{"title":"Radiation safety and dose management in fluoroscopy-guided gastrointestinal procedures: current evidence and future perspectives.","authors":"Tsutomu Nishida, Shiro Hayashi, Kenji Ikezawa, Kengo Matsumoto, Mamoru Takenaka, Makoto Hosono","doi":"10.1080/17474124.2025.2522287","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Fluoroscopy-guided procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), gastrointestinal stenting, balloon-assisted enteroscopy (BAE), and tube placement, are essential in gastroenterology. However, radiation exposure poses risks to patients and clinicians. Many gastroenterologists receive limited training in radiation safety, underscoring the need for increased awareness of radiation and dose management strategies.</p><p><strong>Areas covered: </strong>This review discusses safety and dose optimization strategies for fluoroscopy-guided procedures. Radiation exposure in different procedures, imaging techniques, and methods for minimizing radiation doses are reviewed. International guidelines, including those from the American Society for Gastrointestinal Endoscopy (ASGE), the European Society of Gastrointestinal Endoscopy (ESGE), and Japan's Diagnostic Reference Levels (DRLs), are reviewed. Recommendations, including reducing fluoroscopy durations, performing pulsed fluoroscopy, optimizing collimation, and implementing appropriate shielding measures, are provided. The importance of structured radiation safety education for gastroenterologists is emphasized. Relevant literature was identified through a manual PubMed search.</p><p><strong>Expert opinion: </strong>Increasing radiation safety in gastrointestinal fluoroscopy requires education, technology, and adherence to guidelines. Establishing procedure- and facility-specific DRLs can help standardize dose management. Further research and global collaboration are needed to refine safety protocols. Integrating these strategies into routine practice will significantly reduce radiation exposure, improving safety for patients and clinicians.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Gastroenterology & Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474124.2025.2522287","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Fluoroscopy-guided procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), gastrointestinal stenting, balloon-assisted enteroscopy (BAE), and tube placement, are essential in gastroenterology. However, radiation exposure poses risks to patients and clinicians. Many gastroenterologists receive limited training in radiation safety, underscoring the need for increased awareness of radiation and dose management strategies.
Areas covered: This review discusses safety and dose optimization strategies for fluoroscopy-guided procedures. Radiation exposure in different procedures, imaging techniques, and methods for minimizing radiation doses are reviewed. International guidelines, including those from the American Society for Gastrointestinal Endoscopy (ASGE), the European Society of Gastrointestinal Endoscopy (ESGE), and Japan's Diagnostic Reference Levels (DRLs), are reviewed. Recommendations, including reducing fluoroscopy durations, performing pulsed fluoroscopy, optimizing collimation, and implementing appropriate shielding measures, are provided. The importance of structured radiation safety education for gastroenterologists is emphasized. Relevant literature was identified through a manual PubMed search.
Expert opinion: Increasing radiation safety in gastrointestinal fluoroscopy requires education, technology, and adherence to guidelines. Establishing procedure- and facility-specific DRLs can help standardize dose management. Further research and global collaboration are needed to refine safety protocols. Integrating these strategies into routine practice will significantly reduce radiation exposure, improving safety for patients and clinicians.
期刊介绍：
The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.
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