Introduction
Interventional radiology (IR) is a specialized department of medical radiology aimed at treating diseases using imaging techniques. Compared to open surgery, these procedures are less painful, reduce infection risk, and have shorter recovery periods and hospital stays (Shaw et al., 2010). Consequently, the field remains undiscovered, and its areas of application are still understudied; thus, it can cause occupational risks. Despite the fact that this activity brings positive results in the medical field, especially in the treatment of cancer-like diseases/, potential health hazards arise in the workplace.
This paper will present the historical and mathematical perspectives related to the thesis. The level one historical question is how exposure to radiation on interventional radiologists (IRs) changed over more than fifty years of the technology implementation. The second inquiry relates to the new technologies that can facilitate the working process of IRs and decrease the likelihood of radiation-related occupational risks. What is more, the issue will be discussed from a mathematical perspective. Hence, the first question posed with respect to math concerns the major tools and methods for calculating the amount of time possible for providing an interventional radiologist with permissible radiation doses at the workplace. The other one aims to explore the probable patient per interventional specialist ratio considering the growing demand for specialists in the field.
Historical Perspective
How the exposure to radiation by interventional radiologists has changed
Interventional radiology is a relatively new, dynamically developing field of modern medicine, combining extensive possibilities of radiation diagnostics and experience in the use of various minimally invasive medical diagnostic interventions. The impetus for the rapid development of this direction was the improvement of the hardware and instrumental base of specialized medical institutions (including oncological profiles) and the growing demand for new, precision, minimally invasive technologies. Even though it is a new area of medicine, its technologies have rapidly altered over the course of time.
Primarily, it is vital to explore more about the history of IR in order to trace its development. The pioneer of interventional radiology is Charles Dotter, who, in 1963, at a congress in Czechoslovakia, first expressed the idea of the high therapeutic potential of angiographic technology (Shaw et al., 2010). The researcher said that an angiographic catheter in the hands of a wise doctor with imagination would become an important therapeutic tool. The author confirmed the statement for the first time performing percutaneous angioplasty in 1964 concerning the stenosis of the superficial femoral artery in an 82-year-old patient who saved her from amputation. The world scientific community highly appreciated Dotter’s work, which nominated him for the Nobel Prize in Medicine in 1978. The result of Charles Dotter inspired many researchers, and, in addition, an avalanche of publications about the successful application of various percutaneous techniques followed.
However, their level of radiation was incredibly high, and non-invasive surgeries were rarely conducted in order to prevent occupational hazards. Nowadays, specialists are still rare in the field due to the potential harm that may occur during the shift (Shaw et al., 2010). Nonetheless, professionals use more protective measures to avoid radiation in massive doses. In addition, they use equipment that reduces amounts and directs them to the site of the operation and not to the radiologists themselves. Thus, it can be stated that the exposure to radiation among professionals decreases with the help of technological advances, yet, the level of radiation itself cannot be diminished.
New technologies that facilitate the working process of interventional radiologists
Interventional cardiologists are most exposed to radiation among all medical professionals.1 The average interventionist doctor in the United States receives almost three times the annual radiation dose compared to the average employee of a nuclear power plant. (Vano et al., 2010) This is probably an understatement since everyone knows colleagues who either did not wear their dosimeters or even took them off when they approached the borders of the hospital (Brady et al., 2022; Vano et al., 2010). The International Atomic Energy Agency (IAEA) conducted a survey of interventional cardiologists in 56 countries and found that only 33-77% regularly use radiation badges (Vano et al., 2010). This is the primary equipment used for mitigating the dosages of radiation. However, technological advances help specialists avoid any rays during surgery.
Fortunately, there is a technology that would help people better understand radiation exposure and, more importantly, even reduce the dose. For example, instead of waiting many weeks to find out if you have reached your radiation exposure limit, and after it is too late to do anything about it, we can now see this information during the procedure using a personal dosimeter. Proper use of a suspended lead-acrylic screen suspended from the ceiling can reduce the scattering radiation 2-10 times (Vano et al., 2010). The LED acrylic screen suspended from the ceiling protects the head and neck as well as the eyes (Vano et al., 2010). This technology can be used as an additional protective measure alongside lead sheets, gloves, and shields.
In general, specialists should be aware of the potential health hazards so as not to neglect safety measures and prevent fatal health outcomes. Even though the technologies advance and create new opportunities to reduce radiation exposure, it is indispensable to use existing equipment because modern one can still have implementation flaws. New dosimeters are a good technology to utilize when performing surgery using interventional radiology methods.
Mathematical Perspective
Calculating the amount of time possible for providing an interventional radiologist with permissible radiation doses at the workplace
Radiology directly deals with mathematics in terms of performing algebraic and geometric calculations to measure radiation doses, safety indicators, and other characteristics – the action of ionizing radiation is complex. The effect of irradiation depends on the magnitude of the absorbed dose, its power, the type of radiation, and the amount of irradiation of tissues and organs (Miller et al., 2010). Once the dosage is not calculated properly, there is a risk that an interventional radiologist will receive a dose and suffer from its consequences.
For those exposed to additional radiation and natural background radiation, limiting or shortening the exposure time reduces the radiation dose. As the heat from a fire weakens as one moves away, the radiation dose decreases significantly as the distance from the radiation source increases (Miller et al., 2010). Hence, the major indicators for measuring radiation are time and distance – they show the amount of time and the distance one is supposed to maintain in order not to be irradiated.
The probable patient per interventional specialist ratio
Considering the growing demand for interventional radiologists, it would be interesting to investigate the probable patient-per-specialist ratio. Since the field is relatively new, not many university and college students are willing to become IR (Bilello et al., 2020). However, people are in need of non-invasive treatment, so interventional radiology is gaining popularity. Therefore, the patient-per-professional ratio is supposed to grow within the following decades. The second research question concerns the possibility of expanding the medical staff engaged in interventional radiology in hospitals in the United States.
When speaking about the demand, it is essential to mention that patients tend to select doctors online. This is a trend leading to an increase in the number of professionals in any field. It was established that the digital presence of specialists would enlarge the patient base as well as increase their influence in medicine (Bilello et al., 2020). As a result, by emphasizing the role of IRs in medicine and promoting the profession on online platforms, it is possible that more patients will be able to receive non-invasive treatment.
Conclusion
Interventional radiology is a field of medicine based on the use of radiation diagnostic methods to perform minimally invasive interventions for diagnosis and treatment. Interventional radiologists have been introduced since the late 50s. It was due to the improvement of equipment for radiation diagnostics – with the advent of digital radiographic and fluorographic systems with high resolution and the use of ultrasound and computer guidance devices. The IRs have become widespread in many areas of medicine, replacing, in most cases, full-scale surgical interventions. Since the field is underdeveloped, it was necessary to pose questions regarding its historical and mathematical perspective. Historically viewing the topic, it is vital to analyze the changes in the level of exposure to radiation and the safety measures. When considering the issue from a mathematical standpoint, it was identified that specific tools and methods should be implemented to measure the radiation doses, and the number of specialists is likely to increase.
References
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Brady, Z., Smith, I., & Brown, N. (2022). Scoping the future for interventional radiology and interventional neuroradiology: a clinical physics perspective. Physical and Engineering Sciences in Medicine, 1-4. Web.
Miller, D. L., Vano, E., Bartal, G., Balter, S., Dixon, R., Padovani, R., Schueler, B., Cardella, J. F., & Baere, T. (2010). Occupational radiation protection in interventional radiology: A joint guideline of the cardiovascular and interventional radiology society of Europe and the society of interventional radiology. Cardiovascular and Interventional Radiology, 33, 230-239. Web.
Shaw, A., Speirs, A. J. D., & Howlett, D. (2010). Current applications of interventional radiology. British Journal of Hospital Medicine, 71(11), 619-625. Web.
Vano, E., Kleiman, N. J., Duran, A., Rehani, M. M., Echeverri, D., & Cabrera, M. (2010). Radiation cataract risk in interventional cardiology personnel. Radiation research, 174(4), 490-495. Web.