ACCF/AHA/HRS/SCAI Clinical Competence Statement on Physician Knowledge to Optimize Patient Safety and Image Quality in Fluoroscopically Guided Invasive Cardiovascular Procedures

Name: Work Video:
Duration: 3 min 30 s
John W. Hirshfeld; Stephen Balter; Jeffrey Brinker; Morton J. Kern; Lloyd W. Klein; Bruce D. Lindsay; Carl L. Tommaso; Cynthia M. Tracy; Louis K. Wagner; Mark A. Creager; Michael Elnicki; John W. Hirshfeld; Beverly H. Lorell; George P. Rodgers; Cynthia M. Tracy; Howard H. Weitz
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'https://openalex.org/W2172899499', 'https://openalex.org/W2237993566', 'https://openalex.org/W2979535303', 'https://openalex.org/W3021368244', 'https://openalex.org/W600400939'], 'related_works': ['https://openalex.org/W4389568370', 'https://openalex.org/W3108674512', 'https://openalex.org/W3032375762', 'https://openalex.org/W3031052312', 'https://openalex.org/W2899084033', 'https://openalex.org/W2748952813', 'https://openalex.org/W2080531066', 'https://openalex.org/W1995515455', 'https://openalex.org/W1506200166', 'https://openalex.org/W1489783725'], 'abstract_inverted_index': {'HomeCirculationVol.': [0], '111,': [1], 'No.': [2], '4ACCF/AHA/HRS/SCAI': [3], 'Clinical': [4, 40, 75, 514, 686, 815, 888], 'Competence': [5, 41, 76, 687, 816, 936], 'Statement': [6, 42], 'on': [7, 43, 74, 584, 601, 685, 814, 887, 1183, 1279, 1298, 1309, 1340, 1363, 1578, 1707, 1990, 2838, 2868, 3429, 3791, 3928, 3972, 3981], 'Physician': [8, 44, 534], 'Knowledge': [9, 45], 'to': [10, 29, 46, 536, 566, 575, 652, 692, 731, 754, 820, 859, 893, 924, 1066, 1107, 1194, 1218, 1270, 1418, 1434, 1499, 1511, 1566, 1569, 1628, 1657, 1698, 1710, 1716, 1719, 1724, 1748, 1776, 1870, 1875, 1890, 1895, 1900, 1908, 1918, 1968, 1979, 1983, 2013, 2023, 2071, 2125, 2213, 2248, 2264, 2322, 2330, 2343, 2537, 2550, 2611, 2617, 2637, 2671, 2723, 2773, 2830, 2860, 2892, 2907, 2917, 2964, 3023, 3054, 3067, 3086, 3233, 3237, 3388, 3405, 3482, 3491, 3576, 3755, 3762, 3841, 3855, 3911, 4036, 4099, 4136, 4153, 4278, 4378], 'Optimize': [11, 47], 'Patient': [12, 48, 431, 437, 467, 491, 539], 'Safety': [13, 49, 551], 'and': [14, 50, 77, 178, 310, 326, 332, 402, 486, 541, 627, 640, 650, 697, 701, 721, 735, 779, 793, 904, 937, 940, 944, 965, 975, 978, 1003, 1030, 1112, 1152, 1158, 1204, 1288, 1359, 1461, 1479, 1481, 1541, 1553, 1627, 1723, 1765, 1779, 1804, 1826, 1840, 1855, 1898, 1909, 1923, 1937, 1963, 1970, 1995, 2008, 2108, 2119, 2192, 2373, 2407, 2443, 2483, 2599, 2668, 2759, 2776, 2813, 2849, 2895, 2929, 2938, 2954, 2988, 3252, 3292, 3295, 3494, 3513, 3546, 3568, 3620, 3638, 3658, 3719, 3838, 3906, 3921, 3975, 4062, 4123, 4152, 4171, 4198, 4201, 4299], 'Image': [15, 51, 364, 368, 375, 397, 400, 411, 425, 2622, 2682, 3323, 3325, 3436], 'Quality': [16, 52, 412], 'in': [17, 53, 609, 690, 745, 777, 1075, 1215, 1332, 1413, 1507, 1544, 1594, 1598, 1604, 1612, 1624, 1739, 1754, 1781, 1801, 1805, 1850, 1933, 1938, 2032, 2065, 2113, 2132, 2139, 2167, 2237, 2393, 2447, 2498, 2503, 2540, 2675, 2701, 2820, 3006, 3017, 3091, 3130, 3173, 3202, 3287, 3297, 3315, 3337, 3371, 3395, 3534, 3647, 3701, 3745, 3853, 3937, 4164, 4233, 4357], 'Fluoroscopically': [18, 54], 'Guided': [19, 55], 'Invasive': [20, 56, 510, 557], 'Cardiovascular': [21, 57, 511], 'Procedures': [22, 512, 559], 'Free': [23], 'AccessReview': [24, 38], 'ArticlePDF/EPUBAboutView': [25], 'PDFView': [26], 'EPUBSections': [27], 'ToolsAdd': [28], 'favoritesDownload': [30], 'citationsTrack': [31], 'citationsPermissions': [32], 'ShareShare': [33], 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933], 'Force': [73, 684, 813, 886, 934], 'Training': [78], 'WRITING': [79, 185], 'COMMITTEE': [80, 186], 'MEMBERS': [81, 187], 'John': [82, 155, 189, 287], 'W.': [83, 110, 156, 190, 192, 218, 220, 288, 290], 'HirshfeldJr,': [84, 157], 'MD,': [85, 99, 105, 112, 119, 125, 132, 147, 153, 158, 164, 170, 175, 182, 929], 'FACC,': [86, 100, 106, 113, 120, 126, 133, 148, 159, 165, 171, 176, 183, 930], 'FAHA,': [87, 107, 114, 121, 127, 134, 149, 160, 166], 'FSCAI,': [88, 101, 108, 115, 128], 'Chair,': [89, 150], 'Stephen': [90, 195], 'Balter,': [91], 'PhD,': [92, 138], 'FACR,': [93, 139], 'FAAPM,': [94, 140], 'FSIR,': [95], 'Jeffrey': [96, 199], 'A.': [97, 142, 200, 202, 278, 280, 927], 'Brinker,': [98], 'Morton': [102, 205], 'J.': [103, 206, 208], 'Kern,': [104], 'Lloyd': [109, 217], 'Klein,': [111], 'Bruce': [116, 229], 'D.': [117, 230, 232], 'Lindsay,': [118], 'Carl': [122, 241], 'L.': [123, 242, 244], 'Tommaso,': [124], 'Cynthia': [129, 172, 253, 305], 'M.': [130, 173, 254, 256, 306, 308], 'Tracy,': [131, 174], 'Louis': [135, 271], 'K.': [136, 272, 274], 'Wagner,': [137], 'Mark': [141, 277], 'Creager,': [143, 928], 'TASK': [144], 'FORCE': [145], 'MEMBERS:,': [146], 'Michael': [151, 283], 'Elnicki,': [152], 'FACP,': [154], 'Beverly': [161, 293], 'H.': [162, 180, 294, 296, 312, 314], 'Lorell,': [163], 'George': [167, 299], 'P.': [168, 300, 302], 'Rodgers,': [169], 'FAHA': [177], 'Howard': [179, 311], 'Weitz,': [181], 'FACP': [184], ',': [188, 194, 198, 204, 216, 228, 240, 252, 270, 276, 282, 286, 292, 298, 304], 'HirshfeldJrJohn': [191, 289], 'HirshfeldJr': [193, 291], 'BalterStephen': [196], 'Balter': [197], 'BrinkerJeffrey': [201], 'Brinker': [203], 'KernMorton': [207], 'Kern': [209], '*AHA': [210, 222, 234, 246, 258, 264], 'Representative;': [211, 213, 223, 225, 235, 237, 247, 249, 259, 261, 265, 267], '†HRS': [212, 224, 236, 248, 260, 266], '‡SCAI': [214, 226, 238, 250, 262, 268], 'Representative.': [215, 227, 239, 251, 263, 269], 'KleinLloyd': [219], 'Klein': [221], 'LindsayBruce': [231], 'Lindsay': [233], 'TommasoCarl': [243], 'Tommaso': [245], 'TracyCynthia': [255, 307], 'Tracy': [257, 309], 'WagnerLouis': [273], 'Wagner': [275], 'CreagerMark': [279], 'Creager': [281], 'ElnickiMichael': [284], 'Elnicki': [285], 'LorellBeverly': [295], 'Lorell': [297], 'RodgersGeorge': [301], 'Rodgers': [303], 'WeitzHoward': [313], 'Weitz': [315], 'Originally': [316], 'published1': [317], 'Feb': [318], '2005https://doi.org/10.1161/01.CIR.0000157946.29224.5DCirculation.': [319], '2005;111:511–532TABLE': [320], 'OF': [321], 'CONTENTSPreamble': [322], '512': [323, 328], 'I.': [324], 'Introduction': [325, 939], 'Background': [327], 'II.': [329], 'The': [330, 337, 379, 581, 787, 1187, 1257, 1273, 1338, 1352, 1361, 1407, 1438, 1483, 1683, 1769, 1953, 1993, 2093, 2111, 2226, 2260, 2465, 2487, 2566, 2634, 2659, 2712, 2738, 2767, 2781, 2883, 2967, 3264, 3276, 3353, 3625, 3704, 3923, 3965, 3984, 4076, 4157, 4208, 4250, 4289, 4308], 'Physics': [331, 1994], 'Nature': [333, 338, 1996, 1999], 'X-Radiation': [335, 340], '514': [336, 341, 344, 347, 352, 355, 366, 370], 'X-Ray': [342, 345, 350, 353, 363, 367, 374, 383, 389, 392, 432, 494, 2243, 3322, 3435], 'Generation': [343, 369, 390], 'Spectra': [346], 'Mechanisms': [348], 'Absorption': [351], 'Dose': [354, 415, 420, 433, 438, 440, 451, 454, 469, 485, 545], 'Measurements': [356, 435], 'Radiation': [358, 506, 550, 1238, 1376, 2801], '515': [359], 'III.': [360], 'Principles': [361, 3320], 'Formation': [365, 376], 'Parameters': [371, 408], 'That': [372, 409, 465, 3433], 'Affect': [373, 3434], '516': [377], 'IV.': [378], 'Operation': [380], 'an': [382, 836, 1015, 1108, 1140, 1379, 1387, 1436, 1471, 1518, 1573, 1590, 1816, 1830, 1888, 1906, 1910, 2133, 2140, 2189, 2274, 2309, 2384, 2388, 2641, 2694, 2702, 2716, 2742, 2761, 2833, 2863, 3051, 3364, 3372, 3400, 3442, 3500, 3631, 3788, 4312, 4364], 'Cinefluorographic': [384], 'Unit': [385], '517': [386, 388, 391], 'Overview': [387], 'Exposure': [393, 407, 495, 2905], 'Modulation': [394], '519': [395, 399], 'Video': [396], 'Capture': [398], 'Display': [401], 'Processing': [403], '520': [404], 'Optimizing': [405], 'Determine': [410], '521': [413, 418], 'Fluoroscopy': [414], 'Management': [416, 421, 546], 'Issues': [417, 422], 'Acquisition': [419], '522': [423, 427, 434, 439, 446, 448], 'Digital': [424], 'Subtraction': [426], 'V.': [428], 'Determinants': [429], '(Air': [441], 'Kerma)': [442], 'at': [443, 455, 900, 907, 1175, 1517, 2354, 2422, 2843, 2873, 3127, 3136, 3170, 3179, 3613, 3651, 3776, 3962, 4013, 4094, 4264, 4330], 'IRP': [445, 457], 'DAP': [447, 460], 'Value': [449], 'Monitoring': [452, 458], '523': [453, 459, 463, 470], 'Benchmarking': [461], 'Data': [462], 'Factors': [464, 472, 475, 479], 'Influence': [466], 'Absorbed': [468], 'Equipment-Related': [471], '524': [473, 476, 480, 483, 489], 'Patient-Related': [474], 'Procedure': [477, 531], 'Conduct': [478], 'Beam': [481], 'Collimation': [482], 'Input': [484], 'Frame': [487], 'Rate': [488], 'VI.': [490], 'Effects': [492, 498, 503], '525': [496, 499], 'Deterministic': [497, 521], 'Cataract': [500], '526': [501, 504], 'Stochastic': [502, 527], 'VII.': [505], 'Risks': [507], 'From': [508], 'Typical': [509], '528': [513, 517, 523, 529, 538, 543], 'Risk-Benefit': [515], 'Ratio': [516], 'General': [518, 524], 'Considerations': [519, 525, 532], 'for': [520, 526, 553, 667, 695, 705, 737, 769, 807, 917, 960, 1069, 1120, 1390, 1521, 1654, 1797, 1844, 2097, 2366, 2495, 2901, 2952, 2975, 3218, 3240, 3455, 3479, 3488], 'Risk': [522, 528], 'Multiple': [530], '528VIII.': [533], 'Responsibilities': [535], 'Patients': [537], 'Education': [540], 'Consent': [542], 'Procedural': [544], '529': [547], 'IX.': [548], 'Recommended': [549], 'Curriculum': [552], 'Who': [555], 'Perform': [556], 'Cardiac': [558], '530PreambleThe': [560], 'granting': [561, 593], 'clinical': [563, 971, 1614, 1766, 1856, 1921, 1971, 4202], 'staff': [564, 597, 612, 1857], 'privileges': [565, 598, 669], 'physicians': [567, 1709, 1813, 1841, 1876, 1946], 'is': [568, 642, 724, 729, 791, 1304, 1620, 1651, 1676, 1689, 1696, 1788, 1795, 1837, 1869, 1931, 1977, 2122, 2186, 2195, 2254, 2279, 2404, 2411, 2433, 2490, 2514, 2555, 2571, 2624, 2645, 2736, 2770, 2827, 2857, 2922, 2932, 2948, 2970, 2979, 3227, 3328, 3361, 3369, 3379, 3630, 3670, 3711, 3760, 3818, 3865, 3870, 3881, 3935, 3970, 3979, 4104, 4129, 4239, 4321, 4376], 'a': [569, 710, 833, 840, 844, 1117, 1168, 1253, 1508, 1533, 1559, 1634, 1705, 1735, 1755, 1863, 1873, 1942, 1957, 1981, 1987, 2003, 2043, 2060, 2079, 2145, 2148, 2172, 2177, 2180, 2205, 2214, 2249, 2380, 2408, 2468, 2472, 2484, 2504, 2527, 2556, 2582, 2603, 2619, 2638, 2789, 2984, 3055, 3068, 3128, 3171, 3213, 3259, 3269, 3331, 3390, 3466, 3555, 3597, 3659, 3677, 3746, 3857, 3900, 3955, 4096, 4214, 4258, 4265, 4349], 'primary': [570, 4149], 'mechanism': [571, 2437], 'used': [572, 2096, 2547, 2900, 2906, 3232], 'by': [573, 645, 659, 882, 994, 1022, 1116, 2143, 2201, 2217, 2281, 2338, 2516, 2564, 2581, 2587, 2596, 2626, 2690, 2890, 3117, 3159, 3208, 3257, 3273, 3363, 3464, 3517, 3525, 3698, 3811, 4080, 4091, 4304], 'institutions': [574], 'uphold': [576], 'quality': [578, 1081, 1761, 4087], 'care.': [580], 'Joint': [582], 'Commission': [583], 'Accreditation': [585], 'Healthcare': [587], 'Organization': [588], '(JCAHO)': [589], 'requires': [590, 3554], 'that': [591, 623, 829, 867, 951, 988, 1018, 1100, 1575, 1617, 1640, 1649, 1687, 1695, 1757, 1799, 1945, 1984, 2153, 2210, 2291, 2363, 2438, 2525, 2651, 2718, 2971, 2974, 2989, 3024, 3043, 3200, 3216, 3356, 3383, 3396, 3558, 3591, 3671, 3713, 3833, 3839, 3846, 3876, 4003, 4089, 4116, 4142, 4182, 4193, 4318, 4329], 'continuing': [595], 'medical': [596, 611, 1606], 'be': [599, 803, 869, 1020, 1647, 1699, 1860, 1896, 1980, 2165, 2788, 2818, 2908, 3084, 3255, 3452, 3462], 'based': [600], 'assessments': [602], 'applicants': [604], 'against': [605], 'professional': [606, 625, 1721], 'criteria': [607, 622], 'specified': [608, 3138, 3181], 'bylaws.': [613], 'themselves': [615, 1924], 'are': [616, 670, 719, 742, 752, 776, 947, 982, 992, 1049, 1154, 1213, 1631, 1842, 2002, 2029, 2130, 2336, 2364, 2369, 2455, 2471, 2615, 2673, 2708, 2898, 2961, 3266, 3285, 3293, 3695, 3706, 4004, 4143, 4302, 4363, 4371], 'thus': [617, 3806], 'charged': [618, 3114], 'with': [619, 628, 920, 1475, 1525, 1572, 1762, 1905, 1986, 2151, 2176, 2383, 2426, 2521, 2791, 2879, 2914, 3302, 3330, 3633, 3783, 3896, 3993, 3998, 4017, 4111, 4162, 4273], 'identifying': [620], 'constitute': [624], 'competence': [626, 641, 761, 790], 'evaluating': [629, 637], 'their': [630, 784, 1717, 1720, 2024, 2669, 2976, 3743], 'peers': [631], 'accordingly.': [632], 'Yet': [633], 'process': [635, 2372, 2377, 2419, 2494, 3817], "physicians'": [638], 'knowledge': [639, 649, 1737, 1775, 1835, 1915, 1965], 'often': [643, 1229], 'constrained': [644], "evaluator's": [647], 'own': [648], 'ability': [651], 'elicit': [653], 'appropriate': [655, 806], 'information,': [656], 'problems': [657], 'compounded': [658], 'growing': [661], 'number': [662, 1300, 1561, 2287, 2429, 3260, 3467, 3587, 3599, 3966, 4058], 'highly': [664], 'specialized': [665], 'procedures': [666, 741, 955, 987, 1035, 1042, 1048, 1054, 1104, 1276, 1433, 1656, 1950], 'which': [668, 1266, 1782, 2265, 2747, 3683, 4362], 'requested.The': [671], 'Cardiology/American': [675], '(ACC/AHA/': [681], 'ACP)': [682], 'was': [688, 1243, 1307, 1316, 1412, 1442, 1447, 1459, 1468, 1601], 'formed': [689], '1998': [691], 'develop': [693], 'recommendations': [694, 797], 'attaining': [696], 'maintaining': [698, 3918], 'cognitive': [700], 'technical': [702], 'skills': [703], 'necessary': [704, 2616], 'competent': [707], 'performance': [708], 'specific': [711, 738, 3025, 3238], 'cardiovascular': [712, 763, 954, 969, 986, 1034, 3886], 'service,': [713], 'procedure,': [714], 'or': [715, 740, 805, 824, 839, 873, 910, 991, 1206, 1743, 2994, 2998, 3033, 3037, 3064, 3100, 3104, 3148, 3191, 3195], 'technology.': [716], 'These': [717, 878, 2529, 4359], 'documents': [718], 'evidence-based,': [720], 'where': [722], 'evidence': [723], 'not': [725, 743, 801, 1208, 1602, 1884, 2328, 2655, 2949, 2962], 'available,': [726], 'expert': [727], 'opinion': [728], 'utilized': [730], 'formulate': [732], 'recommendations.': [733], 'Indications': [734], 'contraindications': [736], 'services': [739], 'included': [744], 'scope': [747], 'these': [749, 1007, 1791, 2958, 3092, 3693, 3751], 'documents.': [750], 'Recommendations': [751], 'intended': [753, 1978], 'assist': [755], 'those': [756, 774], 'who': [757, 775, 1877, 1947], 'must': [758, 1019, 1733, 1745, 1771, 1814, 3451, 3849], 'judge': [759], 'health': [764], 'care': [765], 'providers': [766], 'entering': [767, 1201], 'practice': [768, 778, 785, 1727], 'first': [771, 902, 1245, 1585], 'time': [772, 1441, 2057], 'and/or': [773], 'undergo': [780], 'periodic': [781], 'review': [782], 'expertise.': [786], 'assessment': [788], 'complex': [792, 1103], 'multidimensional;': [794], 'therefore,': [795], 'isolated': [796], 'contained': [798], 'herein': [799], 'may': [800, 1060, 1105, 1205, 1207, 1646, 2885, 3461, 3675], 'necessarily': [802], 'sufficient': [804, 1560, 2604], 'judging': [808], 'overall': [809, 1110, 3867], 'competence.The': [810], 'ACC/AHA/ACP': [811, 884, 932], 'makes': [817], 'every': [818], 'effort': [819], 'avoid': [821], 'any': [822, 2277, 3061, 4331], 'actual': [823], 'potential': [825, 874, 1068, 1119, 1653, 3020, 3665], 'conflicts': [826, 875], 'interest': [828, 842, 1852], 'might': [830, 868, 3083], 'arise': [831], 'as': [832, 871, 911, 1051, 1139, 1470, 1532, 1666, 1862, 1872, 2016, 2018, 2075, 2078, 2197, 2270, 2313, 2334, 2546, 2710, 3050, 3529, 4088, 4213, 4236], 'result': [834], 'outside': [837, 4144], 'relationship': [838, 919], 'personal': [841], 'member': [845], 'writing': [848, 855], 'panel.': [849], 'Specifically,': [850], 'all': [851, 864, 894, 1708, 2720, 2778, 3113], 'members': [852, 895], 'panel': [856], 'were': [857, 880, 890, 905, 1043, 1277, 1530, 1538], 'asked': [858], 'provide': [860], 'disclosure': [861], 'statements': [862, 879], 'such': [865, 1665, 1949], 'relationships': [866], 'perceived': [870], 'real': [872], 'interest.': [877], 'reviewed': [881], 'Competence,': [889], 'reported': [891, 1246, 1330, 1531, 1603], 'orally': [892], 'Writing': [898], 'Committee': [899], 'meeting,': [903], 'updated': [906], 'each': [908, 1264, 2888], 'meeting': [909], 'changes': [912], 'occurred.': [913], 'Please': [914], 'see': [915], 'Appendix': [916], 'industry': [921], 'information': [922], 'pertinent': [923], 'this': [925, 1336, 1810, 2729, 2785, 3628, 3668], 'document.Mark': [926], 'FAHAChair,': [931], 'onClinical': [935], 'TrainingI.': [938], 'BackgroundBoth': [941], 'X-ray': [942, 945, 995, 1084, 1179, 1199, 1501, 1751, 1823, 1831, 1879, 2050, 2063, 2094, 2120, 2134, 2156, 2161, 2190, 2223, 2258, 2266, 2310, 2350, 2360, 2402, 2448, 2453, 2474, 2519, 2535, 2642, 2649, 2688, 2703, 2706, 2721, 2762, 2774, 2782, 2835, 2865, 2965, 3373, 3377, 3431, 3447, 3458, 3472, 3501, 3552, 3578, 3589, 3601, 3622, 3661, 3679, 3734, 3769, 3797, 3893, 3932, 3944, 3950, 3960, 3968, 3986, 4011, 4052, 4071, 4077, 4108, 4150, 4169, 4176, 4314, 4369], 'fluoroscopy': [943, 1294, 1440, 1529], 'cinefluorography': [946], 'core': [948, 1668, 1943], 'imaging': [949, 2098, 2368, 3473, 3553], 'techniques': [950], 'make': [952, 2292], 'invasive': [953, 1033], 'possible.': [956], 'Right': [957], 'heart': [958], 'catheterization': [959], 'hemodynamic': [961], 'monitoring,': [962], 'diagnostic': [963, 1002, 2067, 2202, 2367, 2496, 3959, 4007], 'cardiac': [964], 'vascular': [966], 'angiography,': [967], 'interventional': [968], 'procedures,': [970, 1008, 1134, 1263], 'electrophysiologic': [972, 1380, 1431], 'studies,': [973], 'temporary': [974], 'permanent': [976], 'pacemaker,': [977], 'internal': [979, 2698, 2797], 'cardioverter-defibrillator': [980], 'placement': [981], 'among': [983, 3075, 3726], 'important': [985, 2020, 2365, 2968, 3712], 'either': [989], 'require': [990, 3676], 'facilitated': [993], 'imaging.': [996, 2259], 'Although': [997, 1583, 1883], 'many': [998, 1047, 1126, 1146, 2010, 2664, 3997], 'patients': [999, 1127, 1778], 'derive': [1000, 1128], 'great': [1001, 1129], 'therapeutic': [1004, 1050], 'benefit': [1005, 1130], 'from': [1006, 1131, 1252, 1318, 1378, 1925, 2413, 2508, 2533, 2577, 2647, 2832, 2862, 2887, 3222, 3268, 3358, 3382, 3627, 3767, 3803, 4257, 4270], 'use': [1010, 1672, 3889], 'ionizing': [1012, 1674, 2416], 'X-radiation': [1013], 'constitutes': [1014, 4121], 'associated': [1016, 1524], 'hazard': [1017, 1715, 3135, 3178], 'justified': [1021], "procedure's": [1024], 'benefits.In': [1025], 'recent': [1026], 'years': [1027], 'capability': [1029], 'complexity': [1031], 'have': [1036, 1055, 1078, 1209, 2009, 2099, 2319, 3736, 4354], 'increased': [1037, 1109, 3219, 3673], 'substantially.': [1038], 'Originally,': [1039], 'fluoroscopically': [1040, 1132, 1880], 'guided': [1041, 1133, 1881], 'principally': [1044], 'diagnostic.': [1045], 'Currently,': [1046, 3282], 'well.': [1052], 'As': [1053, 1680], 'become': [1056], 'increasingly': [1057], 'complex,': [1058], 'they': [1059, 1537, 2326, 2335, 2341, 3741], 'employ': [1061], 'greater': [1062, 1070, 1097, 1118, 2025, 2457, 3598, 3617, 3621, 3636, 3655, 3660, 3914], 'fluoroscopic': [1063, 1752, 2505, 2643, 3887], 'durations': [1064], 'leading': [1065], 'patient': [1071, 1111, 1143, 1203, 1258, 1315, 1329, 1484, 1764, 1854, 1991, 2598, 2610, 2639, 2848, 2878, 3327, 3339, 3360, 3495, 3515, 3569, 3618, 3721, 3813, 3837, 3852, 3868, 4184, 4197, 4298], 'radiation': [1072, 1401, 1411, 1505, 1675, 1693, 1713, 1819, 1821, 1961, 1973, 2007, 2041, 2502, 2579, 2595, 2607, 2665, 2881, 2959, 3126, 3161, 3169, 3235, 3241, 3283, 3416, 3848, 4103, 4115, 4128, 4192, 4212, 4291, 4338], 'exposure.': [1073, 1768, 2966], 'Refinements': [1074], 'radiologic': [1076, 2620], 'equipment': [1077, 1753], 'improved': [1079], 'image': [1080, 1339, 1362, 1760, 1824, 2331, 2613, 2732, 2763, 2783, 3365, 3374, 3548, 3566, 3611, 3632, 3645, 3686, 3756, 3879, 3919, 4032, 4086, 4119, 4125, 4227, 4252, 4310, 4347, 4373], 'while': [1082, 3917, 4038], 'reducing': [1083, 3518, 3807], 'dose': [1085, 1409, 1510, 2513, 2570, 2635, 2672, 2937, 3042, 3053, 3066, 3198, 3215, 3619, 3809, 3875, 4029, 4098, 4185, 4189, 4248, 4292], 'rates.': [1086, 4249], 'However,': [1087, 3528], 'even': [1088, 3079, 3872, 3913], 'though': [1089, 3080, 3873], 'technologic': [1090], 'progress': [1091], 'has': [1092, 3278, 3772], 'reduced': [1093, 3871, 4097], 'exposure': [1094, 1098, 1114, 1694, 3516, 3657, 3722, 3869, 4135, 4280], 'rates,': [1095], 'duration': [1099], 'attends': [1101], 'more': [1102, 2053, 3413], 'lead': [1106], 'operator': [1113, 1969, 4200], 'accompanied': [1115], 'radiation-induced': [1121, 1137, 1249, 1423, 1786, 1926], 'injury.': [1122, 1425, 1927], 'At': [1123, 1454, 1463], 'present,': [1124], 'although': [1125], 'some': [1135, 1159, 2019, 2594, 3223], 'suffer': [1136], 'injuries': [1138, 1565, 1622], 'unintended': [1141], 'consequence.Radiation-induced': [1142], 'injury': [1144, 1239, 1377, 1714, 1787], 'takes': [1145], 'forms.': [1147], 'Entrance': [1148, 1221, 2853], 'port': [1149, 1222, 2347, 3794, 4016], 'skin': [1150, 1173, 1223, 1231, 1250, 1424, 1592, 2348, 4028], 'ulceration': [1151, 1224], 'necrosis': [1153, 1174, 1251, 1593], 'most': [1156, 1162, 2660, 2910, 3229, 3689], 'obvious': [1157], 'attention-getting.': [1163], 'This': [1164, 1242, 1702, 1834, 1975, 2252, 2418, 2947, 3460, 3542, 3595, 3608, 3816, 3844, 4026], 'complication': [1165], 'consists': [1166], 'localized': [1169, 3062], 'area': [1170, 1192, 1458, 1467, 4244], 'non-healing': [1172], 'site': [1177, 1581], 'beam': [1180, 1200, 2267, 2631, 2689, 2757, 2836, 2841, 2866, 2871, 3332, 3349, 3355, 3393, 3417, 3438, 3469, 3502, 3523, 3544, 3731, 3824, 3864, 3915, 3926, 3945, 3957, 3987, 4012, 4048, 4064, 4109, 4151, 4177, 4243], 'entrance': [1181, 2346], '(typically': [1182], "patient's": [1185, 1311, 2345, 3457, 3747, 4139], 'back).': [1186], 'shape': [1188, 1196], 'affected': [1191], 'conforms': [1193], 'sharp': [1210], 'borders.': [1211], 'Examples': [1212], 'illustrated': [1214], 'Figures': [1216], '1A': [1217], '1C.': [1219], '1–3': [1220], 'causes': [1225], 'considerable': [1226], 'long-term': [1227], 'morbidity': [1228], 'requiring': [1230], 'grafting.': [1232], 'Download': [1233, 2678, 3940, 4204], 'figureDownload': [1234, 2679, 3941, 4205], 'PowerPointFigure': [1235, 2680, 3942, 4206], '1.': [1236, 2677, 2799, 3299], '(A)': [1237], 'following': [1240, 2169, 3649], 'angioplasty.': [1241], 'case': [1247, 1802, 2951], 'coronary': [1254, 1261], 'angioplasty': [1255, 1262], 'procedure.': [1256, 1324, 1382, 1406, 1453], 'underwent': [1259, 1386, 1429], 'three': [1260], 'lasted': [1267], 'between': [1268, 2102, 2116, 2935, 2983], '1': [1269, 1291, 1455, 2942, 2945, 3307], '2': [1271, 1464, 2087], 'h.': [1272], 'last': [1274, 1323], 'two': [1275, 1430, 1740, 2821, 2884], 'performed': [1278], 'same': [1281, 1334, 2903, 3046, 3605, 4085, 4222], 'day,': [1282], '6': [1283], 'months': [1284, 1348, 1370], 'after': [1285, 1321, 1349, 1371, 1451], 'first,': [1287], 'involved': [1289], 'about': [1290, 1443, 2893], 'h': [1292, 1450], 'on-time.': [1295], 'No': [1296], 'data': [1297], 'cine': [1302], 'frames': [1303], 'available.': [1305], 'Erythema': [1306, 1446], 'noted': [1308], 'back': [1312], 'when': [1313, 2136, 2379, 2452, 4106], 'removed': [1317], 'table': [1320], 'One': [1325], 'month': [1326], 'later': [1327, 1576], 'erythema': [1331], 'area;': [1335], 'persisted.': [1337], 'left': [1342, 4260], 'shows': [1343, 1366, 2715, 2741], 'appearance': [1345], 'approximately': [1346], '5': [1347], 'procedures.': [1351, 1882], 'condition': [1353], 'progressed': [1354], 'into': [1355, 2188], 'blistering,': [1356], 'exudation,': [1357], 'ulceration,': [1358], 'necrosis.': [1360], 'right': [1365, 1489, 1513], 'wound': [1368], '22': [1369], 'third': [1373], 'procedure.1': [1374], '(B)': [1375], 'ablation': [1381, 1432], 'A': [1383, 1426, 2048, 2082, 4093], '52-year-old': [1384], 'man': [1385], 'ablative': [1388], 'procedure': [1389, 1806], 'supraventricular': [1391], 'arrhythmias.': [1392], 'His': [1393], 'arm': [1394], 'had': [1395, 1485, 1557], 'accidentally': [1396], 'been': [1397, 3280], 'positioned': [1398], 'within': [1399], 'field': [1402, 1892, 2580, 4146, 4170, 4218, 4256, 4342], 'during': [1403, 2640], '10-h': [1405], 'estimated': [1408], 'range': [1415, 2068, 2211], '15': [1417], '20': [1419], 'Gy.2': [1420], '(C)': [1421], 'Chronic': [1422], '17-year-old': [1427], 'girl': [1428], 'treat': [1435], 'arrhythmia.': [1437], 'total': [1439, 1639, 3151, 3572, 4057], '100': [1444, 4268], 'min.': [1445], 'present': [1448], '12': [1449], 'month,': [1456], 'red': [1460], 'blistering.': [1462], 'years,': [1465], 'described': [1469, 2031], 'atrophic': [1472], 'indurated': [1473], 'plaque': [1474], 'linear': [1476], 'edges,': [1477], 'hyperpigmentation': [1478], 'hypopigmentation,': [1480], 'telangiectasia.': [1482], 'difficulty': [1486], 'raising': [1487], 'her': [1488, 1512, 1516], 'arm.': [1490], 'Because': [1491], 'close': [1494], 'proximity': [1495], 'breast': [1498, 1522], 'beam,': [1502, 3805, 4370], 'scattered': [1504, 2473, 4191, 4211, 4290, 4337], 'resulted': [1506], 'substantial': [1509], 'breast,': [1514], 'placing': [1515], 'elevated': [1519], 'risk': [1520, 1784, 1800, 3022, 3049, 3070, 3236], 'cancer.3Complications': [1523], 'high': [1526, 2427], 'doses': [1527, 3082, 3253], 'theoretical': [1534], 'consideration,': [1535], 'before': [1536], 'actually': [1539, 1641], 'observed': [1540], 'subsequently': [1542], 'published': [1543, 1956], 'refereed': [1546], 'literature.4,5': [1547], 'By': [1548], 'late': [1549], '1994,': [1550], 'Food': [1552], 'Drug': [1554], 'Administration': [1555], '(FDA)': [1556], 'received': [1558], 'reports': [1563, 1611], 'call': [1567], 'attention': [1568], 'problem': [1571, 1619], 'advisory': [1574], 'appeared': [1577], 'its': [1579, 2184, 2588, 2697, 3376, 3385, 3504], 'Web': [1580], '(http://www.fda.gov/cdrh/fluor.html).': [1582], 'known': [1586, 1697], 'modern-era': [1587], 'event': [1588], 'induced': [1591], 'U.S.': [1596], 'occurred': [1597], '1990,': [1599], 'it': [1600, 1645, 1848, 1886, 2271, 2726, 3422, 3759], 'literature': [1607, 1615, 1626, 1936], 'until': [1608], '1996.1': [1609], 'Subsequent': [1610], 'documented': [1616], 'ongoing.6The': [1621], 'cited': [1623], 'FDA': [1630], 'likely': [1632], 'only': [1633, 4282], 'small': [1635], 'fraction': [1636, 2182, 3520, 3828], 'occur.': [1642], 'In': [1643, 1790, 2397, 2728, 3688], 'addition,': [1644], 'suspected': [1648], 'there': [1650, 1688, 2931, 2978], 'X-ray-guided': [1655], 'cause': [1658], 'other': [1659, 2889], 'less': [1660, 3634, 3847], 'clearly': [1661], 'attributable': [1662, 2022, 2124], 'adverse': [1663], 'effects,': [1664], 'neoplasia.The': [1667], 'principle': [1669, 1685, 1703], 'governing': [1670], 'ALARA': [1677, 1684, 1729], '(As': [1678], 'Low': [1679], 'Reasonably': [1681], 'Achievable).': [1682], 'recognizes': [1686], 'no': [1690, 2731, 2792, 2933, 2980, 4006], 'magnitude': [1691], 'completely': [1700, 2405, 2771], 'safe.': [1701], 'confers': [1704], 'responsibility': [1706, 1811], 'minimize': [1711], 'patients,': [1718, 1920], 'staff,': [1722, 1922], 'themselves.': [1725], 'To': [1726], 'principle,': [1730], 'physician': [1732, 1770, 1794, 3714], 'possess': [1734, 1773, 1815], 'basic': [1736], 'base': [1738, 1836, 1916, 1966], 'areas.': [1741], 'He': [1742], 'she': [1744], 'know': [1746], 'how': [1747], 'operate': [1749], 'manner': [1756], 'generates': [1758, 3596], 'optimal': [1759, 3551], 'minimal': [1763], 'personnel': [1767, 1972], 'also': [1772, 3308, 3584, 4031, 4130], 'recognize': [1777, 2973], 'circumstances': [1780], 'increased.': [1789], 'circumstances,': [1792], 'responsible': [1796, 1843], 'considering': [1798], 'selection': [1803], 'conduct': [1807], 'decisions.To': [1808], 'meet': [1809], 'effectively,': [1812], 'understanding': [1817, 1845], 'physics,': [1820], 'biology,': [1822], 'formation,': [1825, 2332], 'operation': [1828, 3718], 'cinefluorographic': [1832, 3691], 'unit.': [1833], 'well': [1838, 2017], 'documented,': [1839], 'it.': [1846, 2417], 'Applying': [1847], 'appropriately': [1849, 3453, 3475], 'protection': [1858, 3242], 'should': [1859, 1951], 'viewed': [1861], 'standard': [1864], 'care.This': [1866], "document's": [1867], 'purpose': [1868], 'serve': [1871], 'resource': [1874], 'perform': [1878, 1948], 'comprehensive,': [1885], 'contains': [1887, 2069, 2086, 3309, 3991], 'introduction': [1889, 1907], 'written': [1893], 'specifically': [1894], 'accessible': [1897], 'relevant': [1899, 1967, 2661, 2963], 'practitioners.': [1901], 'It': [1902, 1940, 2805, 2807, 3710], 'provides': [1903, 4083], 'them': [1904], 'overview': [1911], 'requisite': [1914], 'needed': [1917], 'protect': [1919], 'Additional': [1928], 'educational': [1929], 'material': [1930, 2278], 'available': [1932], 'both': [1934, 2899, 4137, 4195, 4296], 'textbooks.7': [1939], 'recommends': [1941], 'curriculum': [1944], 'study.': [1952], 'ACC': [1954], 'previously': [1955], 'document': [1958, 1976, 1985], 'summarizing': [1959], 'physics': [1962], 'biology': [1964], 'protection.8': [1974], 'companion': [1982], 'principal': [1988, 2435, 4132], 'focus': [1989], 'protection.II.': [1992], 'X-RadiationThe': [1998], 'X-RadiationX-rays': [2001], 'form': [2004, 2618], 'electromagnetic': [2006, 2040], 'characteristics': [2011], 'similar': [2012], 'visible': [2014, 2117, 2446, 2700, 3428], 'light': [2015, 2084, 2118], 'differences': [2021], 'energy': [2026, 2077, 2126, 2185, 2235, 2315, 2321, 2357, 2478, 2532, 2562, 2575, 3003, 3015, 3744, 3952, 3978], 'content.': [2027], 'X-rays': [2028, 2497, 3119], 'conveniently': [2030], 'terms': [2033], 'photons—a': [2035], 'quantum': [2036, 4380], '(discrete': [2037], 'packet)': [2038], 'containing': [2042], 'defined': [2044, 3296], 'amount': [2045, 2573, 3001, 3124, 3167, 4158], 'energy.': [2047, 2092, 2464, 3786], 'stronger': [2049], 'source': [2051, 4133], 'produces': [2052, 3044, 3559], 'photons': [2054, 2095, 2121, 2245, 2318, 2520, 2650, 2707, 2722, 2754, 2775, 3590, 3602, 3735, 3766, 3802, 3832, 3969, 3992, 4060], 'per': [2055, 3008, 3120, 3162], 'unit': [2056, 3009, 3163, 3231], 'than': [2058, 2458, 2479, 3418, 3904], 'does': [2059, 3419], 'weaker': [2061], 'source.An': [2062], 'photon': [2064, 2085, 2208, 2234, 2284, 2311, 2314, 2356, 2381, 2403, 2424, 2475, 2482, 2536, 3778, 3785, 3933, 3951, 3977], '5000': [2070], '75': [2072], '000': [2073, 2106], 'times': [2074], 'much': [2076, 2456, 4095], 'visible-light': [2080], 'photon.': [2081], 'green': [2083], 'electron': [2088, 2174, 2239, 2386, 2410, 2462], 'volts': [2089, 2240], '(eV)': [2090], 'energies': [2100, 2209, 2425, 2454, 3111, 3934, 3995, 3999], 'ranging': [2101], '10': [2103, 3029, 3096, 3142, 3247], 'keV': [2104, 4002], '(10': [2105], 'eV)': [2107], '150': [2109], 'keV.': [2110], 'difference': [2112, 2934, 2982, 3533], 'biologic': [2114], 'effects': [2115], 'largely': [2123], 'content': [2127], 'differences.X-Ray': [2128], 'GenerationX-rays': [2129], 'produced': [2131, 2625, 3158, 3961, 4061, 4105], 'tube': [2135, 2157, 2162, 2224, 2228, 3623, 3662, 3680, 3798, 4053, 4072], 'high-energy': [2137, 2173], 'electrons,': [2138, 2930], 'arc': [2141], 'created': [2142], 'applying': [2144], 'voltage': [2146, 2219, 2229], 'across': [2147, 2221], 'gap,': [2149], 'interact': [2150], 'tungsten': [2152], 'forms': [2154], 'anode.': [2158], '(Details': [2159], 'construction': [2163], 'can': [2164, 2817, 3254, 3583], 'found': [2166], 'text.)': [2170], 'When': [2171], 'interacts': [2175, 2382, 4110], 'target': [2178], 'atom,': [2179], 'variable': [2181], 'converted': [2187], 'photon,': [2191], 'remainder': [2194], 'dissipated': [2196], 'heat.X-Ray': [2198], 'SpectraX-rays': [2199], 'generated': [2200], 'machines': [2203], 'contain': [2204], 'spectrum': [2206, 4078], 'up': [2212, 2293, 2891], 'maximum': [2215, 2233], 'determined': [2216, 2280], 'applied': [2220, 3575], 'gap.': [2225], 'peak': [2227], '(kVp)': [2230], 'determines': [2231], '(expressed': [2236], 'kilo': [2238], '[keV]).Mechanisms': [2241], 'AbsorptionX-ray': [2244], 'penetrate': [2246, 2323, 3592, 3835], 'tissue': [2247, 2585, 3007], 'varying': [2250, 3465], 'degree.': [2251], 'phenomenon': [2253], 'basis': [2256], 'attenuation': [2261, 3781], '(the': [2262], 'degree': [2263], 'intensity': [2268, 2758, 3350, 3394, 4065, 4173, 4209, 4230, 4334], 'decreases': [2269, 3503, 3543, 3782, 4047], 'passes': [2272], 'through': [2273, 2608, 2725], 'object)': [2275], 'four': [2282], 'parameters:X-ray': [2283], 'energyThe': [2285], 'atomic': [2286, 2428], 'atoms': [2290, 2524, 2539], 'objectThe': [2295, 2301, 2305], 'physical': [2296, 3270], 'density': [2297], '(g/cc)': [2298], 'thickness': [2302], 'penetrating': [2306, 3439, 3449, 3606, 3739], 'power': [2307, 3450, 3574], 'increases': [2312, 3826, 4055, 4161, 4163, 4231], 'increases.': [2316], 'Low-energy': [2317], 'insufficient': [2320], 'tissue.': [2324, 2499, 2528, 2542, 2565], 'Consequently,': [2325], 'do': [2327, 2654], 'contribute': [2329, 2342, 3840], 'but,': [2333], 'absorbed': [2337, 2406, 2563, 2576, 2936, 3052, 3063, 3524, 3810], 'skin,': [2340], 'dose.Several': [2349], 'absorption': [2351, 2361, 2432, 2436, 2592, 2628, 2685, 3537, 3775, 3903], 'processes': [2352], 'occur': [2353], 'different': [2355, 2691, 2744, 2749, 3087, 3209, 3262, 3341, 3381, 3391, 3539, 3728], 'ranges.': [2358], 'Two': [2359], 'mechanisms': [2362], 'photoelectric': [2371, 2376, 2399, 3774, 3902], 'Compton': [2374, 2469, 2488, 2510], 'scattering.The': [2375], 'occurs': [2378, 2420, 2451], 'orbital': [2385], 'atom': [2389, 2415], '(generally': [2390], 'electrons': [2392], 'K': [2395], 'shell).': [2396], 'effect,': [2400], 'free': [2409], 'ejected': [2412], 'preferentially': [2421, 3799, 4022], 'low': [2423, 3777], 'absorbers.': [2430], 'Photoelectric': [2431], 'renders': [2439, 2696], 'iodinated': [2440], 'contrast': [2441, 2623, 3480, 3612, 3920, 4045], 'agent': [2442], 'metallic': [2444], 'stents': [2445], 'fluoroscopy.Compton': [2449], 'scattering': [2450], 'absorbing': [2460], "material's": [2461], 'binding': [2463], 'products': [2466], 'interaction': [2470, 2493], 'lower': [2477], 'incident': [2481, 2753, 2834, 2864, 3345], 'recoil': [2485], 'electron.': [2486], 'affect': [2489], 'main': [2492], 'Most': [2500], 'stray': [2501], 'laboratory': [2506, 4155], 'arises': [2507], 'process.X-Ray': [2511], 'DoseRadiation': [2512], 'delivered': [2515, 2636, 3085], 'interactions': [2517, 2530], 'individual': [2523], 'comprise': [2526], 'transfer': [2531], '(The': [2543], 'term': [2544], '"dose"': [2545], 'here': [2548], 'refers': [2549], '"absorbed': [2552], 'dose.")': [2553], '"Dose"': [2554], 'measure': [2557, 3234], 'concentration': [2560, 3013], 'formal': [2567], 'definition': [2568, 2793, 3640], 'volume': [2583], 'divided': [2586], 'mass.': [2589], 'Both': [2590], 'transmission': [2601, 2704], 'quantity': [2605, 3199], 'receptor,': [2614], 'image.': [2621, 2705, 3843], 'partial': [2627], '(Figure': [2632, 3351, 3814, 4178], '2).': [2633, 3352], 'examination': [2644], 'derived': [2646, 3267], 'enter': [2652, 3850], 'but': [2653, 2913, 2957, 4030, 4046], 'leave': [2656], 'patient.': [2658, 3527, 3594, 4113], 'measurement': [2666, 2985], 'parameters': [2667, 3474, 3694], 'relation': [2670], 'shown': [2674, 3314], 'Table': [2676, 3298, 3306], '2.': [2681], 'contrast.': [2683, 3549, 4033, 4126], 'Differential': [2684], 'parts': [2692, 2745, 4141], 'object': [2695, 2717, 2735, 2786, 3368, 4352], 'structure': [2699], 'represented': [2709, 4079], 'arrows.': [2711], 'left-hand': [2713, 4251], 'example': [2714, 2740, 2769], 'allows': [2719], 'pass': [2724], 'unattenuated.': [2727], 'circumstance,': [2730], 'generated.': [2737], 'center': [2739], 'object,': [2743], 'absorb': [2748, 3340], 'fractions': [2750, 3342], 'modulating': [2755, 3347], 'generating': [2760], 'object.': [2766], 'right-hand': [2768, 4309], 'opaque': [2772], 'absorbs': [2777, 3411, 4023], 'them.': [2780], 'would': [2787], 'silhouette': [2790], "object's": [2796], 'structure.TABLE': [2798], 'Relevant': [2800], 'QuantitiesQuantityUnits': [2802], 'MeasurementWhat': [2804], 'IsWhat': [2806], 'MeasuresWhy': [2808], "It's": [2809], 'UsefulConversion': [2810], 'Between': [2811], 'Old': [2812], 'New': [2814], 'Units*Air': [2815], 'kerma': [2816, 2826, 2829, 2856, 2859, 2897, 2921], 'presented': [2819], 'separate': [2822], 'ways.': [2823], 'Incident': [2824], 'air': [2825, 2831, 2855, 2861, 2896, 2920], 'measured': [2837, 2867], 'central': [2840, 2870, 4284], 'axis': [2842, 2872], 'position': [2845, 2875, 4316], 'excludes': [2850], 'backscattered': [2851, 2880], 'radiation.': [2852, 3275], 'surface': [2854], 'included.': [2882], 'differ': [2886], '40%.†Exposure': [2894], 'purpose.': [2904], 'common': [2911, 3230], 'measure,': [2912], 'switch': [2916], 'international': [2918], 'units,': [2919, 3692], 'preferred': [2924], 'unit.‡For': [2925], 'X-rays,': [2926], 'gamma': [2927], 'rays,': [2928], 'equivalent': [2939, 3065], 'dose,': [2940], 'ie,': [2941], 'mGy': [2943, 2987], '=': [2944, 3028, 3095, 3141, 3246, 4341], 'mSv.': [2946], 'neutrons': [2953], 'alpha': [2955], 'particles,': [2956], 'types': [2960, 3210, 3224], 'issue': [2969], 'cardiologists': [2972], 'interests': [2977], 'practical': [2981], 'mSv.Absorbed': [2991], 'dosegray': [2992], '(Gy)': [2993, 3099], 'milligray': [2995, 3101], '(mGy)': [2996, 3102], '[rad': [2997, 3103], 'millirad': [2999, 3105], '(mrad)]The': [3000, 3106], 'locally': [3004], 'deposited': [3005], 'mass': [3010, 3121, 3164], 'tissueMeasures': [3012], 'deposition': [3016], 'tissueAssesses': [3018], 'biological': [3021, 3205, 3220], 'tissue1': [3026], 'rad': [3027, 3140], 'mGyEffective': [3030], 'dosesievert': [3031], '(Sv)': [3032, 3190], 'millisievert': [3034, 3192], '(mSv)': [3035, 3193], '[rem': [3036, 3194], 'millirem': [3038, 3196], '(mrem)]An': [3039], 'attributed': [3040], 'whole-body': [3041, 3069], 'whole-person': [3047], 'stochastic': [3048], 'limited': [3056, 3738], 'portion': [3057], 'bodyConverts': [3060], 'factorPermits': [3071], 'comparison': [3072, 3301], 'risks': [3074], 'several': [3076], 'exposed': [3077, 3444, 4217], 'individuals,': [3078], 'sets': [3088], 'organs': [3090], 'individuals1': [3093], 'rem': [3094, 3245], 'mSvAir': [3097], 'kerma*gray': [3098], 'sum': [3107], 'initial': [3109], 'kinetic': [3110], 'particles': [3115], 'liberated': [3116], 'airMeasures': [3123, 3166], 'point': [3129, 3172], 'spaceAssesses': [3131, 3174], 'level': [3133, 3176], 'location†1': [3139, 3182], 'mGyExposuremillicoulomb': [3143], '·': [3144, 3184], 'kg−1': [3145, 3185], '[roentgen': [3146], '(R)': [3147], 'milliroentgen': [3149], '(mR)]The': [3150], 'charge': [3152], 'ions': [3154], 'one': [3156], 'sign': [3157], 'millicoulomb': [3183], '4': [3186], 'Roentgen': [3187], '(R)Equivalent': [3188], 'dose‡sievert': [3189], '(mrem)]A': [3197], 'factors': [3201], 'relative': [3204, 3214, 3536], 'damage': [3206, 3221], 'caused': [3207], 'radiationsProvides': [3212], 'accounts': [3217], 'radiationsThis': [3226], 'tissues': [3239, 3540], 'personnel‡1': [3244], 'mSvMeasurements': [3248], 'RadiationRadiation': [3250], 'levels': [3251], 'characterized': [3256], 'utilizing': [3258], 'parameters.': [3263, 3470], 'measurements': [3265], 'effect': [3271, 3924], 'evoked': [3272], 'nomenclature': [3277], 'recently': [3279], 'revised.': [3281], 'quantities': [3284], 'expressed': [3286], 'SI': [3288], '(System': [3289], 'Internationale)': [3290], 'units': [3291, 3313], 'listed': [3294], 'For': [3300, 3398, 4220], 'older': [3304], 'literature,': [3305], 'corresponding': [3311], 'earlier': [3312], 'brackets': [3316], '(ie,': [3317], 'gray': [3318], '[rad]).III.': [3319], 'FormationX-Ray': [3324], 'GenerationThe': [3326], 'illuminated': [3329], 'X-rays.': [3334], 'Different': [3335], 'structures': [3336, 3387, 3752], 'radiation,': [3346], 'modulated': [3354], 'exits': [3357], 'detected': [3362], 'receptor.': [3366], 'An': [3367], 'delineated': [3370], 'if': [3375, 3708, 3862], 'absorbance': [3378], 'sufficiently': [3380], 'surrounding': [3386], 'produce': [3389, 3441, 3856, 3912], 'exit': [3392, 3859, 4015], 'location.': [3397], 'example,': [3399], 'iodine-containing': [3401], '"contrast': [3402], 'medium"': [3403], 'employed': [3404], 'enhance': [3406], 'visibility': [3408], 'vessels': [3410], 'significantly': [3412], 'blood': [3421], 'displaces,': [3423], 'rendering': [3424], 'contrast-filled': [3426], 'vessel': [3427], 'image.Parameters': [3432], 'FormationX-ray': [3437], 'power.To': [3440], 'optimally': [3443], 'image,': [3445], "beam's": [3448, 3831], 'adjusted': [3454], 'attenuation.': [3459], 'accomplished': [3463], 'Ideal': [3471], 'balance': [3476, 3562], 'requirement': [3478, 3487], '(needed': [3481, 3490], 'detect': [3483], 'object),': [3485], 'sharpness': [3489], 'characterize': [3492], 'it),': [3493], 'dose.Increasing': [3496, 3570], 'kVp': [3498, 3530, 3557, 4035], 'absorption,': [3505], 'enabling': [3506], 'penetration': [3508, 3564], 'dense': [3510, 4351], 'body': [3511, 4140], 'parts,': [3512], 'reduces': [3514, 3547, 4027, 4124], 'increases,': [3531], 'decreases.': [3541], 'modulation': [3545], 'Therefore,': [3550], 'compromise': [3556], 'best': [3561], 'power,': [3565], 'contrast,': [3567, 3637], 'electrical': [3573], 'tube,': [3579], 'without': [3580, 3753], 'changing': [3581], 'kVp,': [3582], 'increase': [3585], 'power.': [3607], 'strategy': [3609, 3629, 3669], 'maintains': [3610], 'cost': [3615, 3653], 'loading.': [3624, 3663], 'gain': [3626], 'noise,': [3635], 'better': [3639], '(see': [3641], 'discussion': [3643], 'noise': [3646, 4122], 'text)': [3650], 'subject': [3656], 'Another': [3664], 'downside': [3666], 'loading': [3674], 'larger': [3678], 'focal': [3681], 'spot,': [3682], 'will': [3684, 4353], 'reduce': [3685, 4183, 4187], 'sharpness.': [3687], 'modern': [3690], 'set': [3696], 'automatically': [3697], 'programs': [3699, 3705], 'installed': [3700], 'system.': [3703], 'user-configurable': [3707], 'desired.': [3709], 'users': [3715], 'understand': [3716], 'implications': [3723], 'choosing': [3725], 'selectable': [3729], 'programs.X-ray': [3730], 'filtration.Because': [3732], 'low-energy': [3733, 3765, 3801, 4024], 'very': [3737], 'ability,': [3740], 'deposit': [3742], 'superficial': [3748], 'tissues,': [3749], 'exposing': [3750, 4324], 'contributing': [3754], 'formation.': [3757], 'Thus,': [3758, 3861], 'desirable': [3761], 'remove': [3763], '(filter)': [3764], 'beam.': [3770], 'Aluminum': [3771], 'appreciable': [3773], 'energies.': [3779], 'Its': [3780], 'increasing': [3784], 'Placing': [3787], 'aluminum': [3789], 'disk': [3790], 'output': [3793], 'removes': [3800], '3).': [3815], 'called': [3819, 4372], '"hardening': [3820], 'beam."': [3822], 'Increasing': [3823, 4050], 'hardness': [3825], 'successfully': [3834], 'means': [3845], 'order': [3854], 'given': [3858], 'dose.': [3860], 'hardened,': [3866], 'reaches': [3877, 4117], 'detector': [3880], 'same.': [3883], 'Many': [3884], 'newer': [3885], 'systems': [3888], 'combinations': [3890], 'high-power': [3892], 'tubes': [3894], 'equipped': [3895], 'copper': [3897, 4018, 4040], 'filters': [3898, 4019], '(producing': [3899], 'higher': [3901], 'aluminum)': [3905], 'special': [3907], 'system': [3908, 4315], 'regulation': [3909], 'curves': [3910], 'hardening': [3916, 3927], 'quality.': [3922], 'distribution': [3930], 'displayed': [3936], 'Figure': [3938], '3.': [3939, 3943], 'filtration.': [3946], 'Plots': [3947], 'composition': [3953], 'typical': [3956], '70': [3963], 'kVp.': [3964], 'plotted': [3971, 3980], 'ordinate,': [3974], 'abscissa.': [3983], 'original': [3985], 'e': [3988], '(curve': [3989, 4020, 4042, 4074], 'A)': [3990], 'multiple': [3994], 'including': [3996], 'below': [4000], '30': [4001], 'value.': [4008], 'Intercepting': [4009], 'B)': [4021], 'photons.': [4025], 'Decreasing': [4034], '60': [4037, 4259], 'employing': [4039], 'filtration': [4041], 'C)': [4043], 'improves': [4044], 'intensity.': [4049], 'current': [4054], 'restores': [4063], '(at': [4066], 'expense': [4068], 'additional': [4070], 'loading)': [4073], 'D).': [4075], 'curve': [4081, 4092], 'D': [4082], 'provided': [4090], 'patient.Scattered': [4101], 'radiation.Scattered': [4102], 'Scattered': [4114, 4127], 'receptor': [4120], 'staff.': [4156], 'scatter': [4160, 4229, 4247, 4255], 'size': [4166], '4).': [4179], 'All': [4180], 'measures': [4181], 'commensurately': [4186], 'exposes': [4194], 'personnel.': [4203], '4.': [4207], 'function': [4215], 'size.': [4219], 'magnification': [4223], 'mode': [4224], 'intensifier,': [4228], 'everywhere': [4232], 'room': [4235], 'collimator': [4238, 4275, 4320], 'opened.': [4240], 'Doubling': [4241], 'doubles': [4245], 'illustrates': [4253, 4311], 'anterior': [4261], 'oblique': [4262], 'projection': [4263], 'height': [4266], 'cm': [4269], 'floor': [4272], 'partially': [4276], 'closed': [4277], 'allow': [4279], '50%': [4285], 'field.': [4288, 4327], 'rates': [4293], '(which': [4294], 'expose': [4295], 'operator)': [4301], 'indicated': [4303], 'isodose': [4306], 'lines.': [4307], 'identical': [4313], 'except': [4317], 'fully': [4322], 'open,': [4323], 'entire': [4326], 'Note': [4328], 'location,': [4332], 'doubles.': [4339], 'FOV': [4340], 'view.Image': [4344], 'noise.A': [4345], 'radiographic': [4346], 'uniformly': [4350], 'point-to-point': [4355], 'variations': [4356], 'brightness.': [4358], 'random': [4360], 'fluctuations,': [4361], 'inherent': [4365], 'property': [4366], 'noise.': [4374], 'Noise': [4375], 'due': [4377], 'nat': [4381]}, 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