Medical Groups Call for Safer Fluoroscopy Practices

New 'ALARA+' framework aims to reduce radiation exposure and orthopedic strain for healthcare workers

Mar. 25, 2026 at 12:05am

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Nine leading medical societies are calling for updated safety standards in fluoroscopy laboratories, where clinicians performing minimally invasive procedures face radiation exposure and orthopedic injuries from heavy protective equipment. The report proposes an enhanced safety framework called 'ALARA+' or 'As Low and As Light as Reasonably Achievable' to address the dual occupational hazards linked to fluoroscopic procedures.

Why it matters

Fluoroscopy is widely used to perform minimally invasive procedures that treat conditions like heart attack, stroke, and vascular disease. While these procedures improve patient outcomes, they carry long-term occupational risks for the healthcare teams performing them, including cumulative radiation exposure and physical strain from heavy protective equipment. Addressing these risks is essential for maintaining a skilled workforce and ensuring continued access to these lifesaving treatments.

The details

The report details how traditional 'ALARA' (As Low As Reasonably Achievable) principles have proven insufficient, as they focused only on minimizing radiation exposure and did not account for the orthopedic strain caused by wearing heavy lead protective equipment during long procedures. The new 'ALARA+' framework calls for responsible protection strategies that are 'as low and as light as reasonably achievable' for the entire procedural team.

  • The report was published simultaneously today (March 25, 2026) in several medical journals.

The players

Robert F. Riley, MD, MS, FSCAI

Chair of the 2025 Summit on Radiation and Orthopedic Risks in Fluoroscopic Labs.

Arnold H. Seto, MD, MPA, FSCAI

Co-Chair of the Summit on Radiation and Orthopedic Risks in Fluoroscopic Labs.

Srihari S. Naidu, MD, MSCAI

President of the Society for Cardiovascular Angiography and Interventions (SCAI).

Society for Cardiovascular Angiography and Interventions (SCAI)

One of the nine leading medical societies endorsing the 'ALARA+' report.

American College of Cardiology (ACC)

One of the nine leading medical societies endorsing the 'ALARA+' report.

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What they’re saying

“How we think about radiation safety has been historically guided by the ALARA principle, or 'as low as reasonably achievable.' But that approach has proven to be not safe enough for healthcare staff working in fluoroscopic labs.”

— Robert F. Riley, MD, MS, FSCAI, Chair of the 2025 Summit on Radiation and Orthopedic Risks in Fluoroscopic Labs

“These occupational harms affect every member of the procedural team and the healthcare system as a whole, carrying major financial and human costs.”

— Arnold H. Seto, MD, MPA, FSCAI, Co-Chair of the Summit on Radiation and Orthopedic Risks in Fluoroscopic Labs

“ALARA+ represents a shift from accepting risk to expecting better. Fluoroscopy-guided procedures save lives every day by allowing minimally invasive treatment for heart disease, vascular disease, and stroke. The clinicians and teams delivering that care deserve laboratories that protect them just as thoughtfully as we protect our patients.”

— Srihari S. Naidu, MD, MSCAI, President of the Society for Cardiovascular Angiography and Interventions (SCAI)

What’s next

The report calls for several actions to improve safety in fluoroscopy laboratories, including accelerating the adoption of modern radiation protection technologies, expanding real-time radiation monitoring, strengthening education and training in radiation safety, continuing technological innovation to protect all catheterization lab clinicians, and supporting regulatory and accreditation standards that promote safer fluoroscopy laboratory environments.

The takeaway

The new 'ALARA+' framework represents a shift in the medical community's approach to radiation safety, moving from simply minimizing exposure to actively expecting and implementing better protection strategies for healthcare workers performing fluoroscopy-guided procedures. This is essential for maintaining a skilled workforce and ensuring continued access to these lifesaving treatments.