The initial step was the selection of the main topics to fulfil the objectives of the WG (to help in the dosimetry aspects for implementation of the Directive, and to profit from the automatic patient dose registries) carried out by E-mail to the 11 European experts involved in the EuroSafe Imaging WG (radiologists, medical physicists, radiographers and industry engineers).
The eight topics initially considered as the most relevant to collect the opinions and suggestions were:
Information on medical exposure for patients (Art. 58.b of the European directive 2013/59/EURATOM: Member States shall ensure that information relating to patient exposure forms part of the report of the medical radiological procedure).
Individual optimisation (Art. 5.b of the European directive: The optimisation of the protection of individuals subject to medical exposure shall apply to the magnitude of individual doses and be consistent with the medical purpose of the exposure).
Accidental and unintended exposures (Art. 63.c of the European directive: Member States shall ensure that for all medical exposures the undertaking implements an appropriate system for the record keeping and analysis of events involving or potentially involving accidental or unintended medical exposures, commensurate with the radiological risk posed by the practice).
Dosimetric trigger levels (for individual procedures).
Comparison with Diagnostic Reference Levels (DRLs).
Role of the automatic dose registry and management systems.
Dosimetric information for the practitioner.
Dosimetric information for the referrer.
The second step was to collect the answers of a questionnaire. The 11 WG experts completed the questionnaire (Appendix 1) and suggested particular comments to some of the offered answer options, when appropriate. Seven experts (out of 11) completed the questionnaire.
Part of the received comments and suggestions have also been considered for the preparation of scientific sessions for the ECR 2020 (learning objectives or potential topics to discuss with the audience).
One aspect included in the survey was the advantages of automatic dose registries introduced in many European hospitals. Most of these registries are for patient doses but in some cases (e.g. interventional practices) also staff doses may be included.
The distributed questionnaire (after the refinements suggested by the experts of the WG) is included in the Annex.
The survey also included the topic on the advantages of simultaneously monitoring and managing patient and occupational exposures for interventional radiology .
The registration of patient, and sometimes, occupational exposure, for all the radiation events (as part of the DICOM Radiation Dose Structured Reports –RDSR– in the case of patients) allows new possibilities for the global optimisation during interventional practices. The correlation of occupational and patient exposures is recommended by the ICRP . Information in real time inside the catheterisation rooms, not only on patient exposure, but also on occupational exposure during the procedures  is helpful for a global optimisation approach.
Some of the existing problems in reporting occupational exposures from interventionists to international organisations as UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) may be derived from the difficulty to identify the professionals groups involved in these practices. They could be from different clinical services (Radiology, Cardiology, Vascular Surgery, Urology, Gastroenterology, etc.) and sometimes, the occupational dosimetric data may be reported from a mix of professionals performing fluoroscopy guided procedures including others using more conventional imaging techniques. In these cases, the mean/median occupational dose values may result quite low and it is difficult to identify (by the regulatory authorities or by the radiation protection services) the real sub-group of professionals having a relevant occupational radiation risk.
One way to improve these data collection could be to ask the hospitals, to identify “in origin” the professionals (may be medical doctors, nurses and or technicians) involved in interventional procedures (from all the clinical services) to allow radiation protection services and regulatory authorities to process independently the occupational exposure data from this group of professionals.