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29 October 2025, 3:00 pm CET (Vienna time)

Panellists: Steven Balter (USA), Aaron Kyle Jones (USA), Donald Miller (USA), Osvaldo Rampado (Italy), Andy Rogers (UK), Roberto Sanchez (Spain), Jenia Vassileva (Bulgaria)

Moderator: Vesna Gershan (IAEA)

About the webinar:

Fluoroscopically guided interventional (FGI) procedures have increased considerably in number and complexity: the estimated annual global frequency has increased more than fivefold, from 0.6 procedures per 1000 population to 3.2, between 2009 and 2018.

During some complex FGI procedures, patients may receive high radiation doses, leading to tissue reactions, skin injuries and, in severe cases, bone injuries. As there is no immediate sensation, the symptoms and the extent of the injury might not be recognized for weeks or months, yet injuries can become extremely painful and they are often misdiagnosed.

IAEA Specific Safety Guide SSG-46, Radiation Protection and Safety in Medical Uses of Ionizing Radiation, recommends that facilities performing FGI procedures implement systems for identifying and following up with patients who may be at risk of such radiation injuries, and offer appropriate medical attention. However, there is evidence that not all facilities run follow-up programmes, meaning skin injuries might go undetected, causing serious suffering for the patients concerned.

On request of its Member States, in 2022 the IAEA launched an international study of patient doses and tissue reactions from FGI procedures. The study gathered information about the frequency of patient tissue reactions from different types of FGI procedures in different parts of the world, and investigated the relationship between radiation exposure metrics, procedure factors, patient-related factors and tissue reactions. The findings can be used to update trigger values for patient follow-ups for skin reactions, and to update recommendations for improving radiation protection of patients.

The webinar will present the results and conclusions of the study to strengthen radiation protection of patients in FGI procedures, in line with international safety standards and good practice.?

Learning objectives:

1. Understand how often tissue reactions occur, and their correlation with the procedure factors and dose indicators.
2. Increase the awareness of the need for dose monitoring in complex FGI procedures.
3. Understand the importance of implementing a patient follow-up programme in medical facilities that perform FGI procedures.

About the panellists:

Steven Balter is a professor of Radiology and Medicine at Columbia University and a past president of the Radiological and Medical Physics Society of New York, past vice president of the Radiological Society of North America, and a member of the Standards and Safety Committees of the Society for Interventional Radiology. He is a fellow of the Society for Cardiovascular Angiography and Interventions, the Society of Interventional Radiology, etc. He has been a member of National Council on Radiation Protection and Measurements (NCRP) for more than a decade and chaired scientific committees that produced NCRP Report No. 168 and Statement 11. He has over 100 refereed publications in the areas of radiological imaging, radiological health and related topics.

Aaron Kyle Jones is a professor in the Department of Imaging Physics at the University of Texas, MD, Anderson Cancer Center, Jones. He served as president of the Southwest Chapter of the American Association of Physicists in Medicine in 2012. He regularly lectures at national and international conferences, has served as faculty for workshops and written several book chapters. He has mentored numerous clinical residents and fellows and worked as a collaborator on several grants funded by professional societies and industry. He is currently a collaborator on National Institute of Health research project R01 titled Anatomical Modeling to Improve the Precision of IG Liver Ablation. He has published over 70 peer-reviewed articles.

Donald Miller is Chief Medical Officer for Radiological Health at the Food and Drug Administration’s Center for Devices and Radiological Health and previously a professor of radiology at the Uniformed Services University in Bethesda. He was elected a member of International Commission on Radiological Protection (ICRP) Committee 3 and is an author of ICRP publications 117,120,135 and 139. He was elected member of the National Council on Radiation Protection and Measurements (NCRP) in 2006, serves as scientific vice-president and chair of Committee 4, and is an author of NCRP reports 168, 172, 177, 180, 184 and 185, and Statements 11 and 13. He was a member of the World Health Organization’s group of experts on radiation protection of patients and staff. He is an author of more than 200 papers and more than 40 book chapters and reports.

Osvaldo Rampado is a senior medical physicist in the Medical Physics Unit of the University Hospital Città della Salute e della Scienza in Torino, Italy. His professional focus is on radiation protection, dosimetry and image quality optimization in medical imaging for all types of X ray imaging modalities. He is currently teaching medical radiation physics and radiation protection at the University of Torino. His main research interests are in the fields of patient dose assessment and management, quantification of radiological image quality parameters and, more recently, in radiomics analysis.

Andy Rogers is Assistant Professor at the University of Nottingham and a lead interventional medical physics expert at Nottingham University Hospitals National Health Service Trust, and a recent president of the British Institute of Radiology. He currently chairs the UK working group on setting diagnostic reference levels in interventional procedures. He was recently a member of an International Commission on Radiological Protection working group, a full member of the International Electrotechnical Commission Maintenance Teams for interventional and general X ray equipment and a member of two international working groups looking at quality control of radiological equipment in general and angiography imaging equipment.?Current research interests are skin and staff dose assessment and optimization in interventional cardiology and radiology.

Roberto Mariano Casanueva Sanchez is a medical physics expert at Hospital Clínico San Carlos, Madrid with more than 20 years of experience, and an associated professor at Universidad Complutense de Madrid. He is involved with the Cardiovascular and Interventional Radiological Society of Europe (CIRSE): European Union, external adviser (Radiation Protection subcommittee), Service European Alliance for Medical Radiation Protection Research (EURAMED), EFOMP Delegate Service Sociedad Espa?ola de Protección Radiológica Madrid, Member of Service European Society of Radiology, Interventional Radiology Work Group.

Jenia Vassileva is a retired professor of medical physics from Sofia, Bulgaria and former IAEA Radiation Protection Specialist in the Radiation Protection of Patients Unit. Her professional focus has been on quality assurance, dosimetry, optimization and radiation protection in medicine. She has co-authored over 100 peer reviewed articles including three International Commission on Radiological Protection (ICRP) publications. She is actively involved in international collaboration through the IAEA, International Commission on Radiological Protection and other international professional bodies. She is a member of the Radiation Protection Subcommittee of Cardiovascular and Interventional Radiological Society of Europe, and a member of ICRP Committee 3, Radiological Protection in Medicine, for 2025–2029.