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An Investigation of Procedural Radiation Dose Level Awareness and Personal Training Experience in Communicating Ionizing Radiation Examinations Benefits and Risks to Patients in Two European Cardiac Centers

Banerjee, I.1; McNulty, J. P.1; Catania, D.2; Maccagni, D.3; Masterson, L.4; Portelli, J. L.5; Rainford, L.1

doi: 10.1097/HP.0000000000001049

Purpose: Cardiac interventional practitioners need to be appropriately informed regarding radiation dose quantities and risks. Communicating benefit-risk information to patients requires attention as specified in Basic Safety Standards Directive 2013/59/Eurotom. This study investigated the awareness of procedural radiation dose levels and the impact of personal training experience in communicating ionizing radiation benefit-risks to patients. Methodology: A questionnaire, consisting of 28 questions, was distributed directly to adult and pediatric interventional cardiology specialists at specialized cardiovascular imaging centers in Dublin, Ireland and Milan, Italy. Results: A total of 18 interventional cardiologists (senior registrar to consultant grades with between 2 y to over 21 y experience in cardiac imaging) participated. The majority of participants (n = 17) stated that parents of pediatric and adult patients should be informed of the potential benefits and risk. All participants indicated they had radiation safety training; however, 50% had not received training in radiation examination benefit-risk communication. Despite this, 77.8% (n = 14) participants indicated a high confidence level in successfully explaining risks and/or benefits of cardiac imaging procedures. When asked to estimate effective dose (ED) values for common cardiac imaging procedures less than 50% identified appropriate dose ranges. All participants underestimated procedural dose values based on recent European data. 50% (n = 9) participants answered all questions correctly for a number of true or false radiation risk statements. Conclusion: Benefit-risk communication training deficits and inaccurate understanding of radiation dose levels was identified. Further research and training to support clinicians using radiation on a daily basis is required.

1Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland;

2AITRI, Association of Italian Interventional Radiographers, Milan, Italy;

3San Raffaele Hospital, Milan, Italy;

4Our Lady’s University Children’s Hospital, Crumlin, Dublin, Ireland;

5Department of Radiography, Faculty of Health Sciences, University of Malta.

The authors declare no conflicts of interest.

Ipshita Banerjee graduated with a medical degree in 2016 from University College Dublin (UCD). She moved to England to work in the NHS, starting off in the East Lancashire Hospital Trust. She has since moved to the Chester NHS Hospital Trust where she is currently working in Acute Medicine. During the course of her medical studies, an opportunity arose to be involved in radiation dose awareness research and to visit two major European Cardiac Imaging Centers. As Ipshita had an interest in the subject of cardiology, she decided to get involved in the project to gain more information about and experience within the field. Her email address is

Online date: April 5, 2019

© 2019 by the Health Physics Society