Radiation Safety Training Module: Diagnostic Radiology ...

1 Radiation Safety Training Module: Diagnostic RadiologyRadiation Protection in Diagnostic Radiology Radiological Safety DivisionAtomic Energy Regulatory BoardContent Mission of AERB ICRP-Principle for Radiological protection(Practice) Types of Radiation Generating Equipment: (RGE) Typical patient doses Radiation Protection for occupational workers Radiation Protection for patient ConclusionsMission of the (workers,publicandpatients)fromharmfulef fectsofionisingradiationwithoutundulylim itingtheuseoftechniquesthatmaycauseradia tionexposureINTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION(ICRP) Radiation Safety PROGRAMME SHOULD BE DESIGNED TO.

2 PREVENT DETRIMENTAL TISSUE REACTIONS (DETERMINISTIC EFFECTS)LIMIT or MINIMIZE THE PROBABILISTIC EFFECTS TO ACCEPETABLE LEVELS ICRP-Principle for RADIOLOGICAL PROTECTION JUSTIFICATION OPTIMISATION (ALARA ) DOSE LIMITATIONSN ever exceed Dose LimitsJUSTIFICATION The most common type of ionizing Radiation used in medicine all over the world are X-rays since its discovery. There are obvious benefits from medical uses of X-rays , however there are well established health risks from Radiation if improperly applied. Hence every medical procedure involving Radiation needs to be justified.

3 It is fact that Diagnostic x-ray examinations contribute the largest fraction to population dose from man made Radiation Alllivingthingsareexposedtoionisingradia tionfromthenatural(calledbackgroundradia tion)andmanmaderadiationsources Ionisingradiationmaycausebiologicalchang esintheexposedpersonhencethedosestotheoc cupationalworkersshallbekeptaslowasreaso nablyachievableanddosestopatientsshallbe optimized. LIMITSPart of the bodyOccupational ExposurePublic ExposureWhole body 20 mSv/year averaged over 1 mSv/y(Effective dose)5 consecutive years.

4 30 mSv in any single year Lens of eyes 150 mSvin a year15 mSv/y(Equivalent dose)Skin 500 mSv in a year50 mSv/y(Equivalent dose)Extremities 500 mSv in a year-(Hands and Feet) Equivalent doseFor pregnant Radiation workers, after declaration of pregnancy 1 mSv on theembryo/fetus should not exceedTypes of Radiation Generating Equipment: (RGE) computed Tomography Interventional Radiology radiography (Fixed/Mobile) C-Arm/ O-Arm Mammography BMD Dental (Intraoral/OPG/CBCT)Note: MRI and Sonography (Ultrasound) or non-ionising RGE do not come under purview of AERB regulations23 May 20179 Interventional RadiologyComputed TomographyRadiography /FluoroscopyDental-IOPAD ental OPG/CBCTBMDM ammographyC-ArmAverage Effective Dose (mSv) for Diagnostic Radiology procedurescf: Mettler et al.

5 Radiology 2008, 248(1):254-263 ExamDose (mSv)Dental Background mSv/ yearComputed Tomography EquipmentPatient Effective Dose: 2-20 mSvInterventionalRadiology(Angiography& Angioplastyprocedures)Patient Effective Dose : 1to100 mSvGeneral RadiographyPatient Effective Dose : 1 mSvMammography Unit15/98 Patient Effective Dose : ~ mSvDental radiography (IOPA)Patient Effective Dose : mSv17/98 Dual Emission X-ray Absorptiometry (DEXA)/ BMDP atient Effective Dose : ~ Type ApprovalRadiation SafetyBuilt-in Safety (Design Safety ) Operational Safety Facility Proper planningTime -Distance -ShieldingProper Work Practice23-May-1718In this presentation we have considered only operational Safety componentsBuilt is Safety requirements are elaborated in separate presentation BasicFactorsforRadiationProtection Time Distance ShieldingI1 d12 = I2 d2 2 (INVERSE SQUARE LAW))

6 To reduce the Radiation dose to the individual- Reduce the time spent near the X-ray source (reduce fluoroscopy procedure time) Increase the distance from the X-ray source Interpose a shielding material between X-ray source and Operator-(Use of Radiation protection accessories)23-May-1720 Operational SafetyComponents of operational Safety Handling of equipment by Qualified persons Use of protective accessories -Mobile Protective Barrier, Lead Apron, Organ shield etc. Usage of Personnel monitoring devices (TLD) Preventive maintenance and periodic QA of equipment Updating with the current regulatory requirements21 Protection of Staff/OperatorUse protective devices!

7 Advisable skirt type lead apron to distribute weight. use of lead apron ( mm lead equivalent), Radiation dose would be reduced by more than 90 % Use ceiling suspended screens, lateral shields and table curtains-must for interventional Radiology procedures. mm Lead Eqv. glass eyewear with side protection Ways to minimize Radiation exposure Alwayscollimatetotheareaofinterest,thela rgertheamountoftissuethebeamisallowedtoi rradiatethemorescatterradiationisproduce d. Avoidholdingofinfirmpatientbystaff,provi deprotectiveaprontotheattendantwhilehold ingsuchpatients.

8 Alwaysoperatetheequipmentfrombehindthepr otectivebarrierorusingleadequivalentapro n. Duringfluoroscopyexamsalwaysmakesurethat builtinsafetydevicessuchasflaps/ceilings uspendedglass/couchhangingflapsasapplica bleareavailableanduseitonroutinebasis. Duringuseofmobilex-rayequipmentstandatle ast6feetawayfromthepatientandwearleadapr on. Duringc-armproceduresstandingonthesideof theimageintensifierissafestbecausetherei smorescatterproducedattheentrancesurface sideofthepatient. DuringuseofPortableX-rayequipment, (whenX-raytubeisbelowthetable)hencecouch hangingleadequivalentrubberflapsshallbea lwaysused.

9 Ingeneral, sEntranceSkinExposure. storage of Radiation protection devices-Lead apron23-May-1725 Personal Monitoring Badge (TLD) (Refer guidelines for proper use of TLD badges)WearTLDbadgeinsidetheLeadapronatc hestlevel RadiographyForR/ForinCathLab Oneinsidetheapronatchestlevel Additionalwristbadgeforproceduresrequiri nghandsclosetoprimarybeamAfterwork,store TLDbadgesinradiationfreeareaControlTLDC ardshouldbekeptawayfromradiationareaTLD below apronTLD above apronTLD23-May-1727 Radiation Protection Accessories Mobile Protective Barrier (MPB)

10 Mm Lead Eqv Lead Aprons mm Lead Eqv Thyroid Shield mm Lead Eqv Gonads mm Lead Eqv Eye Wear (Shield) mm Lead Eqv Rubber hanging Flaps (In IR ) mm Lead Eqv Hand Gloves mm Lead Eqv Lead Glass mm Lead Eqv Door (Lead Lined) mm Lead EqvRadiation Improvesimagingstandard IncreasetheLifeoftheX-raytube/equipmentb yavoidingretakes Usefulinreductionofunnecessarypatient sDose&hencedosetothestaff Agoodknowledgeofequipmentspecificationan dcharacteristicsisessentialforaneffectiv eoptimizationofradiationprotection (includingshieldingdevices) dose management Quality control protocols Justify the procedure Ask for records of previous Diagnostic procedures Plan the procedure (right patient, right contrast, purpose of scan/investigation)