MPM-D - Special Session: Medical Health Physics Orange A 15:00 - 16:30
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| Chair(s): Bryan Lemieux
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MPM-D.1
15:00 Medical Radiation Exposure of Patients in the United States J Bushberg*, NCRP
; K Held, NCRP; F Mettler, University of New Mexico; M Mahesh, Johns Hopkins University School of Medicine,; D Miller, US Food and Drug Administration; M Bhargavan Chatfield, American Collage of Radiology; D Frush, Stanford Children's Hospital; G Guebert, Logan University; M Milano, University of Rochester; C Chambers, Penn State University College of Medicine
Abstract: The NCRP report 160 (2009) demonstrated the rapid and dramatic increase in diagnostic and interventional patient medical radiation exposures between early 1980 up to 2006. The report led to the examination of medical radiation exposures by many groups both in the United States and Internationally. NCRP SC 4-9 formed in 2016 was charged to prepare a report to evaluate changes in medical x-ray exposure since NCRP 160. The charge to the committee was to assess the number and types of medical x-ray procedures, the average per caput and collective effective doses and the changes since 2006. Even though NCRP 160 was published in 2009, the data was as of 2006. From the onset, the committee members agreed to report effective dose values only for the various medical x-ray procedures and decided not to include organ doses and not include radiation therapy procedures. Details on how the peer reviewed data was collected and analyzed to derive effective dose values for various medical x-ray procedures will be discussed. The publication of new tissue weighting factors (ICRP 103) can result in some confusion and the committee decided to compute collective effective doses using both ICRP 60 and ICRP 103 weighting factors. This was done in order to compare the final results with that of NCRP 160 and to examine the impact of the most recent tissue weighting factors. The process can be broadly examined as an assessment phase, collecting phase and deriving or documentation phase. During assessment and collecting phases, there was extensive literature review as well as use of commercial and government data sources to estimate the number of medical x-ray imaging procedures. Details of the three phases will be presented. Also, limitations and challenges in preparing the report will be discussed. Currently, the report is under review phase and the results will be released shortly by NCRP.
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MPM-D.2
15:30 Past, present and future of patient radiation dose management efforts - has progress been made? CB Martel*, Philips Healthcare
Abstract: Ten plus years have now passed since the initial revelation that medical imaging in the healthcare industry had largely ignored radiation doses delivered to patients, and thus, did not consider the continuous increase in population exposure or impact on individual health. Since the public outcry began, we have seen the promulgation of state regulations, new standards from the Joint Commission, new requirements placed on manufacturers such as the XR29 standard, and industry-sponsored programs such as Image Wisely and Image Gently. This focus also resulted in the establishment of dose tracking as a business which has enabled hospitals to track and trend radiation dose delivery performance and allowed comparisons between institutions across the US. The result of such attempts to understand dose delivery and reduce patient exposure has seen some success in areas such as dose reduction in CT; we have seen a 20% reduction in dose metrics for many protocols commonly used in CT departments. However, we have not seen similar success in other imaging modalities including digital radiography, fluoroscopy and mammography. This presentation will examine the efforts that have been put forth in these areas, the successes achieved, the others for which we are still waiting for signs of improvement, and a look towards the future of dose management.
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MPM-D.3
16:00 International Atomic Energy Agency’s (IAEA) Efforts to Improve Radiation Protection and Patient Safety DB Gilley*, IAEA
Abstract: Medical advancement with the use of radiation is improving patient outcomes. However, with this rapid advancement in uses, there has been an increase in the number of medical events, some have led to patient injuries. The IAEA Radiation Protection of Patients Unit (RPOP) focuses its efforts on the patient. RPOP provides resources to improve understanding of the radiation principles of justification, optimization and dose constraints as described in ICRP103[1]. This is accomplished through development of standards[2], safety guides[3], training and education and developing tools to address radiation protection and safety of the patient. The results of the work has increased the international visibility of RPOP as a leader in radiation protection of patients and it is consistently one of the top three websites within the IAEA. The presentation will highlight the information available and provide participants with information they can use to promote radiation protection and patient safety.
1. ICRP, 2007. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP 37 (2-4)
2. EUROPEAN COMMISSION, FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS, INTERNATIONAL ATOMIC ENERGY AGENCY, INTERNATIONAL LABOUR ORGANIZATION, OECD NUCLEAR ENERGY AGENCY, PAN AMERICAN HEALTH ORGANIZATION, UNITED NATIONS ENVIRONMENT PROGRAMME, WORLD HEALTH ORGANIZATION, Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards, IAEA Safety Standards Series No. GSR Part 3, IAEA, Vienna (2014).
3. INTERNATIONAL ATOMIC ENERGY AGENCY, Radiation Protection and Safety in Medical Uses of Ionizing Radiation, IAEA Safety Standards Series No. SSG-46, IAEA, Vienna (2018).
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MPM-D.4
16:15 Discussion B Lemieux*, UK HealthCare
Abstract: - This discussion session follows the 2 special session talks -
In light of the evolving nature of with respect to medical radiation exposures, including an increased focus on tracking of patient radiation doses from procedures, what can we as medical radiation safety professionals do to interface effectively with providers? What tools and input can we bring to the table in making sense of and managing patient radiation dose?
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