Patient and occupational dosimetry in fluoroscopy-guided interventions in Spain: Progress made, gaps remaining

Purpose This study aimed to assess the current status of patient and occupational dosimetry practices in Spain and identify areas for improvement in relation to European and international recommendations. Methods Two nationwide surveys were conducted by a joint SEFM-SEPR working group, targeting medical physicists at centres performing fluoroscopy-guided interventional procedures. Key topics included DRLs, DMS, occupational radiation protection, certification, and training. Descriptive statistics were used to analyse the responses. Results A total of 38 responses were analysed for patient dosimetry and 32 for occupational radiation protection, with broad geographical representation. Most centres reported access to basic dosimetric data; however, 32 % lacked a dedicated DMS. Although 55 % of respondents reported using DRLs, routine application and physician involvement were limited. Patient dose calculations were performed in 58 % of centres but were mainly not recorded. In occupational radiation protection, the availability of personal protective equipment and eye lens dosimetry was high (97 %), while real-time dosimetry systems were implemented in 44 % of centres and not consistently quality-controlled. Variability was also observed in advanced certification, with only 22 % of centres meeting the requirements for second-level certification, and continuing education remained inconsistent. Conclusions Despite clear progress in recent years, significant variability persists in interventional dosimetry practices across Spanish centres. Wider implementation of DMS, stronger integration of DRLs into clinical workflows, and sustained investment in training and education are required to achieve harmonised and optimised radiation protection in line with European and international guidelines.