Radiology patients dose mastering of Kirchberg hospital center

Abstract

Medical irradiation is the primary exposure source, artificial origin, of the population in industrialized countries (1.3 mSv per year per capita on average according to the IRSN 2010). However, Radiation protection of persons exposed for medical purposes is a relatively recent concern (directives: 84/466 & 97/43 Euratom). The notion of regulatory dose limit is inappropriate in the context of medical examinations, in effect, reduce and maintain exposure to radiation at a dose as low as reasonably possible, in accordance with the ALARA principle (As Low As Reasonably Achievable), cannot be applied directly, the dose ‘‘mastering” through the justification and optimization of medical procedures. The dose mastering is a compromise: must firstly that the expected benefits outweigh the caused risks, and secondly that the dose is consistent with an interpretable medical image. Kirchberg Hospital Center (KHC) in Luxembourg, very aware of the problem of the doses delivered to patients during diagnostic examinations, has established a strategy evaluation and optimization of the dose which organizes around several axes: 1. standardization of procedures for conducting medical examinations, 2. the use of CT reconstruction algorithms in order to obtain interpretable images with low exposure, it is ASIR and VEO, 3. the acquisition of a dose management software connected with all services using radiology equipment (scanners, radiocontrolled table, mammography, surgical, etc.), it is DoseWatch, 4. the appointment of a DACS (Dose Archiving and Communication System) in order to follow exposure of patients in real time, manage alerts and publish monthly dose reports, 5. each actor in the radiological chain (manipulator, physician) is invited to regular meetings where the results are presented with DoseWatch. Following these meetings, he receives a sheet exposure showing the average and the 75th percentile of the dose for different examinations he has done. In this presentation we will discuss the items listed above through the experience of KHC and different conclusions.