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Journal of Vascular and Interventional Radiology: New patient radiation safety guidelines

FAIRFAX, Va."Society of Interventional Radiology 2009 Standards Division Guidelines" is the subject of a special supplement to the July issue of the Journal of Vascular and Interventional Radiology. SIRa national organization of physicians, scientists and allied health professionals dedicated to improving public health through disease management and minimally invasive, image-guided therapeutic interventionsprovides a unique collection of new (such as radiation dose management) and previously published clinical practice guidelines developed since 2003 through its Standards Division.

"The supplement includes 'Guidelines for Patient Radiation Dose Management,' a significant new document providing guidance on the safe use of fluoroscopy for interventional radiologists performing procedures on adult patients and children utilizing fluoroscopy. The safe use of fluoroscopy has always been a primary concern for interventional radiologists," said Michael S. Stecker, M.D., FSIR, an interventional radiologist and assistant professor at Brigham and Women's Hospital in Boston, Mass. This radiation management guideline, tailored to interventional radiology practice, emphasizes the need for increased diligence to safely manage the risks of radiation exposure from such procedures as embolization (including chemoembolization for cancer); transjugular intrahepatic portosystemic shunt (TIPS) creation for liver disease; and renal and/or visceral artery angioplasty and/or stent placement.

"The value of medical imaging is great and the risks of radiation dose are generally negligible compared to the health benefits of having a needed procedure or treatment. However, there are times when a significant radiation dose may need to be administered, and this needs to be properly handled," said Stecker. Due to the scope of the project, the standardized guidelines were developed over the past two years and are for use both in the United States and internationally, having been created in collaboration with and endorsed by the Cardiovascular and Interventional Radiological Society of Europe.

"SIR developed the guidelines collection to improve the quality of clinical care and published research relevant to the practice of interventional radiology," said Albert A. Nemcek Jr., M.D., FSIR, editor of JVIR, a peer-reviewed, monthly publication long recognized for its exceptional quality and influence as an academic and professional resource. "Members of SIR's Standards Division have continued to develop new content as well as to revise older documents as appropriate," added the interventional radiologist at Northwestern Memorial Hospital in Chicago, Ill.

The 376-page collection guest-edited by John F. Cardella, M.D., FSIR, includes quality improvement guidelines, safety guidelines new from 2003, consensus documents, credentialing statements, policy and position statements and technology assessment documents. One new feature added since the 2003 supplement is emerging technologies articles; these state-of-the-art works are written by thought leaders in emerging topics, such as nanotechnology, genetic therapy and digital detectors in computed tomography. Also included are position statements, defining not only SIR's position on a new technique or procedure, but also the societal position on such topics as the role of clinical associates in interventional radiology. There are several such collaborative documents with like-minded societies, adding strength to the collection, said Nemcek.

In the supplement's introduction, Cardella and his collaborating colleagues, Sanjoy Kundu, M.D., FSIR; Donald L. Miller, M.D., FSIR; Steven F. Millward, M.D., FSIR; and David Sacks, M.D., FSIR, offer the hope that "....these documents help you in optimizing the quality of care for patients, assuring consistency and comparability in the publication of clinical and basic science research, establishing quality assurance programs with action thresholds and learn about 'new topics on the horizon' for interventional radiology."


Contact: Maryann Verrillo
Society of Interventional Radiology

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