Radiation Exposure Levels Research Articles

Mitigation of radiation exposure during surgical hepatectomy after yttrium-90 radioembolization

Yttrium-90 (Y-90) radioembolization for the treatment of hepatocellular carcinoma can present safety challenges when transplanting recently treated Y-90 patients. To reduce surgeons’ contact with radioactive tissue and remain within occupational dose limits, current guidelines recommend delaying transplants at least 14 days, if possible. We wanted to determine the level of radiation exposure to the transplant surgeon when explanting an irradiated liver before the recommended decay period. An ex-vivo radiation exposure analysis was conducted on the explanted liver of a patient who received Y-90 therapy 46 h prior to orthotopic liver transplant. To estimate exposure to the surgeon’s hands, radiation dosimeter rings were placed inside three different surgical glove configurations and exposed to the explanted liver. Estimated radiation doses corrected for Y-90 decay were calculated. Radiation safety gloves performed best, with an average radiation exposure rate of 5.36 mSV h−1 in the static hand position, an 83% reduction in exposure over controls with no glove (31.31 mSv h−1). Interestingly, non-radiation safety gloves also demonstrated reduced exposure rates, well below occupational regulation limits. Handling of Y-90 radiated organs within the immediate post-treatment period can be done safely and does not exceed federal occupational dose limits if appropriate gloves and necessary precautions are exercised.

P16. Is there a difference in screw accuracy, robot time per screw, robot abandonment, and radiation exposure between the Mazor X and the renaissance? A propensity-matched analysis of 1,179 robot-assisted screws

P16. Is there a difference in screw accuracy, robot time per screw, robot abandonment, and radiation exposure between the Mazor X and the renaissance? A propensity-matched analysis of 1,179 robot-assisted screws

Advanced image guidance for prostatic artery embolization \u2013 a multicenter technical note

BackgroundProstatic artery embolization (PAE) is associated with patients’ quality of life improvements and limited side effects compared to surgery. However, this procedure remains technically challenging due to complex vasculature, anatomical variations and small arteries, inducing long procedure times and high radiation exposure levels both to patients and medical staff. Moreover, the risk of non-target embolization can lead to relevant complications. In this context, advanced imaging can constitute a solid ally to address these challenges and deliver good clinical outcomes at acceptable radiation levels.Main textThis technical note aims to share the consolidated experience of four institutions detailing their optimized workflow using advanced image guidance, discussing variants, and sharing their best practices to reach a consensus standardized imaging workflow for PAE procedure, as well as pre and post-operative imaging.ConclusionsThis technical note puts forth a consensus optimized imaging workflow and best practices, with the hope of helping drive adoption of the procedure, deliver good clinical outcomes, and minimize radiation dose levels and contrast media injections while making PAE procedures shorter and safer.

Radiation Exposure in the Neonatal Intensive Care Unit in Newborns and Staff.

Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. In this prospective study, dosimeters were placed on premature infants who were ≤1,250 g at birth and ≤30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 ± 2.44 mGy. The mean skin dose of the six staff was 0.087 ± 0.0998 mSV. The mean scattered dose was 67.9 ± 26.5 µGy. Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously. · The premature infants are exposed to radiation due to the bedside X-rays.. · The radiation exposure levels of premature infants and staff may need to be monitored continuously.. · Measures and alternative methods to reduce radiation exposure should be encouraged..

Scientific research and product development in the United States to address injuries from a radiation public health emergency.

The USA has experienced one large-scale nuclear incident in its history. Lessons learned during the Three-Mile Island nuclear accident provided government planners with insight into property damage resulting from a low-level release of radiation, and an awareness concerning how to prepare for future occurrences. However, if there is an incident resulting from detonation of an improvised nuclear device or state-sponsored device/weapon, resulting casualties and the need for medical treatment could overwhelm the nation's public health system. After the Cold War ended, government investments in radiation preparedness declined; however, the attacks on 9/11 led to re-establishment of research programs to plan for the possibility of a nuclear incident. Funding began in earnest in 2004, to address unmet research needs for radiation biomarkers, devices and products to triage and treat potentially large numbers of injured civilians. There are many biodosimetry approaches and medical countermeasures (MCMs) under study and in advanced development, including those to address radiation-induced injuries to organ systems including bone marrow, the gastrointestinal (GI) tract, lungs, skin, vasculature and kidneys. Biomarkers of interest in determining level of radiation exposure and susceptibility of injury include cytogenetic changes, 'omics' technologies and other approaches. Four drugs have been approved by the US Food and Drug Administration (FDA) for the treatment of acute radiation syndrome (ARS), with other licensures being sought; however, there are still no cleared devices to identify radiation-exposed individuals in need of treatment. Although many breakthroughs have been made in the efforts to expand availability of medical products, there is still work to be done.

Mental Health Consequences of the Three Mile Island, Chernobyl, and Fukushima Nuclear Disasters: A Scoping Review.

Many individuals who were affected by the Great East Japan earthquake and tsunami and the subsequent Fukushima Daiichi Nuclear Power Plant accident continue to face a challenging recovery. We reviewed the long-term mental health consequences of three major nuclear power plant accidents: the Three Mile Island (TMI, 1979), Chernobyl (1986), and Fukushima (2011) nuclear disasters. We examined the relevant prospective cohort studies and before-and-after studies that covered more than two timepoints, searching four databases (PubMed, Ichushi, PsyArticles, and PTSDPub). We identified a total of 35 studies: TMI, n = 11; Chernobyl, n = 6; and Fukushima, n = 18. The smaller numbers of early-phase studies (within 6 months) of the Chernobyl and Fukushima disasters may also indicate the chaotic situation at those timepoints, as large-scale interviews were conducted in the early phase after the TMI disaster. Although the patterns of effects on mental health outcomes were diverse, more than half of the participants in the studies we evaluated were categorized into low or under-threshold symptom groups in all three disasters. Across the three disasters, the radiation exposure level estimated by the proximity and stigma were the common risk factors for mental health outcomes. Our findings will contribute to a comprehensive understanding of the impact of the worst nuclear accidents in history on the affected individuals’ mental health, and our results illustrate the longitudinal consequences of such disasters.

ASSESSMENT OF THE OUTDOOR GAMMA RADIATION LEVELS IN ALGIERS PROVINCE, ALGERIA.

The outdoor gamma radiation dose rates due to natural radioactivity and due to the artificial radionuclides released from the Chernobyl and Fukushima accidents and Algeciras incident were assessed in the Algiers province (capital of Algeria). Furthermore, the dose rates induced by the cosmic rays were analytically calculated in the province concerned. The recorded dose rates due to terrestrial outdoor gamma radiation were found to range from 14.3±0.7 to 114.3±5.7 nGy h -1, those due to cosmic rays ranged from 32.021±0.013 to 34.029±0.367 nGy h -1, while the contribution of the dose rate due to external exposure induced by 137Cs deposits, from major accidents, was estimated to be less than 0.3 nGy h-1. The spatial distributions of terrestrial and cosmic rays dose rates were mapped using QGIS software. The obtained radiological baseline maps can be used as reference information to assess any changes in the radiation exposure levels having an impact on the population health.

Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5\u2013S1 disc herniation: preliminary clinical outcomes

ObjectivePercutaneous transforaminal endoscopic discectomy (PTED) is minimally invasive and has been widely used to treat patients with lumbar disc herniation (LDH) due to its safety and efficiency. However, due to the unique anatomy of the L5–S1 level, the PTED procedure is often difficult to perform in the region. ZESSYS, a targeted and quantificational foraminoplasty device, may help to overcome these anatomical limitations. In this study, we assessed the efficiency and the short-term effects of PTED with ZESSYS at the L5–S1 level.MethodsBetween January and August of 2018, fifty-six patients with lumbar disc herniation at the single level of L5–S1 and who underwent percutaneous transforaminal endoscopic discectomy were enrolled in this retrospective cohort study. They were segregated into the transforaminal endoscopic surgical system (TESSYS) group and the ZESSYS group. The puncture time, foraminoplasty time, decompression time, and fluoroscopy time were evaluated for operation efficiency. Clinical outcomes were assessed by the visual analog scale (VAS) score and Oswestry Disability Index (ODI) score. The MacNab criteria were used to evaluate patient subjective satisfaction at 12-month follow-up postoperatively.ResultsThe average puncture time (5.29 ± 2.05 min), foraminoplasty time (12.82 ± 2.52 min), and fluoroscopy time (26.29 ± 5.96 s) were all significantly shorter in the ZESSYS group than in the TESSYS group (average puncture time 8.07 ± 3.13 min, p < 0.01; foraminoplasty time, 17.18 ± 2.92 min, p < 0.01; fluoroscopy time, 34.73 ± 6.86 s; p < 0.01). No significant differences were observed between the 2 groups in the decompression time (p = 0.057). The VAS score of low back pain and leg pain, as well as the ODI score, improved at all time points postoperatively compared with preoperative, in both the TESSYS group and the ZESSYS group (P < 0.05). There were no significant differences in the VAS score of low back pain, VAS score of leg pain, and ODI score between the TESSYS group and the ZESSYS group at the same time points (P > 0.05). According to the MacNab criteria, the excellent and good rate at 12-month follow-up postoperatively was 85.7% in the TESSYS group and 89.3% in the ZESSYS group (P > 0.05).ConclusionThe targeted and quantificational foraminoplasty device named ZESSYS was more efficient in the puncture and foraminoplasty procedures, effectively protecting the exiting nerve and minimizing the level of radiation exposure. The device is efficient and safe for PTED in treating lumbar disc herniation at the L5–S1 level.

Evaluation of the usefulness of deep neural networks in classifying X-ray images according to radiation exposure level for automatic exposure control of digital radiography

Evaluation of the usefulness of deep neural networks in classifying X-ray images according to radiation exposure level for automatic exposure control of digital radiography

Monte-Carlo based investigation of individual dosimetry in deep geological repository for high-level nuclear waste with consideration of realistic body postures

Deep geological disposal with provisions for retrieval is one of the most promising strategies for the definite management of high-level nuclear waste. However, retrieval of disposed waste might require certain extensive work of personnel near the waste package that might also enhance the level of radiation exposure. Hence, a precise estimation of the personal dose with consideration of realistic body postures is highly desired for optimization of individual working scenarios. In this study, the near field of a generic geological disposal facility was modeled with a horizontal emplacement drift in saline host rock. Inside the drift, a shielded disposal cask loaded with spent nuclear fuel was placed on the ground. A whole-body stylized phantom with moveable limbs was applied to represent a reference worker. Several relevant realistic body postures that might be encountered in a disposal facility were investigated. The corresponding radiation exposure was calculated and compared with a general-purpose Monte Carlo code.

ASSESSMENT OF OUTDOOR RADIATION EXPOSURE LEVELS AND HUMAN HEALTH RISK IN A MAJOR SCRAP METAL MARKET IN ABUJA

Background: Scrap metal can contain sources of radiation with the associated environmental and health risks. Radioactive substances can become associated with scrap metal in various ways and if not discovered they can be incorporated into steel and non-ferrous metals through the melting process. This can cause health hazards to workers and to the public as well as environmental concerns Objectives: this study aimed at assessing the outdoor radiation exposure levels and human health risk in a major scrap metal market in Abuja, FCT. Method: An in-situ measurement approach was adopted using a factory calibrated Radiagem-2000 Universal Survey Meter and a handheld Global Positioning System (Garmin GPS 76S) equipment. The monitor was suspended in air at one meter above the ground level. Readings were obtained between the hours of 1200 and 1600 hours since the exposure rate meter has a maximum response to environmental radiation within these hours. Results: The results showed that the average values for the outdoor exposure dose rate for the three location ranges from 0.173±0.042 μSv/h to 0.177±0.046 μSv/h with a mean of 0.176±0.045 μSv/h. These values, though, slightly higher than the standard background radiation of 0.133 μSv/h,are below the ICRP maximum permissible limit of 0.57 μSv/h. The results also show that the AEDE values are lower than the ICRP recommended limits of 1.0 mSv/y for the public and 20 mSv/y for occupationally exposed workers. The ELCR ranges from 0.5926 x 10-3 to 0.6049 x 10-3 with a mean of 0.6008 x 10-3 which is 2.1 times higher than the world’s average. The dosage to organs received shows that the testes have the highest dose while the liver has the lowest dose. The result of the dose to the organs showed that all the values are below the international tolerable limits. Conclusion: Generally, The radiological assessment shows that the study area does not constitute any immediate radiological health effect on the workers and the general public due to radiation exposure rate.

АКТУАЛЬНЫЕ ВОПРОСЫ ОБЕСПЕЧЕНИЯ РАБОТНИКОВ РАДИАЦИОННО ОПАСНЫХ ПРОИЗВОДСТВ СРЕДСТВАМИ ИНДИВИДУАЛЬНОЙ ЗАЩИТЫ

Purpose: The article covers issues related to the providing personal protection for the personnel of radiation hazardous facilities. Specific character of working conditions at the enterprises in the field of atomic energy use is caused by extremely high toxic level of radioactive substances and the fact that there is no human sense organ which can identify dangerous levels of radiation exposure. Establishment of mandatory requirements for manufacturing, identification and verification of personal protection equipment (PPE) in the field of atomic energy use is needed because using of low-quality PPE and PPE not complying with working conditions poses a risk for the health of workers. The article provides results of analysis of the regulatory frameworks, both current and under development, which set the requirements for PPE.&#x0D; Results: Since 2017 Rosatom is executing plans for development of series of industry standards specifying requirements for PPE in the field of atomic energy use and methods of their testing. More than 25 interstate and national standards on PPE were included in the Summary list of standardization documents in the field of atomic energy use. PPE was included in the list of products subject to mandatory certification and having requirements for safety assurance in the field of atomic energy use specified.&#x0D; Industry and national standards establishing requirements for PPE protecting from tritium, radioactive noble gases, radioactive iodine, high-toxic alpha-emitting radionuclides, as well as standards on methods of their testing are planned to be developed soon.&#x0D; Conclusion: The system of standardizing requirements for PPE in the field of atomic energy use being created, together with existing system of certification of PPE in the field of atomic energy use will help to increase effectiveness of personal protection of the personnel at radiation and chemical hazardous facilities in nuclear industry.

Radiation exposure associated with percutaneous fluoroscopically guided lag screw fixation for sacroiliac luxation in dogs.

To determine radiation exposure to surgical personnel and to evaluate the accuracy of a modified percutaneous lag screw fixation technique for sacroiliac luxation (SIL) under fluoroscopic guidance in dogs. Cadaveric experimental study. Seventeen beagle cadavers with iatrogenic SIL. Seventeen beagles with iatrogenic SIL underwent reduction and stabilization with 3.5-mm screws. Hypodermic needles (14 gauge) and fluoroscopy were used to orient two Kirschner wires for temporary stabilization and to guide drilling of glide and pilot holes using cannulated drill bits. Duration of surgery and radiation exposure were recorded. Postoperative computed tomographic evaluation of screw position and angulation was performed. Average time for fixation was 15.85 minutes (range, 6.37-33.5). Cumulative radiation doses of 0.4 mrem for the dominant arm of the assistant and 0 mrem for the primary surgeon were recorded. The mean dorsoventral and craniocaudal screw angles were 0.68° ± 3.4° (range - 5.4° to 9.5°) and 1.9° ± 3.2° (range - 4.3° to 9.1°), respectively. Sixteen of the 17 dogs had 100% sacral screw purchase, with the remaining case achieving 93.4% purchase. Fluoroscopy-assisted percutaneous placement of 3.5-mm cortical screws in lag fashion performed with 14-gauge needles in conjunction with Kirschner wires and cannulated drill bits yielded repeatable accurate screw placement with low levels of ionizing radiation exposure to the surgical team. The described technique may be a viable method for minimally invasive osteosynthesis fixation of SIL with low levels of radiation exposure to the surgical team. These results provide evidence to support further evaluation of radiation exposure in clinical cases and can aid in study design and sample size determination.

The role of mitochondrial oxidative stress and the tumor microenvironment in radiation-related cancer.

ABSTRACTThe health risks associated with low-dose radiation, which are a major concern after the Fukushima Daiichi nuclear power plant accident (the Fukushima accident), have been extensively investigated, and the cancer risks from low-dose radiation exposure (below ~ 100 mSv) are thought to be negligible. According to World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation reports, the level of radiation exposure from the Fukushima accident is limited, estimating no significant increased risk from the accident. Radiation-induced cell injury is mainly caused by oxidative damage to biomolecules, including DNA, lipids and proteins. Radiation stimulates metabolic activation within the mitochondria to provide energy for the DNA damage response. Mitochondrial respiratory chain complexes I and III are the most important intracellular source of reactive oxygen species (ROS) during oxidative phosphorylation in eukaryotic cells. Manganese superoxide dismutase and glutathione are key players in redox control within cells. However, perturbation of the antioxidant response leads to chronic oxidative stress in irradiated cells. Excess ROS of mitochondrial origin is reported in cancer-associated fibroblast and promotes carcinogenesis. The aim of this review paper is to discuss critical roles of mitochondria in radiation-related cancer by introducing our recent studies. In particular, elevated mitochondrial ROS in stromal fibroblasts potentiate transforming growth factor-beta (TGF-β) signaling, which triggers smooth muscle actin (α-SMA) expression to stimulate myofibroblast differentiation. Radiation-induced myofibroblasts promote tumor growth by enhancing angiogenesis. Thus, radiation affects both malignant cancer cells and neighboring stromal cells through secretion of soluble factors.

Level of Supervision and Radiation Exposure of Senior Orthopedic Residents During Surgical Treatment of Proximal Femur Fracture.

The sustained use of intraoperative fluoroscopy has led to increased use of minimally invasive surgical techniques, enhanced surgeon proficiency, improved anatomic corrections, reduced patient morbidity, earlier functional recovery, and decreased length of hospital stay. As a result, orthopedic attending surgeons and residents are exposed to more radiation, increasing the risk of cancer and radiation-induced cataracts compared with the general population and those who work in other surgical specialties. The magnitude of radiation exposure depends on the susceptibility of the tissues affected, medical specialty, the position of the C-arm, distance from the radiation beam, level of difficulty of the surgical procedure, surgeon experience, level of resident training, and level of supervision by the attending surgeon. However, little information is available on the effect of supervision level on radiation exposure for orthopedic senior residents. The goal of this study was to investigate whether level of supervision by the attending surgeon affects the radiation exposure of orthopedic senior residents during surgical treatment of proximal femur fracture with cephalomedullary nail fixation. This retrospective cohort study was performed from January 2019 to March 2019. No significant relationship between supervision level and radiation exposure of senior residents was observed. Supervision level does not significantly affect radiation exposure for senior residents; therefore, the implementation of standardized training in radiation safety may be a more essential measure to decrease radiation exposure. [Orthopedics. 2021;44(3):e402-e406.].

Low-dose computed tomography for axial spondyloarthritis: update on use and limitations.

Recent developments in low-dose computed tomography (ldCT) have greatly reduced radiation exposure levels. This article reviews what a ldCT is and its use and limitations for imaging axial spondyloarthritis. Detection of structural damage in bone with CT is far superior to radiography and ldCT of the sacroiliac joints (SIJ) can now be done at radiation exposure levels equivalent to, or even less than, conventional radiography. ldCT should be considered a 'first-choice' test for arthritis imaging, and wherever available, SIJ ldCT may completely replace conventional radiography. Radiation exposure in the spine with ldCT is lower than conventional CT. However, it is unclear whether the additional information regarding structural damage changes in the spine provided by ldCT will alter patient management sufficiently often to merit switching from spinal radiography to ldCT in routine clinical practice. In addition, ldCT cannot assess osteitis disease activity for which MRI remains the best test. ldCT of the sacroiliac joints (SIJ) can be done at radiation exposure levels equivalent to, or less than, radiography and ldCT may completely replace SIJ radiography. However, the role of spinal ldCT for spondyloarthritis is not clear and MRI is far superior for detecting disease activity.

Geospatial assessment of radiation hazard indices in soil samples from Njaba, Imo State, South-Eastern Nigeria

Radiation emitted from Radioactive Materials present in terrestrial environment is responsible for an estimated level of radiation exposure to both human and non-human biota. In this study, assessment of soil radioactivity level in several locations covered within Njaba, South-Eastern Nigeria has been carried out to ascertain the radioactivity concentration level of radionuclides; 238U, 232Th and 40K, in soil using Radiation Alert Inspector device and gamma-spectrometry system equipped with Sodium Iodide (NaI) detector. Due to the environmental concern arising from the human activities in this Niger Delta region, 55 soil samples were collected for analysis from; operational sites of factories, farmlands, gullies, landslides, water eroded areas and soil deposits very close to running rivers from source rocks. The result showed that the activity concentration values for 238U, 232Th and 40K has average mean values of 3.73, 1.19 and 71.23 Bq.kg−1, respectively. The mean values of the samples for radium equivalent activity, absorbed dose rate and gamma index were 10.914 Bq.kg−1, 5.432 nGyh−1 and 0.084 mSv.yr−1, respectively, with the obtained values been below United Nations Scientific Committee on the Effects of Atomic Radiation safe limit values. The results obtained from the study regions revealed that the regions are relatively safe for human outdoor activities; agriculture, building, and factory activities.

Interventional radiologists have a higher rate of chromosomal damage due to occupational radiation exposure: a dicentric chromosome assay.

There are growing concerns regarding radiation exposure in medical workers who perform interventional fluoroscopy procedures. Owing to the nature of certain interventional procedures, workers may be subjected to partial-body radiation exposure that is high enough to cause local damage. We aimed to investigate the level of radiation exposure in interventional radiologists in South Korea by performing cytogenetic biodosimetry, particularly focusing on partial-body exposure. Interventional radiologists (n = 52) completed a questionnaire, providing information about their work history and practices. Blood samples were collected and processed for a dicentric chromosome assay. We determined Papworth's U-value to assess the conformity of dicentrics with the Poisson distribution to estimate the partial-body exposures of the radiologists. Radiologists had a higher number of dicentrics than the normal population and industrial radiographers. Indeed, subjects with a U-value of > 1.96, an indicator of heterogeneous exposure, were observed more frequently; 4.67 ± 0.81% of their body was irradiated at an average dose of 4.64 ± 0.67 Gy. Logistic regression analysis revealed that the total duration of all interventional procedures per week was associated with partial-body exposure levels. Our findings suggest that interventional radiologists had greater chromosomal damages than those in other occupational groups, and their partial-body exposure levels might be high enough to cause local damage. Use of special dosimeters to monitor partial-body exposure, as well as restricting the time and frequency of interventional procedures, could help reduce occupational radiation exposure. • Interventional radiologists had a higher number of dicentrics than the normal population and industrial radiographers. • The level of partial-body exposure of interventional radiologists might be high enough to cause occupational local damage such as a skin cancer in fingers. • Restricting the duration and frequency of interventional procedures might be helpful in reducing occupational radiation exposure.

Biochemical and hematological study of the effects of annual exposure radiation doses on the operators of X-ray and CT-scan in some Erbil hospitals

The effects of annual exposure radiation doses on the some biochemical {alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and uric acid (UAC)} and hematological parameters (white blood cells (WBCs), red blood cells (RBCs), and plate count (PLT)) of radiographer's blood samples from some Erbil Hospitals have been investigated. Biochemical and hematological tests have been done for both of the radiographers performing X-ray and CT-scans (cases) and the unexposed operators (control). Results of the biochemical and hematological tests proved a significant association between the levels of radiation exposure (effective dose) concerning radiographers of X-ray and CT-scan and the rate of radiation leakage (P < 0.01). Maximum and minimum average leakage radiation doses for the radiographers were found in the Hawler Education hospital (HEH) (3.84 ± 0.03 mSv/year) and CMC hospital (CMCH) (0.28 ± 0.02 mSv/year), respectively. High and low biochemical and hematological effects were found in the HEH and CMCH, respectively. Most of the radiographers (regarding the time of exposure) at risk of exposure to X-ray and CT-scan radiation exposure and the levels are exceeding the standard guidelines. Therefore, immediate radiation protection measures need to be initiated to the employees (technicians, attendants, and maintenance staff) at the X-ray and CT-scan departments.

Self-Shielding for the ZAP-X®: Revised Characterization and Evaluation.

The ZAP-X® is a newly designed, self-contained, and first-of-its-kind self-shielded therapeutic radiation therapy device dedicated to brain and head and neck stereotactic radiosurgery (SRS). By using an S-band linear accelerator (linac) and employing integrated minimal but sufficient shielding, the ZAP-X does not typically require a radiation bunker. At the same time, the self-shielded features of the ZAP-X are designed for more consistency of radiation protection, reducing the risk to radiation workers and others potentially exposed from a poorly designed or constructed radiotherapy vault.This study postulates that a radiosurgical system can be self-shielded, such that it produces radiation exposure levels deemed safe to the public while operating under a full clinical workload. The goal of self-shielding is achieved under all but the most exceptional clinical conditions.This work is intended to serve as guidance for the radiation safety evaluations of future ZAP-X treatment operations, following local or regional applicable regulatory requirements, and utilizing the unique provision of all or most of the required shielding material as an integral part of the device.