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This review provides a historical overview of radiation dosimetry in fluoroscopy, tracing the evolution from rudimentary dose estimation methods to modern tools leveraging standardized dose indices and radiation dose structured reports (RDSRs) for radiation dosimetry at the skin surface as well as at depth in soft tissue. Despite these advancements, substantial uncertainties remain due to technical limitations, beam geometry, dose mapping challenges, and hardware\u2010induced variability. Key sources of uncertainty are examined, some well\u2010known and others that are not well\u2010understood. This work also underscores the need for a deeper understanding of the assumptions and limitations in automated dosimetry systems and calls for enhanced reporting standards and dose mapping capabilities to improve accuracy. Addressing these limitations is essential for integrating radiobiological principles into clinical medical physics and optimizing patient care in FGIs.<\/jats:p>","DOI":"10.1002\/mp.70211","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:57:06Z","timestamp":1767668226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient radiation dosimetry for fluoroscopically guided interventions \u2013 a review of the history and limitations"],"prefix":"10.1002","volume":"53","author":[{"given":"Kevin A.","family":"Wunderle","sequence":"first","affiliation":[{"name":"Division of Medical Physics Department of Radiology College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Balter","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Medicine The Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14910"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncu181"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2021.10.030"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3633935"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.17667"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2020.04.023"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13227"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.08.023"},{"issue":"6","key":"e_1_2_9_10_1","article-title":"Review of patients undergoing fluoroscopically\u2010guided interventionsand external beam radiation therapy within a quaternary caremedical center","volume":"45","author":"Zhoa A","year":"2018","journal-title":"Med Phys"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.20.4.g00jl301115"},{"key":"e_1_2_9_12_1","unstructured":"BalterS Fluoroscopic Technology from 1895 to 2019 Drivers: Physics and Physiology. 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