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MPPG Report 12.a - AAPM Medical Physics Practice Guideline 12.a: Fluoroscopy dose management (2022)

Category: MPPG Report

Fluoroscopy equipment is used to observe or guide moving objects such as internal organs, contrast agents, catheters, and guidewires within the body to diagnose and treat disease. Procedure times range from several seconds to multiple hours, and fluoroscopes range from small, mobile C-arms used to image extremities, to complex single- or bi-plane angiography systems. These more complex fluoroscopes are used to guide performance of fluoroscopically guided interventional (FGI) procedures, and help to provide lifesaving diagnostic and therapeutic services for patients. However, unlike simpler procedures commonly accomplished using general or mobile C-arm fluoroscopes, long and complex FGI procedures can exceed radiation thresholds for tissue reactions. Proper identification, follow-up, and management of patients receiving high doses from FGI procedures are essential parts of patient care due to the slowly developing nature of radiation-induced tissue reactions. Recent standards and requirements from accrediting bodies such as The Joint Commission (TJC) and state regulatory agencies have brought focus to this issue, requiring hospitals to record patient fluoroscopy exam dose indices and to establish committees, policies, and procedures for reviewing those data and providing patient follow-up as appropriate. These standards are in addition to TJC's updated fluoroscopy sentinel event standard, which requires identification and investigation of severe tissue effects.

Journal of Applied Clinical Medical Physics

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Keywords: fluoroscopy, MPPG, practice guideline

Ryan F. Fisher, Kimberly E. Applegate, Lindsey K. Berkowitz, Olav I. Christianson, Jaydev K. Dave, Lindsay S. DeWeese, Nichole A. Harris, Mary Ellen Jafari, A. Kyle Jones, Robert J. Kobistek, Brendan M. Loughran, Loren R. Marous, Donald L. Miller, Beth A. Schueler, BC Schwarz, Adam C. Springer, Kevin A. Wunderle

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