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Radiation Protection in Paediatric Radiology at Medical Physicists and Regulators
Safety Reports Series The Fundamental Safety Principles and the IAEA's General Safety Rquirements publication, Radiation Protection and Safety of Radiation Safety Reports Series Sources: International Basic Safety Standards (BSS) require the radiological protection of patients undergoing medical exposures No.71 through justification of the procedures involved No. and through optimization. This publication 71 provides guidance to radiologists, other clinicians and radiographers/technologists involved in diagnostic procedures using ionizing radiation with children and adolescents. It is also aimed Radiation Protection in Paediatric Radiology at medical physicists and regulators. The focus is on the measures necessary to provide protection from the effects of radiation using the principles established in the BSS and according to the priority given to this issue. Radiation Protection in Paediatric Radiology INTERNATIONAL ATOMIC ENERGY AGENCY VIENNA ISBN 978–92–0–125710–9 ISSN 1020–6450 RELATED PUBLICATIONS IAEA SAFETY STANDARDS AND RELATED PUBLICATIONS RADIATION PROTECTION IN NEWER MEDICAL IMAGING TECHNIQUES: PET/CT IAEA SAFETY STANDARDS Safety Reports Series No. 58 STI/PUB/1343 (41 pp.; 2008) Under the terms of Article III of its Statute, the IAEA is authorized to establish or adopt ISBN 978–92–0–106808–8 Price: €28.00 standards of safety for protection of health and minimization of danger to life and property, and to provide for the application of these standards. The publications by means of which the IAEA establishes standards are issued in the APPLYING RADIATION SAFETY STANDARDS IN DIAGNOSTIC IAEA Safety Standards Series. This series covers nuclear safety, radiation safety, transport RADIOLOGY AND INTERVENTIONAL PROCEDURES USING X RAYS safety and waste safety. -
European Society of Paediatric Radiology Position Paper
This is a repository copy of Non-radiologist-performed point-of-care ultrasonography in paediatrics — European Society of Paediatric Radiology position paper. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/173297/ Version: Published Version Article: van Rijn, R.R., Stafrace, S., Arthurs, O.J. et al. (1 more author) (2021) Non-radiologist- performed point-of-care ultrasonography in paediatrics — European Society of Paediatric Radiology position paper. Pediatric Radiology, 51. pp. 161-167. ISSN 0301-0449 https://doi.org/10.1007/s00247-020-04843-6 Reuse This article is distributed under the terms of the Creative Commons Attribution (CC BY) licence. This licence allows you to distribute, remix, tweak, and build upon the work, even commercially, as long as you credit the authors for the original work. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing [email protected] including the URL of the record and the reason for the withdrawal request. [email protected] https://eprints.whiterose.ac.uk/ Pediatric Radiology (2021) 51:161–167 https://doi.org/10.1007/s00247-020-04843-6 ESPR Non-radiologist-performed point-of-care ultrasonography in paediatrics — European Society of Paediatric Radiology position paper Rick R. van Rijn1 & Samuel Stafrace2,3 & Owen J. Arthurs4,5,6 & Karen Rosendahl7,8 & on behalf of the European Society of Paediatric Radiology Received: 12 June 2020 /Revised: 7 July 2020 /Accepted: 7 September 2020 / Published online: 19 November 2020 # The Author(s) 2020 Abstract Non-radiologist point-of-care ultrasonography (US) is increasingly implemented in paediatric care because it is believed to facilitate a timely diagnosis, such as in ascites or dilated renal pelvicalyceal systems, and can be used to guide interventional procedures. -
A National Model of Care for Paediatric Healthcare Services in Ireland Chapter 35: Paediatric Neurosurgery
A National Model of Care for Paediatric Healthcare Services in Ireland Chapter 35: Paediatric Neurosurgery Clinical Strategy and Programmes Division National Clinical Programme for Paediatrics and Neonatology: A National Model of Care for Paediatric Healthcare Services in Ireland TABLE OF CONTENTS 35.0 Introduction 2 35.1 Current Service Provision 3 35.2 Proposed Model of Care 5 35.4 Requirements for Successful Implementation of Model of Care 26 35.4.1 Staffing Requirements 26 35.4.2 Interdependencies with Other Programmes 27 35.4.3 Education and Training 29 35.4.4 Child and Parent Involvement 29 35.4.5 Transition to Adult Services 30 35.5 Governance 31 35.6 Key Recommendations 31 35.7 Abbreviations and Acronyms 32 35.8 References 33 1 National Clinical Programme for Paediatrics and Neonatology: A National Model of Care for Paediatric Healthcare Services in Ireland 35.0 INTRODUCTION In 1998, a document entitled Safe Paediatric Neurosurgery set out the minimum requirements for paediatric neurosurgery. At about the same time, the Paediatric Forum of the Royal College of Surgeons of England published its vision in Children’s Surgery – A First Class Service which also contained a number of recommendations. These two publications demanded a review of the guidance on safe paediatric neurosurgery and, following the convening of an ‘ad hoc’ working group, a revised version was published – Safe Paediatric Neurosurgery (2001). Drawing from this and other guidelines, Standards for Patients Requiring Neurosurgical Care (2002) sets out ten objectives required to assure that neurosurgical care of children is of the highest quality, delivered by recognised paediatric neurosurgeons, supported by appropriate staff and facilities, in an appropriate paediatric environment. -
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). -
MIRD Pamphlet No. 22 - Radiobiology and Dosimetry of Alpha- Particle Emitters for Targeted Radionuclide Therapy
Alpha-Particle Emitter Dosimetry MIRD Pamphlet No. 22 - Radiobiology and Dosimetry of Alpha- Particle Emitters for Targeted Radionuclide Therapy George Sgouros1, John C. Roeske2, Michael R. McDevitt3, Stig Palm4, Barry J. Allen5, Darrell R. Fisher6, A. Bertrand Brill7, Hong Song1, Roger W. Howell8, Gamal Akabani9 1Radiology and Radiological Science, Johns Hopkins University, Baltimore MD 2Radiation Oncology, Loyola University Medical Center, Maywood IL 3Medicine and Radiology, Memorial Sloan-Kettering Cancer Center, New York NY 4International Atomic Energy Agency, Vienna, Austria 5Centre for Experimental Radiation Oncology, St. George Cancer Centre, Kagarah, Australia 6Radioisotopes Program, Pacific Northwest National Laboratory, Richland WA 7Department of Radiology, Vanderbilt University, Nashville TN 8Division of Radiation Research, Department of Radiology, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark NJ 9Food and Drug Administration, Rockville MD In collaboration with the SNM MIRD Committee: Wesley E. Bolch, A Bertrand Brill, Darrell R. Fisher, Roger W. Howell, Ruby F. Meredith, George Sgouros (Chairman), Barry W. Wessels, Pat B. Zanzonico Correspondence and reprint requests to: George Sgouros, Ph.D. Department of Radiology and Radiological Science CRB II 4M61 / 1550 Orleans St Johns Hopkins University, School of Medicine Baltimore MD 21231 410 614 0116 (voice); 413 487-3753 (FAX) [email protected] (e-mail) - 1 - Alpha-Particle Emitter Dosimetry INDEX A B S T R A C T......................................................................................................................... -
Imaging in Children in Non-Dedicated Paediatric Centres
Recommendations for Imaging in Children in Non-Dedicated Paediatric Centres UPDATED May 2021 Version 2 1. INTRODUCTION 1.1 Purpose The purpose of this document is to provide information to assist radiologists in supplementing adult imaging protocols, and to highlight when an imaging protocol needs to be changed for children (patients <16 years). 1.2 Scope The scope of this document is to provide guidance on the performance of paediatric imaging for radiology practices and hospital departments that are not dedicated paediatric centres. It also provides radiologists and radiology practices with a list of useful references that complement the recommendations contained within this guide. 1.3 Background Most radiology practices and hospital departments perform some paediatric imaging; however, the majority of their patients are likely to be adults. Under the auspice of the Australian and New Zealand Society for Paediatric Radiology (ANZSPR) Special Interest Group, the College has reviewed the original document produced by the Paediatric Imaging Reference Group in 2017. This document supports a consistent approach to paediatric imaging so that all practices are aware of the particular issues that need to be addressed when imaging children. The Alliance for Radiation Safety in Paediatric Imaging, of which the College is a member body, began as a committee within the Society for Paediatric Radiology in late 2006. This resulted in the Image Gently Campaign whose goal is to change practice by increasing awareness of the opportunities to promote radiation protection in the imaging of children and raise awareness of the opportunities to lower radiation dose in the imaging of children. -
Radiation Glossary
Radiation Glossary Activity The rate of disintegration (transformation) or decay of radioactive material. The units of activity are Curie (Ci) and the Becquerel (Bq). Agreement State Any state with which the U.S. Nuclear Regulatory Commission has entered into an effective agreement under subsection 274b. of the Atomic Energy Act of 1954, as amended. Under the agreement, the state regulates the use of by-product, source, and small quantities of special nuclear material within said state. Airborne Radioactive Material Radioactive material dispersed in the air in the form of dusts, fumes, particulates, mists, vapors, or gases. ALARA Acronym for "As Low As Reasonably Achievable". Making every reasonable effort to maintain exposures to ionizing radiation as far below the dose limits as practical, consistent with the purpose for which the licensed activity is undertaken. It takes into account the state of technology, the economics of improvements in relation to state of technology, the economics of improvements in relation to benefits to the public health and safety, societal and socioeconomic considerations, and in relation to utilization of radioactive materials and licensed materials in the public interest. Alpha Particle A positively charged particle ejected spontaneously from the nuclei of some radioactive elements. It is identical to a helium nucleus, with a mass number of 4 and a charge of +2. Annual Limit on Intake (ALI) Annual intake of a given radionuclide by "Reference Man" which would result in either a committed effective dose equivalent of 5 rems or a committed dose equivalent of 50 rems to an organ or tissue. Attenuation The process by which radiation is reduced in intensity when passing through some material. -
This Requirement. Paediatric Radiology Elsewhere. Citing Of
Archives ofDisease in Childhood 1993; 69: 475 475 Pediatric Clinical Skills. Edited by Richard are particularly well written. The chapter on SI units are not used except sporadically B Goldbloom. (Pp 332; £29.95 paperback.) community support services is also useful but throughout the text making assimilation of Arch Dis Child: first published as 10.1136/adc.69.4.475-b on 1 October 1993. Downloaded from Churchill Livingstone, 1992. ISBN 0-443- both this chapter and the chapter discussing the information provided problematical for 0873-0. the legal issues of epilepsy in children are only the British reader. partly relevant to epilepsy care in Great It is likely that the book will be of use as an There is a great British tradition in handbooks Britain, in view of the American authorship. obstetric reference book rather than essential of clinical methods for adult medicine. Both The most obvious criticism is the surprising reading for neonatologists concerned with the Hutchison's Clinical Methods and Macleod's omission of a section on the new antiepileptic care of infants of diabetic mothers. Clinical Examination now have a chapter on drugs. Although most ofthese drugs are not as A C ELIAS-JONES the special techniques for children. However, yet licensed in North America, and the Consultant paediatriciani this pioneering Canadian work is written with intended 'audience' is generalist rather than the child in mind throughout. specialist, this should not have precluded their The impressive thoughts and feelings in the inclusion in a book of this quality, depth, and foreword could alleviate much of the current cost. -
External and Internal Dosimetry
Chapter 7 External and Internal Dosimetry H-117 – Introductory Health Physics Slide 1 Objectives ¾ Discuss factors influencing external and internal doses ¾ Define terms used in external dosimetry ¾ Discuss external dosimeters such as TLDs, film badges, OSL dosimeters, pocket chambers, and electronic dosimetry H-117 – Introductory Health Physics Slide 2 Objectives ¾ Define terms used in internal dosimetry ¾ Discuss dose units and limits ¾ Define the ALI, DAC and DAC-hr ¾ Discuss radiation signs and postings H-117 – Introductory Health Physics Slide 3 Objectives ¾ Discuss types of bioassays ¾ Describe internal dose measuring equipment and facilities ¾ Discuss principles of internal dose calculation and work sample problems H-117 – Introductory Health Physics Slide 4 External Dosimetry H-117 – Introductory Health Physics Slide 5 External Dosimetry Gamma, beta or neutron radiation emitted by radioactive material outside the body irradiates the skin, lens of the eye, extremities & the whole body (i.e. internal organs) H-117 – Introductory Health Physics Slide 6 External Dosimetry (cont.) ¾ Alpha particles cannot penetrate the dead layer of skin (0.007 cm) ¾ Beta particles are primarily a skin hazard. However, energetic betas can penetrate the lens of an eye (0.3 cm) and deeper tissue (1 cm) ¾ Beta sources can produce more penetrating radiation through bremsstrahlung ¾ Primary sources of external exposure are photons and neutrons ¾ External dose must be measured by means of appropriate dosimeters H-117 – Introductory Health Physics Slide 7 -
11. Dosimetry Fundamentals
Outline • Introduction Dosimetry Fundamentals • Dosimeter model • Interpretation of dosimeter measurements Chapter 11 – Photons and neutrons – Charged particles • General characteristics of dosimeters F.A. Attix, Introduction to Radiological Physics and Radiation Dosimetry • Summary Introduction Dosimeter • Radiation dosimetry deals with the determination • A dosimeter can be generally defined as (i.e., by measurement or calculation) of the any device that is capable of providing a absorbed dose or dose rate resulting from the interaction of ionizing radiation with matter reading R that is a measure of the absorbed • Other radiologically relevant quantities are dose Dg deposited in its sensitive volume V exposure, kerma, fluence, dose equivalent, energy by ionizing radiation imparted, etc. can be determined • If the dose is not homogeneous • Measuring one quantity (usually the absorbed dose) another one can be derived through throughout the sensitive calculations based on the defined relationships volume, then R is a measure of mean value Dg Dosimeter Simple dosimeter model • Ordinarily one is not interested in measuring • A dosimeter can generally be considered as the absorbed dose in a dosimeter’s sensitive consisting of a sensitive volume V filled with a volume itself, but rather as a means of medium g, surrounded by a wall (or envelope, determining the dose (or a related quantity) for container, etc.) of another medium w having a another medium in which direct measurements thickness t 0 are not feasible • A simple dosimeter can be -
Can You See Your Future in Radiology? Become Part of a Specialty That Is the Guiding Force Behind Modern Healthcare
Can you see your future in radiology? Become part of a specialty that is the guiding force behind modern healthcare. rcr.ac.uk Clinical Radiology 1 What is clinical radiology? Clinical radiology is commonly misunderstood by the public, at medical school and even among junior doctors, many of who might think that it is limited to simple X-rays and possibly computed tomography (CT) scans. Indeed radiology has arguably been a quite considerably. Modern day clinical mystery since those early days in the late radiology is a branch of medicine that uses 1800s, when Roentgen produced the various imaging techniques to diagnose first image and called the rays ‘X-rays’ and treat various medical conditions. using ‘X’ to portray the unknown nature Although originally based on X-rays, of the rays. Although the principle of clinical imaging now encompasses other radiograph (X-ray) production has remained newer imaging techniques (modalities) the same, the applications to what we which do not involve radiation. The main now call clinical radiology have evolved modalities in use are listed below. Plain radiographs X-rays Computed tomography CT scans Fluoroscopy Similar to plain X-rays. In fluoroscopy, multiple X-rays are taken at high frequency to create a cine loop which can be viewed in real time. This is especially useful in interventional radiology to guide placement of needles and other instruments. Magnetic resonance Uses magnetic fields and radio waves to produce tomographic (imaging imaging (MRI) by section) anatomical images. It produces excellent soft tissue resolution and has become the workhorse of pelvic, gynaecological, musculoskeletal (MSK) and neuro imaging. -
Specialty Training Curriculum for Clinical
SPECIALTY TRAINING CURRICULUM FOR CLINICAL RADIOLOGY 28 October 2014 The Faculty of Clinical Radiology The Royal College of Radiologists 63 Lincoln’s Inn Fields London WC2A 3JW Telephone: 020 7405 1282 Clinical Radiology 28 October 2014 Page 1 of 187 CONTENTS 1 INTRODUCTION 3 1.1 AIMS AND VALUES 5 1.2 CURRICULUM RATIONALE 7 1.3 ENTRY AND INDICATIVE TRAINING 8 1.4 ENROLMENT WITH THE ROYAL COLLEGE OF RADIOLOGISTS 8 1.5 DURATION OF TRAINING 8 1.6 FLEXIBLE TRAINING 9 1.7 TIME OUT OF TRAINING 9 1.8 OUT OF PROGRAMME ACTIVITIES 10 1.9 HOW TO USE THE CURRICULUM 11 1.10 THE SYLLABUS IN PRACTICE 15 2 SYLLABUS AND COMPETENCES 16 2.2 SCIENTIFIC BASIS OF IMAGING 17 2.3 ANATOMY 25 2.4 GENERIC CONTENT 29 A Behaviours in the Workplace 29 B Good clinical care 34 C Managing Long-term Conditions 44 D Infection control 45 E Clinical Governance, Risk Management, Audit and Quality Improvement 47 F Leadership/Management development 49 G Ethical and legal issues 53 H Maintaining good medical practice 58 I Teaching and training 63 2.5 RADIOLOGY SPECIFIC CONTENT 65 Breast Radiology 66 Cardiac Radiology 72 Emergency Radiology 78 Gastro-intestinal Radiology 83 General and Non-vascular intervention 90 Head and Neck Radiology 97 Molecular Imaging 103 Musculoskeletal Radiology 108 Neuroradiology 114 Oncological Radiology 119 Paediatric Radiology 123 Radionuclide Radiology 130 Thoracic Radiology 142 Uro-gynaecological Radiology 150 Vascular Radiology 156 Academic Radiology 162 3 SUPPORT FOR LEARNING, SUPERVISION AND FEEDBACK 164 4 APPRAISAL 170 5 ASSESSMENT 173 6 ANNUAL REVIEW OF COMPETENCY PROGRESSION (ARCP) 178 APPENDICES 180 APPENDIX A: CURRICULUM IMPLEMENTATION AND MANAGEMENT 180 APPENDIX B: CURRICULUM DEVELOPMENT AND REVIEW 182 APPENDIX C: EQUALITY AND DIVERSITY 185 APPENDIX D: CHANGES SINCE PREVIOUS VERSIONS 186 Clinical Radiology 28 October 2014 Page 2 of 187 1 INTRODUCTION The Radiology Curriculum sets out the framework for educational progression that will support professional development throughout Specialty Training in Clinical Radiology.