Principles Of Radiation Protection Research Articles

Medical staff monitoring in interventional cardiology: over apron dosemeter placement based on measurements and simulations.

Interventional cardiology is characterized by high radiation exposure for both the patient and the operator. Adequate shielding and monitoring of the operator are fundamental to comply with radiation protection principles. In a previous work, the effect on the dose of the dosemeter position on the chest was studied. In this paper, the investigation has been completed, employing an anthropomorphic thorax phantom, equipped with arms. Although there are differences between the Monte Carlo simulations and the measurements, similar trends are observed, showing that the reduction in dose, due to the arms, is between 20 and 60%, compared with the situation without arms. For that reason, considering a dosemeter placed on the chest, the upper position, which is the least affected by the arms, should be preferred while the extreme lateral position, near the armpit, should be avoided.

Hysterosalpingography Investigation Versus Patients’ Radiation Dose Risk

Background: Hysterosalpingography (HSG) is a useful radiographic investigation involving the use of contrast medium for the management of infertility in females. It is however, not only a costly procedure but it is also a semi-invasive procedure and carries some radiation risks. One principle of radiation protection is justification of practice which means that the overall benefit of the procedure should outweigh the radiation risks. The aim of this study was to determine justification of HSG procedure by assessing the rate and pattern of pregnancy success among infertile women who underwent HSG procedures at a tertiary hospital in South Eastern Nigeria between 2016 and 2020. Methods: A retrospective cross-sectional study of a sample of 222 women, aged 20-46years (mean 32.55 ±8.16years) who underwent HSG examination at the hospital between 2016 and 2020 was made. The data of eligible subjects were collected from the archives of radiology department of the hospital. Results: The result showed that 121 (54.5%) out of 222 of the patients achieved pregnancy with proper follow up infertility management. Of the 121, 48(39.67%) were in the 25-29 years age group and 35(28.93%) in the 30-34years age group. The commonest pathology found was uterine fibroid 71(32.0%), followed by tubal blockage, 42(18.92%) while the least occurring pathology was salpingitis isthmica nodosa 1(0.45%). Conclusion: There was a strong positive correlation between the age of patient, the HSG findings and the rate of pregnancy success. The procedure is justified in all the age groups except for the >45years group.

Radiographers’ attitudes toward the principles of patient radiation protection in the Souss Massa region of Morocco

Radiographers’ attitudes toward the principles of patient radiation protection in the Souss Massa region of Morocco

Evaluation of the Status of Knowledge, Attitude, and Performance of Radiology Department Staff Regarding Radiation Safety Principles at Hospitals in the North and Northeast of Iran

Purpose: Although ionizing radiation is useful in diagnosing various diseases, it can cause potential biological damage such as cancer, cataracts, and fetal damage for patients and staff working in radiology departments. Therefore, knowledge and practice about applying radiation protection principles are essential. This research investigates radiology personnel's knowledge, attitude, and performance regarding radiation protection in the north and northeast of Iran.
 Materials and Methods: This descriptive-analytical cross-sectional study was conducted using a 30-item questionnaire among 435 radiology personnel in North Khorasan, Razavi Khorasan, Golestan, and Mazandaran provinces. This questionnaire included questions related to demographic information and the level of knowledge, attitude, and performance of radiology personnel regarding radiation protection. Data was also analyzed using SPSS-19 software.
 Results: The participation rate of radiology personnel was 80.55%, and the mean and standard deviation of their knowledge, attitude, and performance regarding radiation protection were 45.9907 ± 1.294, 78.1531 ± 4.707, and 44.9368 ± 6.88, respectively. Based on the results of the study, there is no significant relationship between gender and knowledge (P = 0.781), attitude (P = 0.156), and performance of personnel (P = 0.87); however, a significant relationship was observed between education degree and attitude of personnel (P = 0.026), between working years and knowledge of personnel (P = 0.019), and also between job title and attitude of personnel (P = 0.003).
 Conclusion: The results of this study revealed that there is a significant relationship between education degree and attitude of personnel, working years, and knowledge of personnel, and also between job title and attitude of the personnel. According to these results, our population, both personnel and patients have relatively poor performance and poor knowledge about radiation safety principles. Therefore, formal training in the use of ionizing radiation equipment is necessary for radiation safety.

Measurement of Hp(10), Hp(3) and Hp(0.07) to medical staff in endoscopic retrograde cholangiopancreatography, using thermoluminescence dosimetry.

Endoscopic retrograde cholangiopancreatography (ERCP) is widely used in the diagnosis and treatment of pancreatic and bile duct disorders. The procedure is performed under the guidance of fluoroscopy. This study aims to investigate the dose received by staff in the Endoscopy Department of AbuAli Sina Medicine and Organ Transplant Hospital in Shiraz. The dosimetry was performed using thermoluminescent dosemeters (TLD), type TLD-100. The values of Hp(10), Hp(3) and Hp(0.07) were estimated for the staff for 2months. According to the results obtained in this study, the equivalent dose of the gastroenterologist's body, eye lenses and hands was 0.045±0.001mSv, 0.111±0.014mSv and 0.357±0.034$\mathrm{mSv}$, respectively. This study showed that the annual radiation exposure for ERCP department staff of Abu Ali Sinai Hospital is less than the annual dose limit. However, if the principles of proper radiation protection and individual dosimetry are followed, the dose to staff members can be reduced.

Principles of Radiation Protection for Patients and Medical Staff

Principles of Radiation Protection for Patients and Medical Staff

Audit Dosis dan Optimisasi Pemeriksaan CT Scan Kepala: Studi Multisenter

One of the principles of radiation protection is optimizing radiation dose and image quality. Dose audits and optimization of head CT scans for the adult patient category have been carried out in Hospital A and Hospital B. The research at Hospital A started with a dose audit, revealing that the typical values of CTDIvol and DLP were above the IDRL, and optimization of patient radiation dose was necessary. The optimization strategy at Hospital A involved a gradual selection of exposure factor combinations. In the first stage, a manufactured dedicated water phantom scan was performed with voltage 80, 100, and 120 kVp variations while the current remained constant. Based on image quality evaluation using the Noise Power Spectrum (NPS) method, the lowest NPS was obtained at voltage 120 kV, which was 19,47 HU2mm2. In the second stage, using voltage 120 kVp, a head rando phantom scan was performed with variations of current 100, 150, 200, 250, 300, 350, 400, and 450 mAs. 40% of the radiologists chose the exposure factor combination voltage 120 kVp and current 350 mAs as the combination producing image with the most preferable quality. When comparing the voltage and current combinations before and after optimization with the IDRL, there was a decrease of 7.9% and 2.1% in CTDIvol and DLP. Meanwhile, the dose audit results at Hospital B revealed that the typical value of CTDIvol was already below the IDRL. Still, the typical value of DLP was above the IDRL, so optimization of patient radiation dose for patient-related parameters was necessary. The optimization strategy at Hospital B involved creating new protocols based on exposure factors obtained from image quality evaluation using the NPS method and the interpretation of radiologists. The optimization results with a comparison of four protocols showed that protocol 3 was the most optimal using the exposure factors: collimation 40 × 0.625, the pitch of 0.2, the scan time of 13.8 seconds, Dose Right Index of 25, voltage 120 kVp, and current 144 mAs. The implementation of this protocol contributed to a 67.7% reduction in CTDIvol and a 53.6% reduction in DLP compared to the IDRL. The research objective is to obtain the optimal combination of exposure factors with radiation dosage and image quality as an initial optimization implementation. Keywords: dose audit, radiation protection, optimization, diagnostic reference levels

BEST PRACTICE PERAN TIM PETUGAS PROTEKSI RADIASI (PPR) DALAM IMPLEMENTASI KESELAMATAN RADIASI DI MANDAYA ROYAL HOSPITAL PURI

Utilizing ionizing radiation sources at Mandaya Royal Hospital Puri requires strict implementation of radiation protection measures. The principles of radiation protection must be applied meticulously, considering the potential effects. The hospital has a team of radiation protection officers (RPO) comprising radiographers and medical physicists responsible for ensuring radiation safety and implementing radiation protection measures. The RPO team has conducted various radiation protection activities between January and July 2023, including monitoring radiation worker doses, optimizing patient radiation doses, conducting internal and external quality control, checking radiation protection equipment, monitoring supporting equipment related to radiation safety, socializing radiation protection across all hospital departments, and testing room radiation exposure. The RPO team has been executing their 2023 program, adhering to the best practices. The hospital management plays a crucial role in carrying out radiation protection activities, and their support and commitment are vital to the practical and sustainable implementation of the RPO team's activities. Keywords: Radiation protection officers (RPO), radiation safety culture, radiation dose, radiation protection.

Evaluation of radiation safety levels in the monitor rooms of selected diagnostic centres in Lagos State using thermoluminescent dosimeter

The hazard of exposure to ionizing radiation at low doses has been scientifically proven to be possible for cancer and non-cancer diseases. International and national regulatory bodies have recommended dose limits for occupationally exposed workers to ionizing radiation and the general public. The objective of this study was to assess the radiation safety levels in monitor rooms of x-ray diagnostic radiology facilities. Sixty monitored rooms in twenty radio diagnostic centers were visited. Three tissue-equivalent thermoluminescent dosemeters (TLD-100 (LiF: Mg. Ti)) chips were placed in strategic places a few centimeters from the viewing glass in the monitored rooms for two weeks. The TLDs were analyzed using the RADOS RE 2000 TLD reader. Questionnaires were also distributed to ascertain compliance with the basic principles of radiation protection. The average personnel dose equivalents in the monitored rooms of conventional x-rays, mammography, computed tomography, and fluoroscopy were 0.33, 0.32, 0.28, and 0.34 mSv/year, respectively. The status of the radiation safety levels in the selected monitored rooms is satisfactory because the values obtained were below the international recommended dose limit of 50 mSv in a single year for occupationally exposed radiation workers.

AN AN ASSESSMENT OF INTEGRITY OF RADIATION SHIELDING IN X-RAY RADIOGRAPHIC FACILITIES IN WARRI METROPOLIS

The use of radiation-emitting equipment is highly controlled in order to limit the exposure level for both workers and visitors around such facilities. Shielding is an integral part of radiation protection. This study is aimed at assessing the shielding of x-ray radiographic facilities in Warri metropolis. A total of eleven facilities were assessed in which radiation protection safety checks were carried out across the facilities and the facilities were grouped as controlled and supervised areas following the NCRP 147 protocol. The instantaneous dose rate (IDR) was measured using a calibrated handheld GM-600 radiation detector. The IDR measured for various locations ranges from 0.20 – 89.60 µSv/hr. and their corresponding annual dose rate (ADR) was computed using the measured IDR and the occupancy factor to produce its value which ranges from 0.11 - 51.10 mSv/yr. The ADR results obtained were compared with the limits recommended by the National Commission for Radiation Protection (NCRP) (5 mSv/yr. and 1 mSv/yr. for controlled and supervised areas respectively) and it was observed that five facilities exceeded the NCRP limit for controlled areas while six facilities exceeded the NCRP limits for supervised areas. The study therefore showed that the obtained ADR from the studied facilities were partially within the NCRP recommended limits thus indicating a partial compliance with radiation protection principles. Hence, regular quality control of radiographic x-ray facility checks is recommended.

Analysis of the national and international framework for the EPZ establishment including harmonization and applicability for next generation reactors

Planning zones are the part of nuclear infrastructure that determines the principles of radiation safety, acceptance of the selected technology, as well as sustainability of the installation design. Today, in the Russian Federation, the requirements of regulatory documents on the presence of zones for planning protective measures are mandatory for objects of the 1st and 2nd hazard categories according to national sanitary norms and regulations. Next-generation reactors, including small modular reactors (SMRs), in most cases also require the development of approaches to establish or justify protective action planning zones. In practice, there are no special requirements in terms of protecting the population, so the methods used for VVER-type installations are transferred to such next-generation facilities. In this part, the Russian Federation studies the issue of applying new calculation methods, adapting, and harmonizing the principles of radiation protection, as well as determining reasonable conservatism between the analysis of possible consequences and the means of ensuring the radiation safety of the population in the event of accidental releases. The article considers the current requirements for calculating the size of planning zones based on two different approaches, EUR and IAEA, and their comparative analysis based on some accidents for NPPs with VVER-1000 reactors. The method and technology used for obtaining results can also be applied to next-generation reactors.

Evaluation of awareness and knowledge of CT technologist regarding diagnostic reference levels in Iran

The purpose of this study was to determine the level of knowledge and awareness regarding radiation protection and Dose Reference Levels (DRLs) among 102 Computed Tomography (CT) technologists working in various Iranian hospitals. A questionnaire including 20 multiple-choice and open-format questions was divided into demographic information, general radiation protection knowledge, and DRL knowledge. Regarding radiation protection knowledge concerning CT, about 56.9% of participants exhibited awareness of the dose display on the CT machine’s console, and about 78.4% selected the correct dosimetric units expressed CT dose. Unexpectedly, 90.2% of participants failed to define the concept of dose optimization. A significant association (p < 0.05) was established between technologists’ radiation protection and DRL knowledge and a degree of education, type of hospital, and job experience. In addition, the findings reveal a correlation between radiographers’ DRL knowledge and their propensity to enroll in training courses. 26.5% of participants exhibited awareness of DRLs in CT practice, while 49% and 76.5% of participants were unable to correctly identify DRLs concept and function. To reduce patient dose in accordance with the As Low As Reasonably Achievable (ALARA) radiation protection principle, CT technologists must improve their knowledge of radiation dose and local DRLs should be defined at least at the local level.

Free-Hand MIS TLIF without 3D Navigation-How to Achieve Low Radiation Exposure for Both Surgeon and Patient.

Transforaminal lumbar interbody fusion (TLIF) is one of the most frequently performed spinal fusion techniques, and this minimally invasive (MIS) approach has advantages over the traditional open approach. A drawback is the higher radiation exposure for the surgeon when conventional fluoroscopy (2D-fluoroscopy) is used. While computer-assisted navigation (CAN) reduce the surgeon's radiation exposure, the patient's exposure is higher. When we investigated 2D-fluoroscopically guided and 3D-navigated MIS TLIF in a randomized controlled trial, we detected low radiation doses for both the surgeon and the patient in the 2D-fluoroscopy group. Therefore, we extended the dataset, and herein, we report the radiation-sparing surgical technique of 2D-fluoroscopy-guided MIS TLIF. Monosegmental and bisegmental MIS TLIF was performed on 24 patients in adherence to advanced radiation protection principles and a radiation-sparing surgical protocol. Dedicated dosemeters recorded patient and surgeon radiation exposure. For safety assessment, pedicle screw accuracy was graded according to the Gertzbein-Robbins classification. In total, 99 of 102 (97.1%) pedicle screws were correctly positioned (Gertzbein grade A/B). No breach caused neurological symptoms or necessitated revision surgery. The effective radiation dose to the surgeon was 41 ± 12 µSv per segment. Fluoroscopy time was 64 ± 34 s and 75 ± 43 radiographic images per segment were performed. Patient radiation doses at the neck, chest, and umbilical area were 65 ± 40, 123 ± 116, and 823 ± 862 µSv per segment, respectively. Using a dedicated radiation-sparing free-hand technique, 2D-fluoroscopy-guided MIS TLIF is successfully achievable with low radiation exposure to both the surgeon and the patient. With this technique, the maximum annual radiation exposure to the surgeon will not be exceeded, even with workday use.

Radiological risk assessment method for the interim storage of radioactive materials

Safe storage of radioactive materials is based on three universal radiation protection principles. Justification, optimization and dose limits are applicable to the risk assessment, acknowledging the hazards in each procedure of delivery, usage, storage and disposal of radioactive materials. Failure Modes and Effects Analysis method (FMEA) is developed for the risk evaluation of common practices. In this work FMEA is exploited for the radiological risk assessment in practices using radioactive materials. In addition, the radiological hazard of fire is studied, in order to classify its severity for different examples of radioactive materials inventories. The severity of the hazard, the likelihood and the detectability of its occurrence are exploited for classifying the associated risk. Appropriate measures that should be taken for the emergency preparedness and response are taken into account in order to reduce the Risk Priority Number (RPN). Scenarios of external exposure, skin contamination and inhalation are investigated, in order to calculate the received doses, for workers and members of the public. The outcomes of the analysis indicate low or medium severity of the risks for most of the examined practices, especially under the implementation of the appropriate measures, like: controlled access of the facilities, records keeping for delivery, usage, storage and disposal of radioactive materials; presence of fire detectors and extinguishers; and removal of flammable materials from the vicinity of the radioactive materials.

Evaluation of ambient dose equivalent for photoneutrons around linear accelerator and their radioprotection quantities

The present work aims to assess in a first phase, different parameters influencing the creation and distribution of photoneutrons around Elekta Synergy medical linear accelerator.Field size and photon energy were investigated. The first parameter has allowed the evaluation of the intra and extra fraction of created neutrons. Thus, the ambient equivalent dose has attained in the isocenter, 0.198 ± 0.002 mSv/Gy of neutrons poisoning the therapeutic field, the extra field fraction didn't exceed 0.087 ± 0.001 mSv/Gy for all combinations of field sizes. The source of the current neutron dose is principally arising from the components of the linac head (target, flattening filter ….). The effect of photon energy assessed in the current work reaffirms the dependency of the photonuclear cross-section to photon energy. In fact, the bigger the photon energy is, the more neutron are created otherwise more dose delivered, a factor of 20 has been remarked between photons of 15 MV and 6 MV when comparing equivalent ambient dose H*(10) for both photon energies.In order to implement the optimization principle of radiation protection, the risk related to produced photoneutrons has been evaluated. The effective dose (E) is calculated according to methods established in ICRP 74 and ICRP 116 reports in addition ICRU publication 57, by making transition from the operational quantity H*(10) to the protection quantity E. Results has proved an additional exposition to unwanted dose resumed in an effective dose which could attain a value of 0.113 ± 0.002 mSv/Gy received by patient.

The Role of Diagnostic Medical Imaging Community in Responding to Nuclear and Radiological Events in Urban Environments

Introduction:To understand the role of medical providers in general and the radiology community in the prevention, management, and aftermath of a radiological or nuclear event.Method:Using a power point presentation, the author will describe in detail the role diagnostic medical imagers can play in responding to the radiological or nuclear MASCAL events.Results:The purpose is to educate the civilian radiology audience about their role amidst the changing nature of current nuclear threats and asymmetric and hybrid warfare in urban settings. It is very likely that in the future the civilian radiology community may be involved and respond to a nuclear crisis or a radiation accident or its aftermath before the military gets involved because it will most likely be initially a MASCAL event in a civilian setting, not immediately under the purview of the military.Conclusion:Radiologists and nuclear medicine physicians will play a very critical and central role in the event of a nuclear detonation or a radiation dispersal device detonation due to their inherent knowledge of the principles of radiation, contamination, exposure and radiation protection.

A follow‐up questionnaire survey 2022 on radiation protection among 464 medical staff from 34 endoscopy–fluoroscopy departments in Japan

We surveyed and reported low protective equipment usage and insufficient knowledge among endoscopy-fluoroscopy departments in Japan in 2020. Two years later, we conducted a follow-up survey of doctors, nurses, and technologists in Japan. We conducted a questionnaire survey on radiation protection from May to June 2022. The participants were medical staff, including doctors, nurses, and radiological and endoscopy technicians in endoscopy-fluoroscopy departments. The questionnaire included 17 multiple-choice questions divided into three parts: background, equipment, and knowledge. We surveyed 464 subjects from 34 institutions. There were 267 doctors (58%), 153 nurses (33%), and 44 technologists (9%). The rate of wearing a lead apron was 98% in this study. The rates of wearing a thyroid collar, lead glasses, and radiation dosimeter were 27%, 35%, and 74%, respectively. The trend of the protective equipment rate was similar to that of our previous study; however, radiation dosimetry among doctors was still low at 58%. The percentage of subjects who knew the radiation exposure (REX) dose of each procedure was low at 18%. Seventy-six percent of the subjects attended lectures on radiation protection, and 73% knew about the three principles of radiation protection; however, the concept of diagnostic reference levels was not well known (18%). Approximately 60% of the subjects knew about the exposure dose increasing cancer mortality (63%) and the 5-year lens REX limit (56%). There was some improvement in radiation protection equipment or education, but relatively little compared to the 2020 survey of endoscopy departments.

The importance of quality management system to certify radioprotection professionals in the medical field

Certifying professionals in radioprotection (RP), according to the requirements and qualifications established in current Brazilian legislation, ensures that procedures and practices in radiology, radiotherapy and nuclear medicine be performed based on the fundamental principles of radioprotection. However, in none of the regulations and resolutions of the country involving the use of ionizing radiation, the qualification in RP for interventional physicians, radiologists, radiotherapists, nuclear physicians, dentists, nurses and auxiliaries, specialists in medical physics, radiopharmaceuticals, technologists and technicians are clearly defined. It is necessary to adoption a certification scheme through the ABNT NBR ISO/IEC 17024:2013 standard, which will benefit the professionals themselves as well as the patients increasing the safety in RP in the country. This is to the fact that there is no harmony in the regulation of these professionals with the responsible bodies, nor uniformity in practices through international recommendations. This paper proposes the implementation of a quality management system to certify these professionals according to the principles of radiation protection through a survey of needs regarding to the certification of people and the evaluation of systems implemented in other countries.

Dose Reduction Strategies for Pregnant Women in Emergency Settings.

In modern clinical practice, there is an increasing dependence on imaging techniques in several settings, and especially during emergencies. Consequently, there has been an increase in the frequency of imaging examinations and thus also an increased risk of radiation exposure. In this context, a critical phase is a woman's pregnancy management that requires a proper diagnostic assessment to reduce radiation risk to the fetus and mother. The risk is greatest during the first phases of pregnancy at the time of organogenesis. Therefore, the principles of radiation protection should guide the multidisciplinary team. Although diagnostic tools that do not employ ionizing radiation, such as ultrasound (US) and magnetic resonance imaging (MRI) should be preferred, in several settings as polytrauma, computed tomography (CT) nonetheless remains the examination to perform, beyond the fetus risk. In addition, protocol optimization, using dose-limiting protocols and avoiding multiple acquisitions, is a critical point that makes it possible to reduce risks. The purpose of this review is to provide a critical evaluation of emergency conditions, e.g., abdominal pain and trauma, considering the different diagnostic tools that should be used as study protocols in order to control the dose to the pregnant woman and fetus.

MAKING A SIMPLE TAM-EM BOARD TO ASSIST RADIOLOGICAL EXAMINATION IN BABIES USING ACRYLIC

Repetition on radiographic films due to object movement that often occurs in uncooperative patients, especially occurs in infants or toddlers, examinations that are often performed on infants or toddlers are examinations of the thorax and abdomen. At the time the examination was carried out, then the patient was uncooperative, it would produce an unclear picture caused by the patient's movement, so that the picture was not suitable for reading and resulted in the repetition of the resulting radiographic film. At the time of examination, the baby is often held or assisted by the patient's family or the mother of the baby, so that the family or mother of the baby is exposed to scattered radiation, so that the principle of radiation protection does not work properly, so a tool is needed, namely the manufacture of a Tam-Em device. A simple board to help radiological examinations in infants using Acrylic. To find out the effectiveness of making Tam Em Board Aids on baby examination using acrylic. This type of research is qualitative with experimental methods. Testing the Tam Em-Board tool at Pariaman Hospital by involving a radiographer as an assessor in testing a device with infant patients by assessing several components including the reliability of the tool when used, the safety of a tool during the inspection process, the quality of the radiograph produced when using the tool, the aesthetics of a device. tools and whether there are repeated examinations when using the Tam Em-Board tool, after testing with several assessment components and an assessment questionnaire of a tool assessed by the accompanying radiographer, it can be concluded that the tool works well and there are no repetitions during the examination.