Why have radiation doses and reports of significant tissue injury from interventional fluoroscopy procedures increased over the last two decades?

The increase in radiation doses and reports of significant tissue injury from interventional fluoroscopy procedures over the last two decades can primarily be attributed to the complexity and duration of these procedures. As medical technology and techniques have advanced, interventional procedures have become more intricate, often requiring prolonged exposure to fluoroscopy. This extended use inherently raises the radiation dose to both the patient and the operator.

In complex cases, multiple views may be necessary to achieve accurate diagnoses or interventions, which can lead to increased fluoroscopic times and higher radiation exposure. Additionally, as the complexity of procedures grows, there may be a need for additional imaging and adjustments during the intervention, further compounding the duration and consequent radiation exposure.

While regulations have certainly evolved to address safety concerns, and training is an ongoing area of emphasis, the primary driver for the increase in reported doses and injury remains the technical demands and time associated with modern interventional fluroscopy practices. This highlights the importance of continually assessing and improving safety protocols to minimize radiation risks while effectively managing complex clinical scenarios.