Manual on Radiation Protection in Hospitals and General Practice
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Radiation Protection Guidance for Diagnostic X Rays
Disclaimer - For assistance accessing this document or additional information, please contact [email protected]. EPA 520/4-76-019 FEDERAL GUIDANCE REPORT NO. 9 RADIATION PROTECTION GUIDANCE FOR DIAGNOSTIC X RAYS ENVIRONMENTAL PROTECTION AGENCY INTERAGENCY WORKING GROUP ON MEDICAL RADIATION FEDERAL GUIDANCE REPORT NO. 9 RADIATION PROTECTION GUIDANCE FOR DIAGNOSTIC X RAYS Interagency Working Group on Medical Radiation U.S. Environmental Protection Agency Washington, D.C. 20460 October 1976 PREFACE The authority of the Federal Radiation Council to provide radiation protection guidance was transferred to the Environmental Protection Agency on December 2, 1970, by Reorganization Plan No. 3. Prior to this transfer, the Federal Radiation Council developed reports which provided the basis for guidance recommended to the President for use by Federal agencies in developing standards for a wide range of radiation exposure circumstances. This report, which was prepared in cooperation with an Interagency Working Group on Medical Radiation formed on July 5, 1974, constitutes a similar objective to provide the basis for recommendations to reduce unnecessary radiation exposure due to medical uses of diagnostic x rays. The Interagency Working Group developed its recommendations with the help of two subcommittees. The Subcommittee on Prescription of Exposure to X rays examined factors to eliminate clinically unproductive examinations and the Subcommittee on Technic of Exposure Prevention examined factors to assure the use of optimal technic in performing x-ray examinations. Both subcommittees also considered the importance of appropriate and properly functioning equipment in producing radiographs of the required diagnostic quality with minimal exposure. Reports by these subcommittees were made available for public comment. -
Radiation Risk in Perspective
PS010-1 RADIATION RISK IN PERSPECTIVE POSITION STATEMENT OF THE HEALTH HEALTH PHYSICS SOCIETY* PHYSICS SOCIETY Adopted: January 1996 Revised: August 2004 Contact: Richard J. Burk, Jr. Executive Secretary Health Physics Society Telephone: 703-790-1745 Fax: 703-790-2672 Email: [email protected] http://www.hps.org In accordance with current knowledge of radiation health risks, the Health Physics Society recommends against quantitative estimation of health risks below an individual dose of 5 rem1 in one year or a lifetime dose of 10 rem above that received from natural sources. Doses from natural background radiation in the United States average about 0.3 rem per year. A dose of 5 rem will be accumulated in the first 17 years of life and about 25 rem in a lifetime of 80 years. Estimation of health risk associated with radiation doses that are of similar magnitude as those received from natural sources should be strictly qualitative and encompass a range of hypothetical health outcomes, including the possibility of no adverse health effects at such low levels. There is substantial and convincing scientific evidence for health risks following high-dose exposures. However, below 5–10 rem (which includes occupational and environmental exposures), risks of health effects are either too small to be observed or are nonexistent. In part because of the insurmountable intrinsic and methodological difficulties in determining if the health effects that are demonstrated at high radiation doses are also present at low doses, current radiation protection standards and practices are based on the premise that any radiation dose, no matter how small, may result in detrimental health effects, such as cancer and hereditary genetic damage. -
Cone Beam Computed Tomography (CBCT) Page 1 of 13
Cone Beam Computed Tomography (CBCT) Page 1 of 13 Dental Policy An Independent licensee of the Blue Cross Blue Shield Association Title: Cone Beam Computed Tomography (CBCT) Professional Institutional Original Effective Date: January 1, 2007 Original Effective Date: January 1, 2007 Revision Date(s): May 14, 2013; Revision Date(s): May 14, 2013; December 31, 2013; May 13, 2015; December 31, 2013; May 13, 2015; April 27, 2016; January 18, 2017; April 27, 2016; January 18, 2017; February 15, 2018; July 3, 2019; February 15, 2018; July 3, 2019, October 1, 2020; May 21, 2021 October 1, 2020; May 21, 2021 Current Effective Date: May 21, 2021 Current Effective Date: May 21, 2021 State and Federal mandates and health plan member contract language, including specific provisions/exclusions, take precedence over Medical Policy and must be considered first in determining eligibility for coverage. To verify a member's benefits, contact Blue Cross and Blue Shield of Kansas Customer Service. The BCBSKS Medical Policies contained herein are for informational purposes and apply only to members who have health insurance through BCBSKS or who are covered by a self-insured group plan administered by BCBSKS. Medical Policy for FEP members is subject to FEP medical policy which may differ from BCBSKS Medical Policy. The medical policies do not constitute medical advice or medical care. Treating health care providers are independent contractors and are neither employees nor agents of Blue Cross and Blue Shield of Kansas and are solely responsible for diagnosis, treatment and medical advice. If your patient is covered under a different Blue Cross and Blue Shield plan, please refer to the Medical Policies of that plan. -
Radiation Safety Evidence Table
Guideline for Radiation Safety Evidence Table Citation Conclusion(s) Evidence Type Population Reference# Sample Sample size Intervention Comparision Concensus Concensus score Outcome measure Outcome 1 Chaffins JA. Radiation protection and procedures in Describes radiation protection Expert oninion VB N/A N/A N/A N/A N/A the OR. Radiol Technol . 2008;79(5): 415-428. measures and procedures for radiation protection in the OR. 2 Bindal RK, Glaze S, Ognoskie M, Tunner V, Malone The amount of radiation received by Descriptive IIIC 1 surgeon, N/A N/A 1 surgeon, 24 Radiaiton dose R, Ghosh S. Surgeon and patient radiation patients and physicians is low during 24 patients patients exposure in minimally invasive transforaminal minimally invasive transforaminal lumbar interbody fusion. J Neurosurg Spine. lumbar interbody fusion. 2008;9(6):570–573. 3 Cattani F, Vavassori A, Polo Aet al. Radiation A visitor should stay 1 meter away Descriptive, IIIC Patients N/A N/A 216 patients Radiation dose exposure after permanent prostate brachytherapy. from the patient who has radioactive retrospective Radiother Oncol. 2006;79(1):65–69. seeds implanted for a period of time equal to the half life of the radionuclide to achieve a radiation does as low as reasonably/readily achievable. 4 Brown KR, Rzucidlo E. Acute and chronic radiation Suggestions for patient education and Literature review VB N/A N/A N/A N/A N/A injury. J Vasc Surg. 2011;53(1 Suppl):15S–21S. tips to avoid injury, description of injuries from radiation, patient risk factors for injury. 5 Miller DL. Efforts to optimize radiation protection Historical review of all aspects of Literature review VA N/A N/A N/A N/A N/A in interventional fluoroscopy. -
Radiation Safety in Dental Radiography
Dental Radiography Series Radiation Safety in dental radiography. The goal of dental radiography is to obtain diagnostic information while keeping the exposure to the patient and dental staff at minimum levels. While some exposure to radiation is acceptable in medical practice, it should be understood that levels of radiation exposure to patients, dental staff, and other nearby occupants should be kept to As Low As Reasonably Achievable (ALARA) to reduce health risks from ionizing radiation. Any methods that can reduce patient and area radiation exposures without major difficulty, great expense or inconvenience, should be practiced. Practitioners must always consider the risk of patient exposure with the benefit of diagnosis. Radiograph Guidelines 4 Radiation safety considerations 4 Exposure 5 Patient selection 5 Film 6 Rectangular Collimation 7 Image Density 7 Film Cassettes 7 Minimal Exposure 8 Exposure Protection Basic principals of radiation safety Additional radiation safety controls commonly utilized for dental facilities Engineering controls 9 Summary 9 References Radiograph Guidelines One way to do this is with the use of radiographic patient All x-ray equipment, regardless of date of manufacture, is selection criteria. subject to state and federal x-ray equipment regulations. Guidelines for the prescription of dental radiographs have Although proper filtration is not usually a problem with been developed by an expert panel of dentists sponsored modern equipment, older x-ray machines should be tested by the public health service. by a radiation physicist or qualified technician to verify the presence of the correct amount of filtration. A free brochure is available from Carestream Dental (see last page for ordering information) publication The kilovoltage or kVp setting is one of the most 8616 “Guidelines for prescribing dental radiographs.” important factors that determines the image contrast, The guidelines are voluntary and are intended only as a as well as dosage to the patient. -
Emission Tuned-Aperture Computed Tomography: a Novel Approach to Scintimammography
Emission Tuned-Aperture Computed Tomography: A Novel Approach to Scintimammography Frederic H. Fahey, Kerry L. Grow, Richard L. Webber, Beth A. Harkness, Ersin Bayram, and Paul F. Hemler Division of Radiologic Sciences, Wake Forest University School of Medicine, and Department of Physics, Wake Forest University, Winston-Salem, North Carolina 1 or more distant sites (3). Early detection, therefore, plays Emission tuned-aperture computed tomography (ETACT) is a an essential role in the fight against breast cancer. Although new approach to acquiring and processing scintimammography mammography is currently the best imaging approach for data. A gamma camera with a pinhole collimator is used to breast cancer screening, several factors may limit its accu- acquire projections of the radionuclide distribution within the racy. Dense breasts, breast implants, or scars may either breast. Fiducial markers are used to reconstruct these projec- tions into tomographic slices. Simulation and phantom experi- resemble a tumor or hide true small tumors on the mam- ments were performed to evaluate the potential of the ETACT mogram. As a result, false-positive as well as false-negative method. Methods: In the simulation study, a hemispheric object incidents are increased. Mammography has a relatively high of 15 cm in diameter was constructed to model a breast. A sensitivity (88%), although dense or large breasts may re- ray-tracing technique was used to generate ideal projections. duce this. However, it has a low specificity (67%) (4). These were blurred and noise was added to create images that Scintimammography using 99mTc-labeled sestamibi has resemble scintigraphic images. Tumor size, pinhole size, and target-to-nontarget radioactivity ratios (TNTs) were varied. -
Shielding for Radiation Scattered Dose Distribution to the Outside Fields in Patients Treated with High Energy Radiotherapy Beams
IAEA-CN-85-70 SHIELDING FOR RADIATION SCATTERED DOSE DISTRIBUTION TO THE OUTSIDE FIELDS IN PATIENTS TREATED WITH HIGH ENERGY RADIOTHERAPY BEAMS SungSilChu XA0101718 Department of radiation Oncology, Yonsei Cancer Center, Yonsei University, Seoul, Republic of Korea Abstract Scattered dose of therapeutic high energy radiation beams are contributed significan t unwanted dose to the patient. Measurement of radiation scattered dose outside fields and critical organs, like fetus position and testicle region, from chest or pelvic irradiation by large field of high energy radiation beam was performed using an ionization chamber and film dosimetry. The scattered doses outside field were measured 5 - 10% of maximum doses in fields and exponentially decrease from field margins. The scattered photon dose received the uterus from thorax field irradiation was measured about lmGy/Gy of photon treatment dose Shielding construction to reduce this scattered dose was investigated using lead sheet and blocks About 6 cm lead block shield reduced the scatter photon dose under lOmGy for 60Gy on abdomen field and reduced almost electron contamination. 1. Introduction High energy photon beams from medical linear accelerators produce large scattered radiation by various components of the treatment head, collimator and walls or objects in the treatment room including the patient. These scattered radiation do not provide therapeutic dose and are considered a hazard from the radiation safety perspective. The scattered photon dose received the fetus from thorax field irradiation was measured about lmGy/Gy of photon treatment dose and typical therapeutic doses of photon radiation lie in the range 40 -70Gy. Thus, without additional shielding, the scattered photon dose received by the fetus might be several hundred mGy. -
Essential Tips for Dental Radiographers
Essential Tips for Dental Radiographers The Academy of Dental Learning and OSHA Training, LLC, designates this activity for 2 continuing education credits (2 CEs). Martin S. Spiller, DMD Health Science Editor: Megan Wright, RDH, MS Publication Date: May 2010 Updated Date: December 2019 Expiration Date: December 2021 The Academy of Dental Learning and OSHA Training, LLC is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP. Conflict of Interest Disclosure: ADL does not accept promotional or commercial funding in association with its courses. In order to promote quality and scientific integrity, ADL's evidence- based course content is developed independent of commercial interests. Refund Policy: If you are dissatisfied with the course for any reason, prior to taking the test and receiving your certificate, return the printed materials within 15 days of purchase and we will refund your full tuition. Shipping charges are nonrefundable. California Registered Provider Number: RP5631 Answer Sheet: Essential Tips for Dental Radiographers 1. _______ 3. _______ 5. _______ 7. _______ 9. _______ 2. _______ 4. _______ 6. _______ 8. _______ 10. _______ Name: ________________________________________ Profession: _________________________ License State: ____________ License Number: ________________ Expiration Date Address City: ____________________________________ State: __________ Zip Code: Telephone:________________________________ Fax: ____________________________________ E-mail: If you have downloaded the course and printed the answer sheet from the Internet please enter payment information below. -
Dental Radiography
Dental Radiology Made Easy - Tips and Tricks for Great Rads! Mary L. Berg, BS, LATG, RVT, VTS(Dentistry) Beyond the Crown Veterinary Education Lawrence, KS [email protected] Here are some quick tips for great x-rays every time: 1. You need a diagnostic x-ray – not a perfect x-ray. A diagnostic x-ray allows for the visualization of 2-3 mm of bone around the apex of the root and the level of the alveolar bone. The crown does not need to be on the x-ray. 2. The entire tooth does not need to be on one view. If both roots are visible but on two separate x-rays, it’s okay! 3. Get all the teeth in as few views as possible. This saves time and gives a quick survey of the oral cavity. If more detail is needed, additional view should be obtained. 4. Every patient, every time! Not only will this help you become faster at taking x-rays, but it is also better medicine. Remember the patients can’t tell us where it hurts. 5. Proper positioning of the animal is key! Place the animal (both dog and cat) in sternal recumbency for the maxillary views and dorsal recumbency for the mandibular. Ensure that the dental arcade is parallel to the table, and the mouth is straight, not tilted in either direction. 6. The sensor (film) should always be placed with the teeth on the very edge of the sensor with the remainder of the sensor inside the mouth, and the sensor should be flat or parallel to the table for maxillary views. -
Maxillofacial Imaging
3 ▼ MAXILLOFACIAL IMAGING SHARON L. BROOKS, DDS, MS ▼ SELECTION CRITERIA The role of imaging in oral medicine varies greatly with the ▼ IMAGING MODALITIES AVAILABLE IN DENTAL type of problem being evaluated. Certain problems, such as OFFICES AND CLINICS pain in the orofacial region, frequently require imaging to Intraoral and Panoramic Radiography determine the origin of the pain. For other conditions, how- Digital Imaging ever, such as soft-tissue lesions of the oral mucosa, imaging Conventional Tomography offers no new diagnostic information. ▼ IMAGING MODALITIES AVAILABLE IN HOSPITALS The variety of imaging techniques available to the clinician AND RADIOLOGY CLINICS has grown in number and in degree of sophistication over the Computed Tomography years. While this means that there is an imaging procedure Magnetic Resonance Imaging that will provide the information desired by the clinician, it Ultrasonography Nuclear Medicine also means that choosing the best technique is not necessarily Contrast-Enhanced Radiography an easy process. This chapter first explores the underlying principles the ▼ IMAGING PROTOCOLS Orofacial Pain clinician should consider when deciding whether imaging is Disease Entities Affecting Salivary Glands appropriate for the case in question and then discusses the Jaw Lesions imaging techniques that are available in dental offices and in ▼ BENEFITS AND RISKS referral imaging centers. Examples of specific imaging proto- cols are then described, followed by a discussion of risk-ben- efit analysis of imaging in oral medicine. ▼SELECTION CRITERIA The decision to order diagnostic imaging as part of the evalu- ation of an orofacial complaint should be based on the prin- ciple of selection criteria. Selection criteria are those histori- cal and/or clinical findings that suggest a need for imaging to provide additional information so that a correct diagnosis and an appropriate management plan can be determined. -
Occupational Radiation Protection Record-Keeping and Reporting Guide
DOE G 441.1-11 (formerly G-10 CFR 835/H1) 05-20-99 OCCUPATIONAL RADIATION PROTECTION RECORD-KEEPING AND REPORTING GUIDE for use with Title 10, Code of Federal Regulations, Part 835, Occupational Radiation Protection Assistant Secretary for Environment, Safety and Health (THIS PAGE INTENTIONALLY LEFT BLANK) DOE G 441.1-11 i 05-20-99 CONTENTS CONTENTS PAGE 1. PURPOSE AND APPLICABILITY ........................................................ 1 2. DEFINITIONS ........................................................................ 2 3. DISCUSSION ........................................................................ 3 4. IMPLEMENTATION GUIDANCE ......................................................... 4 4.1 RECORDS TO BE GENERATED AND MAINTAINED ................................ 4 4.1.1 Individual Monitoring and Dose Records ........................................ 4 4.1.2 Monitoring and Workplace Records ............................................ 8 4.1.3 Administrative Records .................................................... 11 4.2 REPORTS ................................................................... 15 4.2.1 Reports to Individuals ...................................................... 16 4.2.2 Reports of Planned Special Exposures ......................................... 17 4.3 PRIVACY ACT CONSIDERATIONS .............................................. 17 4.3.1 Informing Individuals ...................................................... 17 4.3.2 Identifying Individuals ..................................................... 17 -
The International Commission on Radiological Protection: Historical Overview
Topical report The International Commission on Radiological Protection: Historical overview The ICRP is revising its basic recommendations by Dr H. Smith Within a few weeks of Roentgen's discovery of gamma rays; 1.5 roentgen per working week for radia- X-rays, the potential of the technique for diagnosing tion, affecting only superficial tissues; and 0.03 roentgen fractures became apparent, but acute adverse effects per working week for neutrons. (such as hair loss, erythema, and dermatitis) made hospital personnel aware of the need to avoid over- Recommendations in the 1950s exposure. Similar undesirable acute effects were By then, it was accepted that the roentgen was reported shortly after the discovery of radium and its inappropriate as a measure of exposure. In 1953, the medical applications. Notwithstanding these observa- ICRU recommended that limits of exposure should be tions, protection of staff exposed to X-rays and gamma based on consideration of the energy absorbed in tissues rays from radium was poorly co-ordinated. and introduced the rad (radiation absorbed dose) as a The British X-ray and Radium Protection Committee unit of absorbed dose (that is, energy imparted by radia- and the American Roentgen Ray Society proposed tion to a unit mass of tissue). In 1954, the ICRP general radiation protection recommendations in the introduced the rem (roentgen equivalent man) as a unit early 1920s. In 1925, at the First International Congress of absorbed dose weighted for the way different types of of Radiology, the need for quantifying exposure was radiation distribute energy in tissue (called the dose recognized. As a result, in 1928 the roentgen was equivalent in 1966).