strategies for operator eye protection in the interventional radiology suite. J. Vasc. Interv. Radiol. 21, 1703–1707.
236. Togni, M., Balmer, F., Pfiffner, D., et al., Group Interventional Cardiology and Coronary Pathophysiology of the European Society of Cardiology, 2004. Percutaneous coronary interventions in Europe 1992–2001. Eur. Heart J. 25, 1208–1213.
237. Tsapaki, V., Kottou, S., Vañó, E., et al., 2004. Occupational dose constraints in interventional cardiology procedures: the DIMOND approach. Phys. Med. Biol. 49, 997–1005.
238. Tsapaki, V., Ahmed, N.A., AlSuwaidi, J.S., et al., 2009. Radiation exposure to patients during interventional procedures in 20 countries: initial IAEA project results. AJR Am. J. Roentgenol. 193, 559–569.
239. Turreson, I., Notter, G., 1986. The predictive value of skin telangiectasia for late radiation effect in different normal tissues. Int. J. Radiat. Oncol. Biol. Phys. 12, 603–609.
240. UNSCEAR, 1993. Sources and Effects of Ionizing Radiation. UNSCEAR 1993 Report to the General Assembly, with Scientific Annexes. United Nations, New York.
241. UNSCEAR, 2000. Sources and Effects of Ionizing Radiation: Volume I, Sources: Annex D, Medical Radiation Exposure. Report to the General Assembly. United Nations, New York.
242. UNSCEAR, 2008. Effects of Ionizing Radiation. UNSCEAR 2006 Report to the General Assembly, with Scientific Annexes. United Nations, New York.
243. UNSCEAR, 2010. Sources of Ionizing Radiation: Volume I. Report to the General Assembly, with Scientific Annexes. United Nations, New York.
244. Vanñó, E., 2003. Radiation exposure to cardiologists: how it could be reduced. Heart 89, 1123–1124.
245. Vanñó, E., Gonzalez, L., 2001. Approaches to establishing reference levels in interventional radiology. Radiat. Prot. Dosimetry 94, 109–112.
246. Vanñó, E., Guibelalde, E., Fernandez, J.M., et al., 1997a. Patient dosimetry in interventional radiology using slow films. Br. J. Radiol. 70, 195–200.
247. Vanñó, E., Gonzalez, L., Faulkner, K., et al., 1997b. Specific Training Objectives in Radiation Protection for Medical Staff in Interventional Radiology Installations. Draft document. DIMOND European Concerted Action.
248. Vanñó, E., Arranz, L., Sastre, J.M., et al., 1998a. Dosimetric and radiation protection considerations based on some cases of patient skin injuries in interventional cardiology. Br. J. Radiol. 71, 510–516.
249. Vanñó, E., González, L., Beneytez, F., et al., 1998b. Lens injuries induced by occupational exposure in non-optimised interventional radiology laboratories. Br. J. Radiol. 71, 728–733.
250. Vanñó, E., Gonzalez, L., Guibelalde, E., et al., 1998c. Radiation exposure to medical staff in interventional and cardiac radiology. Br. J. Radiol. 71, 954–960.
251. Vanñó, E., Goicolea, J., Galvan, C., et al., 2001a. Skin radiation injuries in patients following repeated coronary angioplasty procedures. Br. J. Radiol. 74, 1023–1031.
252. Vanñó, E., Gonzalez, L., Canis, M., et al., 2003. Training in radiological protection for interventionalists. Initial Spanish experience. Br. J. Radiol. 76, 217–219.
253. Vanñó, E., Gonzalez, L., 2005. Accreditation in radiation protection for cardiologists and interventionalists. Radiat. Prot. Dosimetry 117, 69–73.
254. Vanñó, E., Gonzalez, L., Fernandez, J.M., et al., 2006a. Occupational radiation doses in interventional cardiology: a 15 year follow-up. Br. J. Radiol. 79, 383–388.
255. Vanñó, E., Gonzalez, L., Fernandez, J.M., et al., 2006b. Influence of patient thickness and operation modes on occupational and patient doses in interventional cardiology. Radiat. Prot. Dosimetry 118, 325–330.
256. Vanñó, E., Gonzalez, L., Fernandez, M., et al., 2008a. Eye lens exposure to radiation in interventional suites: caution is warranted. Radiology 248, 945–953.
257. Vanñó, E., Järvinen, H., Kosunen, A., et al., 2008b. Patient dose in interventional radiology: a European survey. Radiat. Prot. Dosimetry 129, 39–45.
258. Vanñó, E., Kleiman, N.J., Duran, A., et al., 2010. Radiation cataract risk in interventional cardiology personnel. Radiat. Res. 174, 490–495.
259. Vliestra, R.E., Wagner, L.K., Koenig, T., et al., 2004. Radiation burns as a severe complication of fluoroscopically guided cardiological interventions. J. Interv. Cardiol. 17, 131–142.
260. von Ballmoos, M.W., Haring, B., Juillerat, P., et al., 2011. Meta-analysis: diagnostic performance of lowradiation- dose coronary computed tomography angiography. Ann. Intern. Med. 154, 413–420.
261. von Boetticher, H., Lachmund, J., Hoffmann, W., 2009. Cardiac catheterization: impact of face and neck shielding on new estimates of effective dose. Health Phys. 97, 622–627.
262. Wagner, L.K., Mulhern, O.R., 1996. Radiation-attenuating surgical gloves: effects of scatter and secondary electron production. Radiology 200, 45–48.
263. Wagner, L.K., McNesse, M.D., Marx, M.V., et al., 1999. Severe skin reactions from interventional fluoroscopy: case report and review of literature. Radiology 213, 773–776.
264. Wagner, L.K., Archer, B.R., 1997. Minimizing Risks from Fluoroscopic Radiation, fourth ed. R.M. Partnership, The Woodlands, TX.
265. Wagner, L.K., Archer, B.R., Cohen, A.M., 2000. Management of patient skin dose in fluoroscopically guided interventional procedures. J. Vasc. Interv. Radiol. 11, 23–33.
266. Wagner, L.K., Archer, B.R., 2004. Minimizing Risks from Fluoroscopic X-rays: Bioeffects, Instrumentation, and Examination, fourth ed. The Woodlands, TX.
267. Wagner, L.K., 2007. Radiation injury is a potentially serious complication to fluoroscopically-guided complex interventions. Biomed. Imag. Intervent. J. 3, e22.
268. Wall, B.F., Shrimpton, P.C., 1998. The historical development of reference doses in diagnostic radiology. Radiat. Prot. Dosimetry 80, 15–19.
269. Wang, J.X., Zhang, L.A., Li, B.X., et al., 2002. Cancer incidence and risk estimation among medical x-ray workers in China, 1950–1955. Health Phys. 82, 455–466.
270. Weigold, W.G., Abbara, S., Achenbach, S., et al., 2011. Standardized medical terminology for cardiac computed tomography: a report of the Society of Cardiovascular Computed Tomography. J. Cardiovasc. Comput. Tomogr. 5, 136–144.
271. Wenzl, T.B., 2005. Increased brain cancer risk in physicians with high radiation exposure. Radiology 235, 709–710, author reply 710–711.
272. Whitby, M., Martin, C.J., 2005. A study of the distribution of dose across the hands of interventional radiologists and cardiologists. Br. J. Radiol. 78, 219–229.
273. WHO, 1982. Quality Assurance in Diagnostic Radiology. World Health Organization, Geneva.
274. WHO, 2000. Efficacy and Radiation Safety in Interventional Radiology. World Health Organization, Geneva.
275. Wolk, M.J., Peterson, E., Brindis, R., et al., 2004. President's page: the appropriate cardiologist: responsible stewardship in a golden era of cardiology. J. Am. Coll. Cardiol. 44, 933–935.
276. Worgul, B.V., Kundiyev, Y.I., Sergiyenko, N.M., et al., 2007. Cataracts among Chernobyl clean-up workers: implications regarding permissible eye exposures. Radiat. Res. 167, 233–243.
277. Yonehara, S., Brenner, A.V., Kishikawa, M., et al., 2004. Clinical and epidemiologic characteristics of first primary tumors of the central nervous system and related organs among atomic bomb survivors in Hiroshima and Nagasaki, 1958–1995. Cancer 101, 1644–1654.
278. Zanchetta, M., Maiolino, P., 2004. Intracardiac echocardiography. Do we need a new ultrasonographic window? Ital. Heart. J. 5, 173–177.