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RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY L 9: Medical Exposure - BSS (Potential exposure and investigation of accidental medical exposures) IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
TOPICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overview ,[object Object],[object Object]
Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 1: The BSS requirements IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
National Regulatory Authority ,[object Object],[object Object],[object Object]
Main International Institutions involved in Regulatory aspects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Regulatory aspects (I) ,[object Object],[object Object]
[object Object],[object Object],Regulatory aspects (II)
The Basic Safety Standards
Regulatory aspects (III) ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Structure of the BSS
Application Fields ,[object Object],[object Object],[object Object],[object Object],[object Object]
Responsibilities Main responsibilities: registrants and licensees employers  Subsidiary include: suppliers workers radiation protection officers medical practitioners & health professionals qualified experts, ethical review committees
Medical exposure responsibilities (I) ,[object Object],[object Object],[object Object]
Medical exposure responsibilities (II) ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Medical exposure responsibilities (III)
Radiation Protection Requirements - JUSTIFICATION (I) ,[object Object],[object Object],[object Object],[object Object]
Radiation Protection Requirements - JUSTIFICATION (II) ,[object Object],[object Object],[object Object]
Radiation Protection Requirements - JUSTIFICATION (III) ,[object Object],[object Object]
Radiation Protection Requirements - JUSTIFICATION (IV) ,[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (I) ,[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (II) ,[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (III) ,[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (IV) ,[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (V) ,[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION OF PROTECTION FOR MEDICAL EXPOSURES - DESIGN CONSIDERATIONS (VI) ,[object Object],[object Object],[object Object]
OPTIMIZATION -  DESIGN CONSIDERATIONS (VII) ,[object Object],[object Object],[object Object]
OPTIMIZATION -  OPERATIONAL CONSIDERATIONS (I) ,[object Object],[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  OPERATIONAL CONSIDERATIONS (II) ,[object Object],[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  OPERATIONAL CONSIDERATIONS (III) ,[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  OPERATIONAL CONSIDERATIONS (IV) ,[object Object],[object Object],[object Object],[object Object]
OPTIMIZATION -  CLINICAL DOSIMETRY ,[object Object]
OPTIMIZATION - QUALITY ASSURANCE (I) ,[object Object]
OPTIMIZATION -  QUALITY ASSURANCE (II) ,[object Object],[object Object],[object Object],[object Object],[object Object]
GUIDANCE LEVELS ,[object Object],[object Object],[object Object],[object Object]
ACCEPTABLE AND INTERVENTION (or investigation) LEVELS  +   intervention   level +   tolerated level guidance level -   tolerated level -   intervention level time ( Immediate action required ) ( Corrective action recommended ) test value
DOSE CONSTRAINTS FOR MEDICAL EXPOSURE ,[object Object]
Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 2: Investigation of accidental medical exposure  IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
Investigation of  exposure (B.S.S. II.29) ,[object Object],[object Object],[object Object]
Investigation of  exposure  (B.S.S. II.30) ,[object Object],[object Object],[object Object],[object Object]
Investigation of  exposure  (B.S.S. II.30) ,[object Object],[object Object],[object Object]
Potential exposure (I) ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Potential exposure (II)
Reduction of the probability and magnitude of accidental exposures  ,[object Object],[object Object],[object Object]
Potential exposures in the different stages of the installation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Potential exposures are relevant for the classification of areas  ,[object Object],[object Object],[object Object],[object Object]
Potential exposures are relevant for occupational dose monitoring  ,[object Object],[object Object]
Practical advice (I) ,[object Object],[object Object]
[object Object],[object Object],Practical advice (II)
Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 3: Accidental medical exposure  IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
Coronary angioplasty twice in a day followed by  bypass graft because of complication. Dose    20 Gy (ICRP 85) (a)  6-8 weeks after multiple coronary angiography and angioplasty procedures. (b)  16-21 weeks  (c)  18-21 months after the procedures showing tissue necrosis . (d)  Close-up photograph of the lesion shown in (c). (e)  Photograph after skin grafting. (Photographs courtesy of T. Shope & ICRP).
Photograph showing temporary epilation of the right occipital  region of the skull 5-6 weeks following embolization  (Courtesy W. Huda).   Regrowth (greyer than original) reported after 3 months.   Neuroradiology Trans-arterial embolization of para orbital AVM twice at a gap of 3 days  Total dose    8 Gy
Trans-jugular Intrahepatic Portosystemic Shunt - TIPS  - a) Sclerotic depigmented plaque with surrounding hyperpigmentation on the midback of a patient following three TIPS procedures.  These changes were present 2 years after the procedures and were described as typical of chronic radiodermatitis.  (Photograph from Nahass and Cornelius (1998). b) Ulcerating plaque with a rectangular area of surrounding hyperpigmentation on the midback (a) (b)
[object Object],[object Object],[object Object],Interventional radiology (I)
Interventional radiology (II) (occupational injuries) ,[object Object]
Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 4: Lessons learned and preventive actions IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
I.R.: recommendations for avoiding potential exposures (I) ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],I.R.: recommendations for avoiding potential exposures (II)
Discussion (I) ,[object Object]
Discussion (II) ,[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Where to Get More Information ,[object Object],[object Object],[object Object]
References (I) ,[object Object],[object Object],[object Object]
References (II) ,[object Object],[object Object],[object Object],[object Object]

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L09 Med Exp Bss

  • 1. RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY L 9: Medical Exposure - BSS (Potential exposure and investigation of accidental medical exposures) IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
  • 2.
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  • 4. Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 1: The BSS requirements IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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  • 9. The Basic Safety Standards
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  • 13. Responsibilities Main responsibilities: registrants and licensees employers Subsidiary include: suppliers workers radiation protection officers medical practitioners & health professionals qualified experts, ethical review committees
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  • 36. ACCEPTABLE AND INTERVENTION (or investigation) LEVELS + intervention level + tolerated level guidance level - tolerated level - intervention level time ( Immediate action required ) ( Corrective action recommended ) test value
  • 37.
  • 38. Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 2: Investigation of accidental medical exposure IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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  • 50. Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 3: Accidental medical exposure IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
  • 51. Coronary angioplasty twice in a day followed by bypass graft because of complication. Dose  20 Gy (ICRP 85) (a) 6-8 weeks after multiple coronary angiography and angioplasty procedures. (b) 16-21 weeks (c) 18-21 months after the procedures showing tissue necrosis . (d) Close-up photograph of the lesion shown in (c). (e) Photograph after skin grafting. (Photographs courtesy of T. Shope & ICRP).
  • 52. Photograph showing temporary epilation of the right occipital region of the skull 5-6 weeks following embolization (Courtesy W. Huda). Regrowth (greyer than original) reported after 3 months. Neuroradiology Trans-arterial embolization of para orbital AVM twice at a gap of 3 days Total dose  8 Gy
  • 53. Trans-jugular Intrahepatic Portosystemic Shunt - TIPS - a) Sclerotic depigmented plaque with surrounding hyperpigmentation on the midback of a patient following three TIPS procedures. These changes were present 2 years after the procedures and were described as typical of chronic radiodermatitis. (Photograph from Nahass and Cornelius (1998). b) Ulcerating plaque with a rectangular area of surrounding hyperpigmentation on the midback (a) (b)
  • 54.
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  • 56. Part 9: Medical exposure - BSS (Potential exposure and investigation of accidental medical exposures) Topic 4: Lessons learned and preventive actions IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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