Rebecca Zener MD, Presenter: Nothing to Disclose

Daniele Patrice Wiseman MD, FRCPC, Abstract Co-Author: Nothing to Disclose

Amol Mujoomdar MD, Abstract Co-Author: Speaker, Cook Group Incorporated Speaker, Covidien AG

Radiation exposure is inherent in interventional radiology procedures. A potential exposure of 1 mSv has been suggested as a cutoff for provision of risk information, as it corresponds to a 1 in 10000 cancer risk. Informed consent requires disclosure of rare yet potentially significant risks, yet patient knowledge of these risks is lacking. The purpose of this study is to explore patient perception of cancer-related risk exposure and whether inclusion of radiation risks in the informed consent is warranted. 

A multiple-choice survey was prospectively administered to 26 adult interventional radiology patients at a tertiary care centre (patient mean age = 61.4 years; 64% female,; 36% male). 58% of patients had previously undergone an IR procedure. Statistical analysis with Fisher Exact test (p<0.05) was performed.

Most patients want to be informed if there is a radiation-related 3% increased cancer risk over 5 years (89%), or if the associated risk is 1 in 1000 (79%) or 1 in 10000 (63%). While half of the cohort considers 3% small, 35% want to further discuss the risks and alternate options, and 15% would only proceed if it were a life-saving procedure. Only 62% of patients were aware they were going to be exposed to radiation, irrespective of previous IR history. Most patients believe radiation consent should be routine for IR procedures (85%) and include radiation-related cancer risks (88%). A majority (62%) believes that the referring physician and the interventional radiologist are responsible for informing patients, and verbal radiation consent is sufficient. No significant difference was present between groups based on previous IR history (p>0.05). 

Patient awareness of radiation exposure is suboptimal. Based on this survey, a majority of patients want to discuss cancer-related radiation risks in order to make informed decisions. Interventional radiologists should consider including radiation consent in the informed consent for procedures with anticipated doses above 1 mSv.

Interventional radiology patients want to discuss cancer-related radiation risks in order to make informed decisions, and interventional radiologists should consider including radiation consent in the informed consent for procedures with anticipated doses above 1 mSv.

Zener, R, Wiseman, D, Mujoomdar, A, Should the Informed Consent Process for Interventional Radiology Procedures include the Risk of Radiation Exposure: The Interventional Radiology Patient Perspective.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003476.html