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Brain and Neck Cancer Prominence Amongst Interventional Cardiologists

by Kane Wallmann

Due to the lengthy periods of time interventional cardiologists remain in close proximity to the radiation zone, the risk of radiation-induced malignancies is critically high.

The potential for dramatic biological effects on humans from long-term exposure to ionizing radiation is well-known. Interventional cardiologists, more than most, face this unfortunate reality each time they step into a medical procedure. Due to the repeatedly long exposures experienced during interventional procedures, the occupational health concerns for interventional cardiologists are amongst the highest of all healthcare imaging professions.

A recent study published in The American Journal of Cardiology[1] places a spotlight on the health risks within interventional radiology. The researchers behind this study report on 9 cases of brain cancer in interventional physicians within America and an additional 22 cases from around the world. Notably, the cases reported on in this study observed tumour types which have all been associated with long-term radiation exposure, the majority of which being glioblastoma multiforme.

The regrettable outcome of these cases were that more than half of the diagnoses resulted in death within 4 years of detection. A number of staggering statistics were developed as a result of this research. Of the 31 cases in this study, cancer was detected as early as 12 years after the cardiologist started work in their field and on average 22 years after. All but 4 operators had malignancy detected in the left side of their brain.

During interventional procedures, physicians are required to wear heavy leaded aprons to provide a physical barrier to scatter and direct radiation exposure. A typical lead apron only provides protection from the neck to the knees. Whilst covering these areas is important, reports show that cardiologists receive almost 10 times more radiation exposure to their head than the rest of their body. This fact is coherent with the disproportionate pattern of left-sided lesions shown in this recent study.

The left side of the brain is known to be both less protected by shielding and more exposed to radiation – a potentially fatal combination. The information gathered from this study provides insight into the occupational risks associated with interventional cardiology. The good news is that knowing what we know about the exposure patterns for these procedures we can take steps to reduce the risks that physicians, like the ones in this study, present themselves to on a daily basis.

Lead aprons are only a single element of a more complete requirement. Full protection, specifically for the neck and head, is of the utmost importance.

Imaging Solutions recommends the usage of a complete gamut of radiation protective apparel. The importance of this is compounded for interventional physicians. Moreover, all physicians who are exposed to radiation in an occupational setting should always be looking for ways to reduce their exposure to radiation. This can be achieved through education, training and the use of purposed-designed protective equipment. For more information about radiation protection or to book an in-service presentation for your department on the care and use of personal radiation protection, contact us today.

Information in this article was gathered from: Roguin, A., Goldstein, J., Bar, O. and Goldstein, J. (2013). Brain and neck tumors among physicians performing interventional procedures. The American journal of cardiology, 111(9), pp.1368–1372.