This publication provides a general overview of interventional radiology (IR). It presents an evidence-based rationale for establishing, improving and maintaining an IR service consistent with current clinical knowledge benchmarks. A summary is provided of necessary elements for the establishment of an IR clinical service and to ensure its sustainability. The publication includes information on specific challenges faced especially but not uniquely in emerging nations, as well as a defined list of expert recommendations. Safety and quality standards are emphasized in addition to necessary funding, human resources, education, training and certification/recertification, as well as involvement of the main professional societies.

• 1. Introduction
  • 1.1. Background
  • 1.2. Objective
  • 1.3. Scope
  • 1.4. Structure
• 2. Introduction to interventional radiology
  • 2.1. Imaging techniques
  • 2.2. Clinical care
    • 2.2.1. Procedures
    • 2.2.2. Procedural care
• 3. Physical and infrastructure requirements
  • 3.1. Interventional facility
  • 3.2. Imaging equipment
  • 3.3. Interventional X ray equipment
  • 3.4. Ancillary equipment
  • 3.5. Equipment procurement, repair and maintenance
    • 3.5.1. Equipment maintenance and quality control
• 4. Human resource requirements
  • 4.1. Background
  • 4.2. Interventional radiology specialists
  • 4.3. Non-physician service providers
  • 4.4. Technologists
  • 4.5. Clinically qualified medical physicists
  • 4.6. Physician assistants
  • 4.7. Anaesthesiologists
  • 4.8. Administrators or managers
  • 4.9. Administrative assistants
  • 4.10. Biomedical engineers
  • 4.11. Radiation protection officer
  • 4.12. Information technology professionals
  • 4.13. Waste disposal unit
  • 4.14. Difficulties
  • 4.15. Additional recommendations
  • 4.16. Conclusion
• 5. Radiation protection and safety
  • 5.1. Background
  • 5.2. Management system for radiation protection
  • 5.3. Safety assessment analysis
  • 5.4. Design of an interventional radiology facility and equipment
    • 5.4.1. Facility design
    • 5.4.2. Safety features of fluoroscopy equipment
  • 5.5. Radiation protection of patients
    • 5.5.1. Justification of medical exposure
    • 5.5.2. Optimization of protection and safety
    • 5.5.3. Dose audits and diagnostic reference levels
    • 5.5.4. Skin dose monitoring and prevention of tissue overexposure
    • 5.5.5. Operational considerations
  • 5.6. Radiation protection of staff
    • 5.6.1. Practical aspects of staff protection
    • 5.6.2. Occupational dose limits and individual dose monitoring
  • 5.7. Education, training and certification
  • 5.8. Conclusion
• 6. Quality management
  • 6.1. Background
  • 6.2. Quality programme
  • 6.3. Quality programme guidelines
    • 6.3.1. Quality assurance
    • 6.3.2. Ongoing PDSA projects
    • 6.3.3. Continued quality improvement
  • 6.4. Accreditation
  • 6.5. Conclusion
• 7. Medical education and training
  • 7.1. Background
  • 7.2. Medical school graduation
  • 7.3. Clinical internship training
  • 7.4. Radiation protection
  • 7.5. Diagnostic imaging
  • 7.6. Radiation physics and safety
  • 7.7. Certification
  • 7.8. Conclusion
• 8. Certification and recertification
  • 8.1. Background
  • 8.2. Certification level
  • 8.3. Certification of personnel
  • 8.4. Certification elements
  • 8.5. Certification in interventional radiology
    • 8.5.1. Interventional radiology physicians
    • 8.5.2. Interventional radiology radiographers and nurses
    • 8.5.3. Medical physicists
  • 8.6. Conclusion
• 9. Funding
  • 9.1. Background
  • 9.2. Establishment of new interventional radiology centres
  • 9.3. Maintenance and improvement of existing centres
  • 9.4. Purchase of consumables
  • 9.5. Human resource development
  • 9.6. Health insurance or fee for service
  • 9.7. Research and education
  • 9.8. External funding
  • 9.9. Charities
  • 9.10. Public–private partnerships
• 10. Professional Societies and Bodies
• 11. Promotion and public awareness
  • 11.1. Background
  • 11.2. Public awareness
  • 11.3. Good image
  • 11.4. Health promotion
  • 11.5. International organizations
  • 11.6. Professional societies
  • 11.7. Equipment and consumable manufacturers
  • 11.8. Research
  • 11.9. Targets
  • 11.10. Mechanisms
  • 11.11. Educational programmes and materials
• 12. Challenges facing low and middle income countries
  • 12.1. Background
  • 12.2. Incorporation into clinical practice
  • 12.3. Definition and improvement of interventional radiology practice
  • 12.4. Building blocks of the practice
  • 12.5. Recognition of the interventional radiology subspeciality
  • 12.6. Training and certification
  • 12.7. Quality benchmark
  • 12.8. Regulatory environment
  • 12.9. Equipment and hardware availability
  • 12.10. Accessibility and affordability
  • 12.11. Evidence based clinical practice guidelines
  • 12.12. Interventional radiology procedures, personnel and facilities
  • 12.13. Continuing medical education
  • 12.14. Interaction with government
  • 12.15. Funding for interventional radiology procedures
  • 12.16. National organization of interventional radiology specialists
  • 12.17. Local and regional needs and local research
• 13. Recommendations of the IAEA Expert Committee
• Appendix PROCEDURES
• REFERENCES
• LIST OF ABBREVIATIONS
• CONTRIBUTORS TO DRAFTING AND REVIEW