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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. -
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. -
Neurological Critical Care: the Evolution of Cerebrovascular Critical Care Cherylee W
50TH ANNIVERSARY ARTICLE Neurological Critical Care: The Evolution of Cerebrovascular Critical Care Cherylee W. J. Chang, MD, FCCM, KEY WORDS: acute ischemic stroke; cerebrovascular disease; critical FACP, FNCS1 care medicine; history; intracerebral hemorrhage; neurocritical care; Jose Javier Provencio, MD, FCCM, subarachnoid hemorrhage FNCS2 Shreyansh Shah, MD1 n 1970, when 29 physicians first met in Los Angeles, California, to found the Society of Critical Care Medicine (SCCM), there was little to offer for the acute management of a patient suffering from an acute cerebrovascular Icondition except supportive care. Stroke patients were not often found in the ICU. Poliomyelitis, and its associated neuromuscular respiratory failure, cre- ated a natural intersection of neurology with critical care; such was not the case for stroke patients. Early textbooks describe that the primary decision in the emergency department was to ascertain whether a patient could swallow. If so, the patient was discharged with the advice that nothing could be done for the stroke. If unable to swallow, a nasogastric tube was inserted and then the patient was discharged with the same advice. In the 50 intervening years, many advances in stroke care have been made. Now, acute cerebrovascular patients are not infrequent admissions to an ICU for neurologic monitoring, observa- tion, and aggressive therapy (Fig. 1). HISTORY Over 50 years ago, stroke, previously called “apoplexy” which means “struck down with violence” or “to strike suddenly,” was a clinical diagnosis that was confirmed by autopsy as a disease of the CNS of vascular origin (1). In the 1960s, approximately 25% of stroke patients died within 24 hours and nearly half died within 2 to 3 weeks. -
Pneumoencephalographic Planimetry in Neurological Diseaset
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.32.3.241 on 1 June 1969. Downloaded from J. Nearol. Neurosurg. Psychiat., 1969, 32, 241-248 Pneumoencephalographic planimetry in neurological diseaset H. E. BOOKER, C. G. MATTHEWS, AND W. R. WHITEHURST2 From the Epilepsy Center and Department of Neurology, University of Wisconsin, Madison, Wisconsin, U.S.A. The outline of the ventricular system on the In the present investigation planographic rather pneumoencephalogram (PEG) can be easily than linear measures of ventricular size were used. measured and lends itself to quantification. Several The subjects were not selected on the basis of a methods have been developed which utilize linear particular aetiology nor on the basis of presence or measures of the ventricles, or ratios of ventricle to absence of asymmetry of the lateral ventricles. skull size. Planographic measurements of the area of Detailed clinical and electroencephalographic data the ventricles have been employed in a few studies, were available on all subjects for purposes of but have generally been dismissed as too cumber- diagnostic classification, and, in addition, a stan- some for use (Bruijn, 1959). dardized battery of neuropsychological tests pro- While a number of previous investigators have viding quantitative measurement of intellectual and Protected by copyright. related quantitative PEG findings to clinical motor-sensory status was administered to the neurological and psychometric data, most studies majority of the subjects. PEG data on a group of have suffered from one or more limitations. Studies subjects without clinical, neurological, or electro- reporting measurements on a large number of PEGs encephalographic evidence of neurological disease have usually been limited in amount and specificity were also included for comparison purposes. -
Digital and Advanced Imaging Equipment
CHAPTER 9 Digital and Advanced Imaging Equipment KEY TERMS active matrix array direct-to-digital radiographic systems photostimulated luminescence amorphous dual-energy x-ray absorptiometry picture archiving and communication analog-to-digital converter F-center system aspect ratio fill factor preprocessing cinefluorography frame rate postprocessing computed radiography image contrast refresh rate detective quantum efficiency image enhancement special procedures laboratory Digital Imaging and Communications image management and specular reflection in Medicine group communication system teleradiology digital fluoroscopy image restoration thin-film transistor digital radiography interpolation window level digital subtraction angiography liquid crystal display window width digital x-ray radiogrammetry Nyquist frequency OBJECTIVES At the completion of this chapter the reader should be able to do the following: • Describe the basic methods of obtaining digital cathode-ray tube cameras, videotape and videodisc radiographs recorders, and cinefluorographic equipment and discuss • State the advantages and disadvantages of digital the quality control procedures for each radiography versus conventional film/screen • Describe the various types of electronic display devices radiography and discuss the applicable quality control procedures • Discuss the quality control procedures for evaluating • Explain the basic image archiving and management digital radiographic systems networks and discuss the applicable quality control • Describe the basic methods -
Esotropia: Unusual Complication of Myelography and Pneumoencephalography
278 Esotropia: Unusual Complication of Myelography and Pneumoencephalography Harris Newmark 111,1 Norman Levin,2 Richard K. APV and Jack D. Wax2 Myelography and pneumoencephalography are invasive years later showed occasional diplopia on left gaze. The patient procedures with many complications. We report two cases was asymptomatic 10 years later. of esotropia that developed 8 and 7 days after a Pantopaque myelogram and a pneumoencephalogram, respectively. For Discussion tunately, the esotropia was temporary in both cases. This rare complication, of which very few radiologists are aware, These cases are interesting in that they illustrate that was presumably secondary to the lumbar puncture per esotropia can be a complication of myelography and pneu formed for the procedure. moencephalography, although it is extremely rare. It has been reported to be a complication in 0.25%-1.00% of lumbar punctures [1 , 2], but we believe it is much rarer Case Reports since none of us, or any of our colleagues, could recall a Case 1 similar episode. The probable pathogenesis is that cerebrospinal fluid A 27-year-old man had a lumbar myelogram for a suspected leaks through the dura at the puncture site. The cerebro herniated nucleus pulposus at L5-S1 which caused right-sided leg spinal fluid pressure is less in the lumbar region than in the pain . The lumbar puncture was performed with ease on the first attempt with an 18 gauge spinal needle. The cerebrospinal fluid intracranial area after this procedure. Subsequently the was clear and the laboratory test results were normal except for a brain stem shifts caudally and the cranial nerves are slightly slight elevation of protein. -
A-Scan Echoencephalography in Measurement of the Cerebral Ventricles
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.31.3.245 on 1 June 1968. Downloaded from J. Neurol. Neurosurg. Psychiat., 1968, 31, 245-249 A-scan echoencephalography in measurement of the cerebral ventricles ANAND G. GARG AND ALEX. R. TAYLOR From the Department ofNeurological Surgery, Royal Victoria Hospital, Belfast, Northern Ireland The first attempts at ultrasonic visualization of the METHOD cerebral ventricles were made by Dussik (1948), The ventricular measurements obtained at echoen- Ballantine, Ludwig, Bolt, and Hueter (1950), and cephalography were compared with the x-ray measure- Hueter and Bolt (1951), using the transmission ments made at pneumoencephalography. method. The possible use of the pulse-echo method ANATOMICAL CONSIDERATIONS The third and lateral (echoencephalography) for the diagnosis of hy- ventricles are supratentorial structures. The third ventricle lies between the two thalmi, communicating drocephalus was suggested by Leksell (1956). Later in front with the lateral ventricles through the inter- Kikuchi, Uchida, Tanaka, and Wagai (1957) and de ventricular foramina and behind with the aqueduct of Vlieger and Ridder (1959) recorded echoes from the the midbrain. The septum lucidum and the third ventricle walls of the lateral ventricles. According to Gordon lie in the central plane of the brain. Protected by copyright. (1959), and de Vlieger and Ridder (1959), the width The lateral ventricle is a C-shaped cavity lying within of the third ventricle can also be measured. ter the cerebral hemisphere. It consists of a central body and Braak, Crezde, Grandia, and de Vleger (1961) used three horns-anterior, posterior, and temporal-running pneumoencephalography to study the origin of into the frontal, occipital, and temporal lobes respec- ventricular echoes. -
Radiation and Your Patient: a Guide for Medical Practitioners
RADIATION AND YOUR PATIENT: A GUIDE FOR MEDICAL PRACTITIONERS A web module produced by Committee 3 of the International Commission on Radiological Protection (ICRP) What is the purpose of this document ? In the past 100 years, diagnostic radiology, nuclear medicine and radiation therapy have evolved from the original crude practices to advanced techniques that form an essential tool for all branches and specialties of medicine. The inherent properties of ionising radiation provide many benefits but also may cause potential harm. In the practice of medicine, there must be a judgement made concerning the benefit/risk ratio. This requires not only knowledge of medicine but also of the radiation risks. This document is designed to provide basic information on radiation mechanisms, the dose from various medical radiation sources, the magnitude and type of risk, as well as answers to commonly asked questions (e.g radiation and pregnancy). As a matter of ease in reading, the text is in a question and answer format. Interventional cardiologists, radiologists, orthopaedic and vascular surgeons and others, who actually operate medical x-ray equipment or use radiation sources, should possess more information on proper technique and dose management than is contained here. However, this text may provide a useful starting point. The most common ionising radiations used in medicine are X, gamma, beta rays and electrons. Ionising radiation is only one part of the electromagnetic spectrum. There are numerous other radiations (e.g. visible light, infrared waves, high frequency and radiofrequency electromagnetic waves) that do not posses the ability to ionize atoms of the absorbing matter. -
The Distinguished History of Radiology at the University of Michigan
The Distinguished History of Radiology at the University of Michigan On the Occasion of the Centennial Celebration of the Discovery of X-rays William Martel Fred Jenner Hodges Professor Department of Radiology 1 The Distinguished History of Radiology at the University of Michigan On the Occasion of the Centennial Celebration of the Discovery of X-rays by William Martel Fred Jenner Hodges Professor Department of Radiology 2 To my beloved wife, Rhoda, and our wonderful children, Lisa, Pamela, Caryn, Jonathan and David. Acknowledgements The Bentley Historical Library, University of Michigan, was a major information resource for this paper. I appreciate the information and advice provided by N. Reed Dunnick, Barry H. Gross, Nicholas H. Steneck, Terry M. Silver and Donna C. Eder and thank Horace W. Davenport for permitting wide use of material from his book [4] and Kallie Bila Michels, Judalyn G. Seling, Cynthia Sims-Holmes and Diane D. Williams for their assistance in preparing the manuscript. I also appreciate the editorial assistance of Keri Ellis of the American Roentgen Ray Society. Finally, I regret the inability, for lack of space, to cite many individuals whose accomplishments contributed to the rich heritage of the department. Some of this material has been previously published (Martel W. The Rich Tradition of Radiology at the University of Michigan. AJR 1995;165:995-1002) and is reproduced here with permission of the American Roentgen Ray Society. 3 The Distinguished History of Radiology at the University of Michigan As we celebrate the centennial of Roentgen's discovery of X-rays, it is appropriate to reflect on the events at the University of Michigan that arose from that discovery and on the significant influence the Department of Radiology subsequently had on the emergence of radiology as an important, scientific medical specialty. -
Neuroradiology Back to the Future: Brain Imaging
Published December 8, 2011 as 10.3174/ajnr.A2936 50TH ANNIVERSARY PERSPECTIVES Neuroradiology Back to the Future: Brain Imaging E.G. Hoeffner SUMMARY: The beginning of neuroradiology can be traced to the early 1900s with the use of skull S.K. Mukherji radiographs. Ventriculography and pneumoencephalography were introduced in 1918 and 1919, re- spectively, and carotid angiography, in 1927. Technical advances were made in these procedures A. Srinivasan during the next 40 years that lead to improved diagnosis of intracranial pathology. Yet, they remained D.J. Quint invasive procedures that were often uncomfortable and associated with significant morbidity. The introduction of CT in 1971 revolutionized neuroradiology. Ventriculography and pneumoencephalogra- phy were rendered obsolete. The imaging revolution continued with the advent of MR imaging in the early 1980s. Noninvasive angiographic techniques have curtailed the use of conventional angiography, and physiologic imaging gives us a window into the function of the brain. In this historical review, we will trace the origin and evolution of the advances that have led to the quicker, less invasive diagnosis and resulted in more rapid therapy and improved outcomes. ABBREVIATIONS: CPA ϭ cerebellopontine angle; EDH ϭ epidural hematoma; LP ϭ lumbar punc- ture; NMR ϭ nuclear magnetic resonance; SDH ϭ subdural hematoma fforts to image the CNS began with skull radiographs duced by trauma, surgery, or infection.3 Skull radiographs Eshortly after Roentgen’s discovery of x-rays.1-3 In the early were also used to diagnose fractures and foreign bodies.9 20th century, contrast studies of the brain, by using air for Obtaining a single skull radiograph took minutes, with the contrast, were developed with the introduction of ventriculog- radiograph being produced on a glass plate with a slowly re- raphy and pneumoencephalography.4,5 Shortly thereafter, ce- sponding photographic emulsion. -
Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy
Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy Proceedings of an international conference held in Málaga, Spain, 26–30 March 2001, organized by the International Atomic Energy Agency and co-sponsored by the European Commission, the Pan American Health Organization and the World Health Organization RADIOLOGICAL PROTECTION OF PATIENTS IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE AND RADIOTHERAPY a PROCEEDINGS SERIES RADIOLOGICAL PROTECTION OF PATIENTS IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE AND RADIOTHERAPY PROCEEDINGS OF AN INTERNATIONAL CONFERENCE HELD IN MÁLAGA, SPAIN, 26–30 MARCH 2001, ORGANIZED BY THE INTERNATIONAL ATOMIC ENERGY AGENCY AND CO-SPONSORED BY THE EUROPEAN COMMISSION, THE PAN AMERICAN HEALTH ORGANIZATION AND THE WORLD HEALTH ORGANIZATION INTERNATIONAL ATOMIC ENERGY AGENCY VIENNA, 2001 c Permission to reproduce or translate the information contained in this publica- tion may be obtained by writing to the International Atomic Energy Agency, Wagramer Strasse 5, P.O. Box 100, A-1400 Vienna, Austria. © IAEA, 2001 VIC Library Cataloguing in Publication Data International Conference on Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy (2001 : Malaga, Spain) Radiological protection of patients in diagnostic and interventional radiol- ogy, nuclear medicine and radiotherapy : proceedings of an international con- ference held in Malaga, Spain, 26–30 March 2001 / organized by the International Atomic Energy Agency...[et al.]. — Vienna : The Agency, 2001. p. ; 24 cm. — (Proceedings series, ISSN 0074–1884) STI/PUB/1113 ISBN 92–0–101401–5 Includes bibliographical references. 1. Diagnosis, Radioscopic—Safety measures—Congresses. 2. Interventional radiology—Safety measures—Congresses. 3. Nuclear medicine—Safety measures—Congresses. -
Application of Recombinant Antibody Technology for the Development of Anti-Lipid Antibodies for Tuberculosis Diagnosis
APPLICATION OF RECOMBINANT ANTIBODY TECHNOLOGY FOR THE DEVELOPMENT OF ANTI-LIPID ANTIBODIES FOR TUBERCULOSIS DIAGNOSIS CONRAD CHAN EN ZUO NATIONAL UNIVERSITY OF SINGAPORE 2013 APPLICATION OF RECOMBINANT ANTIBODY TECHNOLOGY FOR THE DEVELOPMENT OF ANTI-LIPID ANTIBODIES FOR TUBERCULOSIS DIAGNOSIS CONRAD CHAN EN ZUO BSc. (Hons.), MRes. Imperial College London A THESIS SUBMITTED FOR THE DEGREE OF DOCTOR OF PHILOSOPHY DEPARTMENT OF MICROBIOLOGY NATIONAL UNIVERSITY OF SINGAPORE 2013 DECLARATION I hereby declare that this thesis is my original work and it has been written by me in its entirety. I have duly acknowledged all the sources of information which have been used in the thesis. This thesis has also not been submitted for any degree in any university previously __________________________ Conrad Chan En Zuo 5th August 2013 Acknowledgements Acknowledgements The work here would not have been possible without the assistance of so many people. Firstly, to A/Prof Paul MacAry and Dr. Brendon Hanson, my co- supervisors, thank you for your encouragement, advice, support and the opportunity to carry out research in a very exciting field. Also to my collaborators with whom I had the privilege of working with over these five years; From NUS: Dr Timothy Barkham, Dr Seah Geok Teng, Prof Markus Wenk, Dr Anne Bendt, Dr Amaury Cazenave-Gassiot; From FIND: Dr Gerd Michel, From Max Planck Institute Berlin: Prof Peter Seeberger & Sebastian Gotze, From Georgia: Dr Nestan Tukvadze and the staff of the TB Institute, Dr Mason Soule and Dr Mzia Kutateladze, I really appreciate the sharing of your scientific expertise and efforts. A special note of thanks to those in Georgia, who made my trip a real pleasure.