Radiation Protection In Diagnostic Radiology Research Articles

Training on Radiation Protection in Diagnostic Radiology: Role of the Regulatory Body to Ensure the Safe Use of Ionizing Radiation in Bangladesh

Radiation has been used since its invention in various sectors like medicine, agriculture, industry, research & education, power production, and so on, for the benefit of mankind. With this trend, Bangladesh is also using radiation to achieve economic development through the application of radiation in all possible ways. Proper education, knowledge, training, and awareness are a mandatory part of using radiation to ensure safe use of it against its harmful effects. Concerning the control of the safe use of radiation, an extensive regulatory system: “Bangladesh Atomic Energy Regulatory Authority (BAERA)” was set up in 2013 in Bangladesh consisting of acts, rules, and guidance. The primary objective of the regulatory body is to protect the workers, the public, and the environment from the possible adverse effects of radiation use. To deal with its objective, it is a core activity of the regulatory body to create radiation awareness among radiation workers and related personnel all over the country through the provision of the existing act and rules regarding radiation protection training. The current study is done to have an overview of the role of the regulatory body in this regard and their present status related to the radiation protection training program for radiation workers in the field of diagnostic radiology in the country.

Radiation Protection Device Composite of Epoxy Resin and Iodine Contrast Media for Low-Dose Radiation Protection in Diagnostic Radiology

Radiation protection in radiology is important because radiation may cause harm to the human body. The equipment for radiation protection is essential to ensure safe operations. Currently, there is widespread research on lead-free radiation shielding material. The aim of this research was to study lead-free material containing epoxy and iodine contrast media that was easy to form, low in cost, and environmentally friendly. The results showed that 2-cm material thickness with a concentration of 20% iodine had the greatest properties of radiation attenuate in the peak potential applied at technique 60-120 kVp, but the structure and strength of the shielding materials were decreased in accordance with increasing concentrations of iodine contrast media. It can be concluded that the lead-free epoxy radiation-shielding materials are able to absorb radiation at energy levels of 60-120 kVp. However, with improvement on homogeneity in the future, it could be used as a refractory shielding material in the radiology department.

Knowledge and Practices of Health Professionals on the Optimization of Radiation Protection in Diagnostic Radiology in Children and Adults in the General Referral Hospitals of Bukavu in South Kivu, DRC

Knowledge and Practices of Health Professionals on the Optimization of Radiation Protection in Diagnostic Radiology in Children and Adults in the General Referral Hospitals of Bukavu in South Kivu, DRC

Application of personal non-lead nano-composite shields for radiation protection in diagnostic radiology: a systematic review and meta-analysis

composites with micro- and nano-metal fillers has attracted the attention of researchers for radiation shielding applications. Lead toxicity and heaviness have oriented extensive research toward the use of non-lead composite shields. The present study aimed to systematically review the efficiency of the composite shields of various micro- and nano-sized materials as composite shields have been considered in radiation protection and diagnostic radiology. In addition, a meta-analysis was performed to determine the effects of filler size, filler type, shield thickness and tube voltage on dose reduction. The relevant studies published since 2000 were identified via searching in databases such as Google Scholar, Medline, Web of Science, Scopus, and Embase. In total, 51 articles were thoroughly reviewed and analyzed. Heterogeneity was assessed using the χ2 and I-square (I2) tests, and a fixed effects model was used to estimate the pooled effect sizes. The correlations between the subgroups were determined separately using meta-regression analysis. According to the results, the bismuth shield dose reduced from 22% to 98%, while the tungsten shield dose increased from 15% to 97%. The rate also increased from 6% to 84% in the barium sulfate shields. The combination of two metals resulted in higher attenuation against radiation, with the nano-shields exhibiting higher attenuation compared to the micro-shields, especially in low energies. Moreover, the meta-analysis indicated that the fixed effects pooled estimation of dose reduction was 89% for shield thickness (95% CI: 79-100; P 100). The single-metal personal shields made of bismuth powder had better performance than tungsten and barium sulfate. In addition, the combined metals in a shield showed more significant attenuation and dose reduction compared to the single-metal shields.

Review of the current status of radiation protection in diagnostic radiology in Africa.

The aim of this paper is to review the available published studies from African countries on patient doses and medical radiation protection and identify strengths, weaknesses, and challenges. Papers on radiation doses to patients published until 2016 pertaining to studies in African countries were reviewed. Radiography, interventional radiology, computed tomography (CT), and mammography modalities were covered. In radiography, the entrance surface air kerma values were below the established diagnostic reference levels (DRLs) provided by the International Atomic Energy Agency, European Commission, and National Council on Radiation Protection and Measurements. Patient and staff doses in interventional procedures were not on the higher side when compared with other published reports from developed countries. The dose length product values in CT in many situations were higher than established DRLs. In mammography, the variations of clinical image quality and dose to standard breast between African countries and other countries were insignificant. In conclusion, like in any continent, not all countries in Africa are active, but some have produced good results. The potential for optimization of radiation protection using simple and inexpensive techniques has been demonstrated. The lack of medical physicists is one of the important challenges.

Pragmatic ethical basis for radiation protection in diagnostic radiology.

Objective:Medical ethics has a tried and tested literature and a global active research community. Even among health professionals, literate and fluent in medical ethics, there is low recognition of radiation protection principles such as justification and optimization. On the other hand, many in healthcare environments misunderstand dose limitation obligations and incorrectly believe patients are protected by norms including a dose limit. Implementation problems for radiation protection in medicine possibly flow from apparent inadequacies of the International Commission on Radiological Protection (ICRP) principles taken on their own, coupled with their failure to transfer successfully to the medical world. Medical ethics, on the other hand, is essentially global, is acceptable in most cultures, is intuitively understood in hospitals, and its expectations are monitored, even by managements. This article presents an approach to ethics in diagnostic imaging rooted in the medical tradition, and alert to contemporary social expectations. ICRP and the International Radiation Protection Association (IRPA), both alert to growing ethical concerns, organized a series of consultations on ethics for general radiation protection in the last few years.Methods:The literature on medical ethics and implicit ICRP ethical values were reviewed qualitatively, with a view to identifying a system that will help guide contemporary behaviour in radiation protection of patients. Application of the system is illustrated in six clinical scenarios. The proposed system is designed, as far as is possible, so as not to be in conflict with the conclusions emerging from the ICRP/IRPA consultations.Results and conclusion:A widely recognized and well-respected system of medical ethics was identified that has global reach and claims acceptance in all cultures. Three values based on this system are grouped with two additional values to provide an ethical framework for application in diagnostic imaging. This system has the potential to be robust and to reach conclusions that are in accord with contemporary medical, social and ethical thinking. The system is not intended to replace the ICRP principles. Rather, it is intended as a well-informed interim approach that will help judge and analyse situations that arouse ethical concerns in radiology. Six scenarios illustrate the practicality of the value system in alerting one to possible deficits in practice.Advances in knowledge:Five widely recognized values and the basis for them are identified to support the contemporary practice of diagnostic radiology. These are essential to complement the widely used ICRP principles pending further development in the area.

The patient dose estimation from medical exposure for 2010-2012 years

In order to reduce the risk associated with diagnostic medical exposure by optimizing the quality of radiological imaging, a nation-wide evaluation concerning the monitoring of the patient radiation protection in diagnostic radiology and interventional radiology was initiated in 2006.

Web-based tools for quality assurance and radiation protection in diagnostic radiology

Practical and philosophical aspects of radiation protection in diagnostic radiology have changed very little over the past 50 y even though patient doses have continued to rise significantly in this period. This rise has been driven by technological developments, such as multi-slice computed tomography, that have been able to improve diagnostic accuracy but not necessarily provide the same level of risk-benefit to all patients or groups of patients given the dose levels involved. Can practical radiation protection strategies hope to keep abreast of these ongoing developments? A project was started in 1992 in Liverpool that aimed to develop IT driven quality assurance (QA)/radiation protection software tools based upon a modular quality assurance dose data system. One of the modules involved the assessment of the patient entrance surface air kerma (ESAK) for an X-ray examination that was based upon the use of calibrated X-ray tube exposure factors to calculate ESAK as well as collecting appropriate patient details (age, sex, weight, thickness etc). The package also contained modules for logging all necessary equipment performance QA data. This paper will outline the experience gained with this system through its transition from a local application on a stand alone PC within the department to the current web-based approach. Advantages of a web-based approach to delivering such an application as well as centrally storing data originating on many hospital sites will be discussed together with the scientific support processes that can be developed with such a system. This will include local, national and international considerations. The advantages of importing radiographic examination details directly from other electronic storage systems such as a hospital's radiology information system will be presented together with practical outcomes already achieved. This will include the application of statistical techniques to the very large data sets generated. The development of new examination QA performance indicators will be discussed. The application of web-based IT tools for QA and radiation protection in diagnostic radiology is already opening up the possibility of developing new and improved scientific support services as well as research possibilities in radiological informatics. These will be outlined together with areas for possible future development by the medical physics community.

Radiation Protection in Diagnostic Radiology: More Intense Communication is Required

The article on radiation protection in diagnostic radiology constitutes an important scientific contribution. Details of individual dosimetric terms are explained in an exemplary fashion. All reported estimates are based primarily – as mentioned in the article – on the experiences of the nuclear bombs dropped on Japan in World War II. These calculations are bound to be rough estimates as the radiation doses and types at the time were different to those used in diagnostic radiology today. The reported tables are for orientation purposes, and it should be mentioned that a substantial variation in range exists which is mainly user dependent. The factor 400 for a thoracic computed tomography scan seems high, whereas in abdominal CT, more than 10 mSv can occur, depending on the number of the examined phases (1). Data are missing on catheter investigations (cardiac catheter, percutaneous transluminal coronary angioplasty), image guided treatments (vertebroplasty and kyphoplasty, intraoperative radiology), and modern methods (CT colography, cardiac CT, high resolution CT of the lung). The doses of all these investigations are often not known to referring doctors (2). Many unpredictable factors exist with regard to the attributable mortality risk (3). The absolute numbers may be correct under the given circumstances, but they are suitable merely for comparing exposure practices in the different countries. With regard to potential deaths or malignancies due to radiography, it needs to be kept in mind that investigations using ionizing radiation are usually done on severely ill patients who are often of advanced age. The authors emphasized the need for intensive communication between referrers and specialists – this is of crucial relevance. Radiation protection should start earlier than in the radiography department! The correct indication with set requirements and radiation-sparing investigation techniques will result in a dose reduction in the individual as well as in the population. In radiation protection, 1 g of cerebral matter weighs more than 1 tonne of lead (Felix Wachsmann, 1965).

Radiation Protection in Diagnostic Radiology: In Reply

Radiation Protection in Diagnostic Radiology: In Reply

New ethical issues for radiation protection in diagnostic radiology

The ethical basis for many medical practices has been challenged over the last two decades. Radiology has seen enormous growth during the same period. Many practices and equipment types, now commonplace, did not exist a generation ago. Yet the fundamental ethical basis for these practices has not seen a corresponding level of development. This is possibly an oversight, and may be particularly important given that these innovations have taken place over a period of changing social attitudes. Areas of concern include, for example, issues around justification, consent/authorisation, inadvertent irradiation of the foetus/embryo during pregnancy and the place of paternalism/individual autonomy in the structure of practice. This paper provides the background to a workshop on these issues held in late-2006 and presents a summary of its findings.

Radiation protection in diagnostic radiology.

The use of ionizing radiation is regulated by legislative bodies to limit both individuals' and the population's exposure to radiation. Germany has implemented the European 97/43/EURATOM directive in national law by updating the existing radiation protection regulations. The German Commission on Radiological Protection regularly publishes statements and recommendations on radiation protection in medicine and diagnostic radiology, such as the introduction of diagnostic reference levels and referral guidelines for radiological and nuclear medicine imaging. Review of selected literature, national and international recommendations and legal texts. From a radiological protection perspective, clear justification for radiological examinations and techniques aimed at minimizing radiation dose while providing the required diagnostic information, are essential. Referring doctors should be sure to use existing guidelines for medical imaging, and liaise with radiologists and nuclear medicine specialists, with whom they share the responsibility for choosing appropriate imaging modalities.

Health effects of radiation exposure in diagnostic radiology

For risk estimations, scientists have at their disposition results from molecular, cellular and animal experiments, risk modelling and human epidemiological studies. Much has been achieved, but large uncertainties in quantitative risk estimates of exposure of humans to low levels of ionising radiation still remain. Radiation risks in diagnostic radiology are reviewed in this paper. The paper addresses stochastic as well as deterministic effects. Risks for adult, paediatric and prenatal exposures are discussed. It is concluded that a pragmatic approach for radiation protection in diagnostic radiology is indicated, i.e. precautionary measures should be taken even if some cause-and-effect relationships are not fully established scientifically.

Establishing Local Reference Dose Values and Optimisation Strategies

The revised EC Patient Directive 97/43 EURATOM introduces the concepts of clinical audit, diagnostic reference levels and optimisation of radiation protection in diagnostic radiology. The application of reference dose levels in practice involves the establishment of reference dose values as actual measurable operational quantities. These values should then form part of an ongoing optimisation and audit programme against which routine performance can be compared. The CEC Quality Criteria for Radiographic Images provides guidance reference dose values against which local performance can be compared. In many cases these values can be improved upon quite considerably. This paper presents the results of a local initiative in the North West of the UK aimed at establishing local reference dose values for a number of major hospital sites. The purpose of this initiative is to establish a foundation for both optimisation strategies and clinical audit as an ongoing and routine practice. The paper presents results from an ongoing trial involving patient dose measurements for several radiological examinations upon the sites. The results of an attempt to establish local reference dose values from measured dose values and to employ them in optimisation strategies are presented. In particular emphasis is placed on the routine quality control programmes necessary to underpin this strategy including the effective data management of results from such programmes and how they can be employed to optimisation practices.

Audit Programmes in a Diagnostic Radiological Facility

The effective implementation of optimsation strategies for radiation protection ir diagnosti radiology including nuclear medicine requires mechanisms for ongoing audit of all relevant factors. The Quality Criteria of the Commission of European Communities highlights clearly the three aspects of a radiological examination which needed to be considered, which are: (i) radiographic technique. (ii) patient dose, and (iii) image quality. Therefore, it is important that the choice of a known and acceptable radiographic technique provides a known outcome in terms of patient dose and image quality. This requirement should be capable of being achieved throughout Europe and capable of being updated as new radiological strategies are developed. Audit programmes aimed at monitoring that this situation exists may be considered at three levels: Level 1 involves routine, periodic, assessment of patient doses on a representative sample of patients undergoing a particular type of examination. Results from this audit are then compared with acceptable and clearly defined diagnostic reterence levels or reference dose values which provides a framework for guidance on acceptable practice. A summary of such level I programmes which are being pursued in Europe is presented. Level 2 audit programmes, beside patient dose assessment, will also involve an assessment of all those parameters relevant to an X ray examination which may have a bearing on the actual dose delivered to the patient. Such level 2 audit programmes provide the basis for implementation of optimisation strategies for radiation protection in terms of risk reduction, one of the fundamental tenets of radiati on protection philosophy. Level 3 audit programmes also include assessment and verification of image quality requirements for particular examinations. This latter aspect is a necessary basis for overall optimisation of radiation protection in diagnostic radiology.

Editorial - Data Analysis in Quality Control and Radiation Protection in Diagnostic Radiology and Nuclear Medicine

Journal Article Editorial - Data Analysis in Quality Control and Radiation Protection in Diagnostic Radiology and Nuclear Medicine Get access G. Contento, G. Contento Search for other works by this author on: Oxford Academic PubMed Google Scholar B. Wall, B. Wall Search for other works by this author on: Oxford Academic PubMed Google Scholar H. Schibilla, H. Schibilla Search for other works by this author on: Oxford Academic PubMed Google Scholar D. Tuenen D. Tuenen Search for other works by this author on: Oxford Academic PubMed Google Scholar Radiation Protection Dosimetry, Volume 57, Issue 1-4, 1 January 1995, Pages vii–viii, https://doi.org/10.1093/oxfordjournals.rpd.a082493 Published: 01 January 1995

Data Analysis and Information Modelling: Objects Codes, Concepts

Acceptance, performance and usefulness of knowledge-based systems for quality control and radiation protection in diagnostic radiology and nuclear medicine depend on the technical competence of its developers and the medical, juridical and/or administrative relevance for its users. In promoting the efficient application of communication and information technologies the two groups of experts (developers, users) distinguished by overlapping domains of knowledge, objectives, subject fields and different concept, term and code systems have to be harmonised. On conceptual and methodological levels various strategies are discussed: conventional and classification systems (Read Codes, ICD-9, SNOMED etc.), object-oriented analysis and design (e.g. NHS: CBS, CCPM), and standardised terminologies for international vocabularies, nomenclatures, encyclopaedias and thesauri according to ISO, CEN/TC 251, UMLS, AIM. Conceptual modelling using new terminological representation languages based on formal logic and semantics is proposed for the development of an open, unified concept and code system for the liberation of concepts from inadequate codes. It is assumed that work on well-formed terminologies promises more consistent and superior representation of expert knowledge for European information interchange, computer processing and quality assurance than (sometimes necessary) 'separatistic' and 'particularistic' solution islands.

Editorial - Data Analysis in Quality Control and Radiation Protection in Diagnostic Radiology and Nuclear Medicine

Editorial - Data Analysis in Quality Control and Radiation Protection in Diagnostic Radiology and Nuclear Medicine

Exposure to Operating Staff During Cardiac Catheterisation Measured by Thermoluminescence Dosimetry

The exposure of medical personnel to X radiation due to cardiac catheterisation has been investigated with thermoluminescence dosimetry using GR-200. This TL material shows a high sensitivity, a low detection limit and a relatively flat energy response in the 30 keV to 110 keV region. Because of these properties it is possible to measure the organ dose equivalent during one examination. Measurements during five examinations were conducted on forehead, thyroid, trunk, wrist and groin of operating staff. Organ dose equivalent varied from less than 1 µSv to 650 µSv. Maximum dose equivalent was measured on the wrist. The measured doses are no reason for special limitating measures. The results show the capabilities of the TL material GR-200 to optimise radiation protection in diagnostic radiology.

Aims and Goals of the ICRU and Other International Organisations with Respect to Patient Radiation Protection

After a short historical review, the goals of the ICRU are first presented: definition of quantities and units to be used in the field of ionising radiation, recommendations of measurement procedures for these quantities, definitions of terms and concepts, and investigation and selection of physical parameters. As far as the other international organisations are concerned, some of the main achievements are briefly presented for the IEC, UNSCEAR, ICRP, WHO, and IAEA. Besides technical developments and dosimetric intercomparisons, the importance of the education and of the continuous information of the radiologists is stressed. The role played by the CEC in education is recognised in the field of radiation protection in diagnostic radiology.