Occupational Radiation Exposure in Diagnostic and Interventional Radiology: A Comprehensive Review

Abstract

Abstract Introduction: The use of ionising radiation in medical imaging and interventional procedures has been steadily increasing for both diagnostic and therapeutic purposes. Fluoroscopy, which provides real-time imaging, is widely employed in diagnostic and interventional radiology. However, fluoroscopy-guided interventional procedures (FGIPs) represent one of the highest occupational radiation exposure risks for healthcare personnel. This review aims to evaluate the radiation doses received by medical staff in fluoroscopy rooms and to discuss protective strategies based on current literature. Materials and Methods: A comprehensive literature review was conducted by analysing studies published between 2000 and 2025 in PubMed, Scopus, and Google Scholar databases using the keywords “fluoroscopy,” “radiation exposure,” “occupational dose,” “interventional radiology,” and “radiation protection.” Studies reporting staff dose measurements, effects of procedure type, protective equipment performance, and scatter geometry were reviewed. Findings were compared with international reference limits recommended by the ICRP and UNSCEAR. Results: Most reported annual effective doses among fluoroscopy personnel remained within regulatory limits; however, up to 15% of interventional radiology staff exceeded the revised 20 mSv/year lens dose limit. The highest exposures occurred at the hands and eye lenses of operators. Proper use of lead glasses and ceiling-suspended shields reduced radiation by 60–98%. Dose optimisation through low-dose modes, Digital Subtraction Angiography (DSA) parameter adjustment, and real-time feedback systems provided further reduction in occupational exposure. Conclusion: Fluoroscopy-guided interventions continue to pose a significant occupational hazard. Minimising operator dose requires not only effective shielding and equipment optimisation but also the adoption of a proactive safety culture supported by continuous feedback, proper dosimetry, and geometry-aware procedural awareness. Keywords: Fluoroscopy, Occupational radiation exposure, Interventional radiology, Radiation protection, Dose optimisation, Scatter radiation, Lens dose.