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Vascular and Interventional Radiology

E3180. Radiologic Physics: What Every Interventional Radiologist Should Know

Bhatt N,  Abdelbaki A,  Kumar Y. Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT

Address correspondence to A. Abdelbaki (a.baki@aol.com)

Background Information: Knowledge of radiation physics basic principles is paramount to the interventional radiologist. The interventional radiologist is ultimately responsible for radiation exposure. Therefore, it is important to achieve the lowest possible dose for the patient and staff. The interventional radiologist should have a solid background in physics. Furthermore, having a solid physics background improves image quality which ultimately improves the clinical outcome. The purpose of this exhibit is to emphasize the different fluoroscopy parameters that affect radiation doses during angiography.

Educational Goals/Teaching Points: This exhibit serves as a refresher to interventional radiologists and residents about the basic physics. Upon reviewing the exhibit, the participant should be able to understand steps to minimize radiation exposure to the interventional radiology staff, use different techniques that affect patient radiation dose, and explain different ways to optimize image quality.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Physics principles are usually taught in residency and often forgotten after residency completion. This exhibit discusses different physics principles related to interventional radiology. Image quality is mainly determined by image intensifiers and flat panel detectors. Principles include appropriate distances between the patient and the x-ray tube as well as the patient and receptor, inverse square principle, and nature of scatter radiation. Additionally, other factors such as personal protective devices, tube voltage and current, collimation, pulsed fluoroscopy, magnification, and beam filtration are discussed. Furthermore, attention to dose metrics included in the dose report is required to guarantee safe practice. The concept of sentinel event is also discussed including definition, how to avoid sentinel events from happening, and what needs to be done if such event occurs.

Conclusion: Having a solid understanding of basic physics principles is needed for the interventional radiologist to safely carry out different procedures. Knowledge of physics is also essential for improvements in image quality. This exhibit serves as a quick refresher for the interventional radiologists and residents on basic physics principles.