COMP Report: A survey of radiation safety regulations for medical imaging x-ray equipment in Canada.

Thorarin A Bjarnason,Judy Kainz,Brent Preston,Pierre Therrien,Michelle Cottreau,Robert Rees,Clément Arsenault,Elena Tonkopi,Idris Elbakri,I Martin Benoît Gagnon,Lawrence H Le,Ingvar A J Fife,Errol E Stewart,John E Aldrich,Edward Kendall,Ting‐Yim Lee

doi:10.1002/acm2.12708

Abstract

X‐ray regulations and room design methodology vary widely across Canada. The Canadian Organization of Medical Physicists (COMP) conducted a survey in 2016/2017 to provide a useful snapshot of existing variations in rules and methodologies for human patient medical imaging facilities. Some jurisdictions no longer have radiation safety regulatory requirements and COMP is concerned that lack of regulatory oversight might erode safe practices. Harmonized standards will facilitate oversight that will ensure continued attention is given to public safety and to control workplace exposure. COMP encourages all Canadian jurisdictions to adopt the dose limits and constraints outlined in Health Canada Safety Code 35 with the codicil that the design standards be updated to those outlined in NCRP 147 and BIR 2012.

Highlights

Medical image registration (IR) enables a user to combine and compare information from multiple images and has applications in radiology,[1] nuclear medicine,[2,3] and radiotherapy.[4,5,6,7] The use of images is increasing in healthcare,[1] and applications of IR can benefit patients in diagnosis, planning, treatment, and response assessment.[1]
On the April 19, 2018, the Australia/New Zealand (ANZ) survey was distributed through emails to Medical Physics Directors, while the INTL survey was distributed through the MEDPHYS email list hosted by Wayne State University.[16]
Results on the number of datasets (xvi), the number of datasets used for commissioning by application (xvii), and patient‐specific QA (xviii) were excluded as there was no ability for respondents to skip questions that were not applicable to them and they were forced to input nominal values to questions

Summary

Introduction

Medical image registration (IR) enables a user to combine and compare information from multiple images and has applications in radiology,[1] nuclear medicine,[2,3] and radiotherapy.[4,5,6,7] The use of images is increasing in healthcare,[1] and applications of IR can benefit patients in diagnosis, planning, treatment, and response assessment.[1] Almost every software system that uses images in radiotherapy has rigid image registration (RIR) functionalities[4] that involves translational and rotational corrections with up to 6 degrees of freedom. More complex is deformable image registration (DIR) which has 3 degrees of freedom for every voxel in the image.[4] Validation and clinical translation of IR have been considered challenging for over 20 yr,[8] with DIR validation considered an unresolved subject.[5,6]. This report increased awareness in the need for formal quality management to better understand, communicate, and manage the uncertainty of both rigid and deformable image registration. As a single IR technique (RIR or DIR) may not be robust for all circumstances,[10] there is value in data to help select an appropriate IR technique, and data to help decide on a per‐patient IR quality assurance.[4]

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