Interventional radiology (IR) occupies a unique position in the radiation safety landscape of UAE hospitals. IR staff receive the highest occupational radiation doses of any group in healthcare — higher than diagnostic radiographers, higher than nuclear medicine staff, higher than radiologists who only read images. The combination of extended fluoroscopy times, proximity to the primary beam, and the physical demands of procedural work creates a radiation protection challenge that standard diagnostic X-ray safety protocols do not adequately address. This article addresses the specific radiation protection needs of interventional radiology teams in UAE hospitals.
During a fluoroscopy-guided interventional procedure, the operator works at or near the patient — within the scattered radiation field — for the entire procedure duration. A complex hepatic TACE, a long EVAR, or a multi-stage peripheral vascular intervention can involve 30–60 minutes of active fluoroscopy. The scattered radiation dose rate at the operator's position during active fluoroscopy is orders of magnitude higher than the dose rate in a standard diagnostic X-ray room.
Additional factors that drive IR doses upward:
Lateral projections: Steep angulations required for complex procedures direct the beam toward the operator's hands, head and eyes.
Table height: A low table position — sometimes preferred for procedural access — places the operator closer to the scatter source and to the primary beam entry point.
Manual injections: Operators who perform manual contrast injections, balloon inflation or device manipulation during active fluoroscopy have their hands directly in or near the primary beam.
Standard IR personal protective equipment includes:
Lead aprons: Full wrap-around (front and back) 0.5mm Pb equivalent aprons are recommended for IR. Front-only aprons provide no protection to the spine when the operator is positioned with their back toward the X-ray source — a common working position during complex procedures. Weight-distributed apron systems that transfer load from the spine to the hips are strongly recommended for IR operators who spend multiple hours per day in the lab.
Thyroid collars: The thyroid is one of the most radiation-sensitive organs in adults. Thyroid collar use in IR is not optional — it is a fundamental protection measure. Dose to the lens of the eye — also highly sensitive — can be reduced by 80–90% with appropriate thyroid collar and face protection.
Lead glasses: Eye dose in IR has become a major focus internationally following the reclassification of the lens of the eye dose limit from 150 mSv/year to 20 mSv/year. For IR operators performing high-workload fluoroscopy, lead glasses are now considered mandatory, not optional.
Ring dosimeters: Extremity doses in IR — particularly to the hands of operators who perform manual procedures under fluoroscopy — frequently exceed the doses recorded by the whole-body dosimeter at the collar level. Ring dosimeters, worn on the dominant hand, measure this extremity dose and are required for IR operators in a properly managed dosimetry programme.
Technique modifications that reduce operator dose without compromising procedure quality:
Pulsed fluoroscopy: Using the lowest pulse rate that provides adequate image quality — typically 7.5 or 4 frames per second rather than 15 or 30 — reduces dose by 50–75% compared to continuous fluoroscopy.
Last image hold: Using the last image hold (stored fluoroscopic image) for reference rather than continuous fluoroscopy while not actively advancing devices reduces unnecessary exposure.
Collimation: Tight collimation reduces the field of radiation to the minimum needed. A smaller primary beam means less scatter at the operator's position.
Couch position: Positioning the patient as close to the detector as possible — and as far from the X-ray source as possible — reduces scatter intensity at the operator's position.
Fluoroscopy time discipline: Minimising fluoroscopy time through preparation, planning and skill is the most powerful dose reduction strategy. A planned procedure performed efficiently produces far less radiation than a poorly planned procedure with multiple runs.
IR operators should have at minimum two dosimeters:
Whole-body dosimeter worn at collar level, outside the lead apron: This measures dose to the head, neck and lens of the eye — areas not covered by the apron.
Ring dosimeter on the dominant hand: This measures extremity dose during manual fluoroscopy-guided procedures.
For high-workload IR operators, monthly dosimetry reporting is strongly recommended. Annual dose investigation levels for IR staff should be reviewed against FANR dose limits and compared with published benchmarks for IR dose levels.
RevirzaMed provides complete dosimetry programmes for IR departments, including collar and ring dosimeters, monthly reporting, investigation level alerts, and dose history management.
FANR follows IAEA recommendations: effective dose limit 20 mSv/year averaged over 5 years, with no single year exceeding 50 mSv. For the lens of the eye: 20 mSv/year. For the extremities: 500 mSv/year. High-performing IR departments internationally maintain operator doses well below these limits through technique optimisation and protective equipment.
Ceiling-mounted or table-mounted lead glass screens, positioned between the operator and the primary beam scatter source, reduce head and lens dose by 60–90% without requiring the operator to wear heavy lead glasses. They are strongly recommended for IR suites and catheterisation laboratories.
RevirzaMed Healthcare Solutions — Abu Dhabi's trusted FANR Approval and medical equipment specialists since 2015.