RTs and Radiation Dose

There’s good news and bad news from a new study in Journal of Vascular and Interventional Radiology that tracks 40 years of occupational radiation dose to radiologic technologists who assist with fluoroscopically guided interventional procedures. The good news is that radiation dose is low and trending lower over time; the bad news is that dose to RTs can vary based on work setting. 

As we discussed last month, interventional radiology has delivered major benefits in patient care, replacing invasive surgery for many clinical applications. 

  • But the downside of interventional procedures is that they are performed for extended periods under fluoroscopy guidance, and more complex procedures are requiring longer times with the fluoro beam on – potentially leading to more radiation exposure. 

Researchers from the NIH wanted to investigate how changes in interventional use over the past 40 years affected occupational radiation dose exposure to RTs, while also looking at the impact of radiation exposure control methods. 

  • They reviewed records from 1980 to 2020, starting with RTs participating in the US Radiologic Technologists (USRT) research study who they then linked to data submitted to radiation dosimeter badge maker Landauer. 

In all, 19.7k RTs who reported assisting with fluoroscopically guided interventional procedures over the study period were included, with researchers finding … 

  • Median annual radiation dose of 0.65 mSv, well below the occupational limit of 20 mSv
  • Median doses were highest in the 1980s and decreased over time, reflecting greater awareness of patient radiation dose and better radiation protection gear
  • A second peak in radiation dose happened from 1999-2011, most likely due to more sensitive dosimeters
  • RTs who worked closer to patients (<3 feet) had higher median annual dose, at 1.20 mSv
  • RTs who reported assisting with ≥ 20 procedures per month had higher dose, at 0.75 mSv

The researchers concluded that their findings show that radiation dose control measures are working, and better radiation dosimetry technology offers a far more accurate picture of how much dose RTs are actually exposed to. 

The Takeaway

The study’s findings should give technologists who assist with interventional procedures peace of mind that their radiation dose exposure is well within established limits. But as always with radiation exposure, vigilance is warranted. 

Technologists in the Spotlight

Radiographers and technologists were at the center of this week’s radiology news cycle, as three unrelated pieces highlighted the crucial role radtechs play, the significant challenges they face, and the actions required to help them succeed.

CXR Call to Action – After finding that nearly half of their portable chest X-ray images were “problematic,” a team of Stony Brook physicians issued a “call to action” to better support radiology technologists. Analysis of 500 portable CXRs found 231 problematic exams (46.2%), which most commonly occurred during overnight shifts (48%), and often stemmed from patient positioning issues. 

  • A focus group featuring six technologist department managers led the authors to propose three additional RT resources: (1) creating ongoing training programs focused on patient positioning, (2) assigning nurses to assist technologists during exams, 3) tasking internal medicine residents with reviewing CXRs before they’re sent to radiologists.

Big Teams, Little Training – The UK’s Society of Radiographers highlighted radiography managers’ struggles with high workloads and insufficient training (n = 200), finding that many of these leaders directly manage over 20 or 30 employees (52% & 40%… yikes) and never received manager training from their hospital (45%).

  • The authors called these huge team sizes and lack of training a “gross miscalculation,” warning that it will cause managers to “undoubtedly fail in their duty of care to their staff,” especially considering that managers are often pulled into clinical duties due to understaffing.

Patient Safety’s Last Step – The WHO partnered with the ISRRT and ISR to emphasize radiographers and radtechs’ role as “the last step” in patient safety and medicine delivery, filling in gaps missed by radiation and magnetic safety experts. The collaborative webinar addressed radiographers/technologists’ responsibilities for ensuring safe contrast and radiopharmaceutical use, maintaining pediatric imaging best practices, and ensuring that pre-administration processes are complete before medication delivery. 

The Takeaway

We talk a lot about modality-based approaches to improve radtech efficiency and reduce team burnout, and those are surely needed. However, this week’s news cycle was a solid reminder of HR’s role in technologist performance and what’s at stake if techs aren’t properly supported, trained, and staffed.

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