Pub Date : 2023-01-04DOI: 10.1051/radiopro/2022039
M. Benamar, A. Housni, S. Sadiki, K. Amazian, A. Essahlaoui, A. Labzour
Facing the inflation of the number of irradiating radiological examinations, particularly in Computed Tomography (CT), several countries in the world have resorted to diagnostic reference levels (DRLs), below which dosimetric values must be kept or else corrective actions will be infligated. In Morocco, in the absence of national diagnostic reference levels, we proposed to evaluate the professional practice in CT by recording the radiation doses values delivered to adult patients and comparing the 75th percentile values of the dosimetric indicators (CTDIvol and DLP) per acquisition to the international published values of DRLs, in order to judge the need for optimization of CT examination protocols. The 75th percentile values in terms of CTDIvol for head, chest, abdomen-pelvis, chest- abdomen-pelvis, and lumbar examinations were respectively 57.7, 11.1, 11.3, 11.6 and 20 mGy. In terms of DLP, the 75th percentile values were 1250.4, 392.2, 517.1, 833.27 and 707.37 mGy.cm, for the mentioned type of examinations. These results prompt us to make corrections to the used protocols and to ensure a more rigorous follow-up of the radiation protection principles with particular attention to the principle of dose optimization in order to establish a good practice in CT.
{"title":"Patient dose assessment in Computed Tomography in a Moroccan imaging department","authors":"M. Benamar, A. Housni, S. Sadiki, K. Amazian, A. Essahlaoui, A. Labzour","doi":"10.1051/radiopro/2022039","DOIUrl":"https://doi.org/10.1051/radiopro/2022039","url":null,"abstract":"Facing the inflation of the number of irradiating radiological examinations, particularly in Computed Tomography (CT), several countries in the world have resorted to diagnostic reference levels (DRLs), below which dosimetric values must be kept or else corrective actions will be infligated. \u0000In Morocco, in the absence of national diagnostic reference levels, we proposed to evaluate the professional practice in CT by recording the radiation doses values delivered to adult patients and comparing the 75th percentile values of the dosimetric indicators (CTDIvol and DLP) per acquisition to the international published values of DRLs, in order to judge the need for optimization of CT examination protocols. \u0000The 75th percentile values in terms of CTDIvol for head, chest, abdomen-pelvis, chest- abdomen-pelvis, and lumbar examinations were respectively 57.7, 11.1, 11.3, 11.6 and 20 mGy. In terms of DLP, the 75th percentile values were 1250.4, 392.2, 517.1, 833.27 and 707.37 mGy.cm, for the mentioned type of examinations. \u0000These results prompt us to make corrections to the used protocols and to ensure a more rigorous follow-up of the radiation protection principles with particular attention to the principle of dose optimization in order to establish a good practice in CT. \u0000","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74804556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-04DOI: 10.1051/radiopro/2022042
Shubayr
The monitoring of radiation workers’ (RWs) occupational doses resulting from working in different applications is essential to comply with the recommended dose limit (20 mSv) and to establish a reference level for the annual occupational dose. In this study, the thermoluminescent dosimeter (TLD) records of 58,156 RWs in the medical and industrial fields were collected and analysed to assess the annual occupational dose—in terms of mean annual effective dose (AMED). The RWs in the medical field included workers in diagnostic radiology (DR), nuclear medicine (NM), radiotherapy (RT), dentistry (Dent.), interventional radiology (IR), and operating rooms (OR). The RWs in the industrial field included road industry workers who used nuclear moisture density gauges (PCRI), workers in the phosphate mining industry (PMI), and workers in cyclotron facilities (CF). The AMED ± SD was 0.88 ± 0.56 mSv for DR, 1.22 ± 1.01 mSv for NM, 0.73 ± 0.49 mSv for RT, 0.78 ± 0.48 mSv for Dent., 0.89 ± 0.57 mSv for IR, 0.59 ± 0.45 mSv for OR, 0.80 ± 0.46 mSv for PCRI, 0.66 ± 0.45 mSv for PMI, and 1.60 ± 1.46 mSv for CF. The results showed significant differences in the AMEDs among the workers (p = 0.001). The highest AMEDs in the medical and industrial fields were those of NM and CF workers, respectively. However, the AMEDs for the RWs in both fields were below the annual recommended occupational dose limit and 72% were below the public dose limit (1 mSv).
{"title":"Measurement of annual whole-body occupational radiation exposure in the medical and industrial fields in Saudi Arabia","authors":"Shubayr","doi":"10.1051/radiopro/2022042","DOIUrl":"https://doi.org/10.1051/radiopro/2022042","url":null,"abstract":"The monitoring of radiation workers’ (RWs) occupational doses resulting from working in different applications is essential to comply with the recommended dose limit (20 mSv) and to establish a reference level for the annual occupational dose. In this study, the thermoluminescent dosimeter (TLD) records of 58,156 RWs in the medical and industrial fields were collected and analysed to assess the annual occupational dose—in terms of mean annual effective dose (AMED). The RWs in the medical field included workers in diagnostic radiology (DR), nuclear medicine (NM), radiotherapy (RT), dentistry (Dent.), interventional radiology (IR), and operating rooms (OR). The RWs in the industrial field included road industry workers who used nuclear moisture density gauges (PCRI), workers in the phosphate mining industry (PMI), and workers in cyclotron facilities (CF). The AMED ± SD was 0.88 ± 0.56 mSv for DR, 1.22 ± 1.01 mSv for NM, 0.73 ± 0.49 mSv for RT, 0.78 ± 0.48 mSv for Dent., 0.89 ± 0.57 mSv for IR, 0.59 ± 0.45 mSv for OR, 0.80 ± 0.46 mSv for PCRI, 0.66 ± 0.45 mSv for PMI, and 1.60 ± 1.46 mSv for CF. The results showed significant differences in the AMEDs among the workers (p = 0.001). The highest AMEDs in the medical and industrial fields were those of NM and CF workers, respectively. However, the AMEDs for the RWs in both fields were below the annual recommended occupational dose limit and 72% were below the public dose limit (1 mSv).","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85255757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-04DOI: 10.1051/radiopro/2022032
Sh. Abolhadi, A. Parach, A. Mehdipour, P. Mehnati, AR. Sayadi
one of the methods to reduce breast radiation dose in chest CT exam is using the bismuth shield. Due to the fact that in CT tests, the breast dose is higher on the central axis of the body than on the sides, so in this study, a bismuth shield with variable thickness (outer half 1mm thick and inner half 2mm thick) was designed. the objective of this study was to investigate effectiveness of silicon and 10% bismuth composite shied with variable thickness on reducing radiation dose and image quality parameters in chest CT scan test compared to fixed thickness shield with 1mm and 2mm. physical chest phantom underwent chest CT scan without and with bismuth shields with thickness of 1mm, 2mm and variable in 90, 120 and 140 kVp in inactive TCM mode. Dosimetry was performed using TLD, and image quality was evaluated quantitatively (by drawing the ROI in the same identical parts of the images in image j, and then, calculation of noise, CT number, SNR and CNR) and qualitatively (by two experienced radiologists). designed bismuth shield with variable thickness in inner and outer side compared to 1 and 2mm thickness shields presented at 120 kVp had a significant difference in the amount of breast dose reduction (19% reduction), and at 140 kVp, all three bismuth shields resulted in a significant dose reduction almost similar to each other. At 120 kVp, the bismuth shield with variable thickness led to a significant change in CT numbers in the heart and lungs, but it did not have a significant effect on other image quality parameters. The bismuth shield with variable thickness can lead to better effectiveness in reducing breast dose without negative effects on image quality at 120 kVp, which requires further studies in this field.
{"title":"Evaluation of Silicon and 10% Bismuth Shield with variable thickness compared with constant thickness on the dose reduction and image quality during chest CT examination","authors":"Sh. Abolhadi, A. Parach, A. Mehdipour, P. Mehnati, AR. Sayadi","doi":"10.1051/radiopro/2022032","DOIUrl":"https://doi.org/10.1051/radiopro/2022032","url":null,"abstract":"one of the methods to reduce breast radiation dose in chest CT exam is using the bismuth shield. Due to the fact that in CT tests, the breast dose is higher on the central axis of the body than on the sides, so in this study, a bismuth shield with variable thickness (outer half 1mm thick and inner half 2mm thick) was designed. the objective of this study was to investigate effectiveness of silicon and 10% bismuth composite shied with variable thickness on reducing radiation dose and image quality parameters in chest CT scan test compared to fixed thickness shield with 1mm and 2mm. physical chest phantom underwent chest CT scan without and with bismuth shields with thickness of 1mm, 2mm and variable in 90, 120 and 140 kVp in inactive TCM mode. Dosimetry was performed using TLD, and image quality was evaluated quantitatively (by drawing the ROI in the same identical parts of the images in image j, and then, calculation of noise, CT number, SNR and CNR) and qualitatively (by two experienced radiologists). designed bismuth shield with variable thickness in inner and outer side compared to 1 and 2mm thickness shields presented at 120 kVp had a significant difference in the amount of breast dose reduction (19% reduction), and at 140 kVp, all three bismuth shields resulted in a significant dose reduction almost similar to each other. At 120 kVp, the bismuth shield with variable thickness led to a significant change in CT numbers in the heart and lungs, but it did not have a significant effect on other image quality parameters. The bismuth shield with variable thickness can lead to better effectiveness in reducing breast dose without negative effects on image quality at 120 kVp, which requires further studies in this field.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90583608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-04DOI: 10.1051/radiopro/2022034
A. Housni, O. ES-Samssar, B. Saoud, N. El Amrani, M. Malou, K. Amazian, A. Essahlaoui, A. Labzour
The objective of this work was to evaluate the knowledge of the professionals working in the operating room about the risks associated to exposure to X-rays, and the radiation protection practices. To meet this objective, we conducted a multicenter study in three Moroccan hospitals. Data collection was carried out with a self-administered questionnaire to the professionals. The results showed that more than a third of the participants ignore the ionizing nature of X-rays; and that the effects of exposure to ionizing radiation are related to cumulative dose. 3% of the participants were aware about the effective dose limit of ionizing radiation for workers for a year and the annual dose limits to the extremities or to the skin. 45.50% of participants had no knowledge about the most irradiating technique when using the amplifier; 58.21% felt that continuous fluoroscopy mode was the most irradiating. All of the participants declared the absence of a radiation protection referent, and did not use any written procedures guide for the most common radiological examinations in interventional imaging. Multidisciplinary cooperation, at least, between radiology staff and operating room staff appears imperative, and seems to strengthen the system of vigilance and protection against the harmful effects of ionizing radiation.
{"title":"Radiation protection in the operating room: \u0000Need for training, qualification and accompaniment for the professionals","authors":"A. Housni, O. ES-Samssar, B. Saoud, N. El Amrani, M. Malou, K. Amazian, A. Essahlaoui, A. Labzour","doi":"10.1051/radiopro/2022034","DOIUrl":"https://doi.org/10.1051/radiopro/2022034","url":null,"abstract":"The objective of this work was to evaluate the knowledge of the professionals working in the operating room about the risks associated to exposure to X-rays, and the radiation protection practices. To meet this objective, we conducted a multicenter study in three Moroccan hospitals. Data collection was carried out with a self-administered questionnaire to the professionals. The results showed that more than a third of the participants ignore the ionizing nature of X-rays; and that the effects of exposure to ionizing radiation are related to cumulative dose. 3% of the participants were aware about the effective dose limit of ionizing radiation for workers for a year and the annual dose limits to the extremities or to the skin. 45.50% of participants had no knowledge about the most irradiating technique when using the amplifier; 58.21% felt that continuous fluoroscopy mode was the most irradiating. All of the participants declared the absence of a radiation protection referent, and did not use any written procedures guide for the most common radiological examinations in interventional imaging. Multidisciplinary cooperation, at least, between radiology staff and operating room staff appears imperative, and seems to strengthen the system of vigilance and protection against the harmful effects of ionizing radiation.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83335764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1051/radiopro/2022030
A. Rump, C. Hermann, A. Lamkowski, M. Abend, M. Port
Early fallout is defined as the fallback to the earth’s surface of radioactive particles shortly after a nuclear detonation (often arbitrarily defined within 24 h). At the difference of wide spreading global fallout, early fallout mainly consists of larger particles that are often visible. The initial mixture is rich in short- and very short-lived radionuclides associated with a very high initial activity that decreases rapidly (in 7 h, the dose rate is reduced by 90%). The main danger of early fallout results from external irradiation by highly penetrating gamma-radiation that may cause acute radiation sickness. Only in the case of the thyroid, internal irradiation by the incorporation of radioiodine may prevail. The bombings of Hiroshima and Nagasaki are examples of airbursts with many fatalities by prompt effects (blast, burns, and initial ionizing radiations), but they produced little fallout. The nuclear test code-named Castle Bravo on the Marshall Islands (1954) did not have casualties by its blast, thermal or initial radiation effects, but the inhabitants of the nearby islands and the crew of a Japanese fisherboat (Lucky Dragon) were affected by large amounts of fallout. For the inhabitants of the Rongelap Atoll, the average dose from external irradiation was assessed at 1.6 Gy. From a clinical point of view, based on hematological data using the METREPOL classification system, the acute radiation syndrome can be categorized as mild (H1). Blood transfusions were not required, and antibiotics were not administered for prophylaxis or therapy of infections related to irradiation. The equivalent dose received by the thyroid resulted mainly from internal irradiation with 7.6 Gy. The major late effects were thyroid abnormalities, including thyroid failure, nodules, and malignant tumors. The 23 Japanese crewmen seem to have been irradiated by higher doses (2.9 Gy). Compared to the hematological data of the Rongelap victims, the evolution pattern over time is quite similar. Still, the absolute values of the cell counts are lower, and on average, the acute radiation syndrome can be categorized as rather moderate (H2). Considering the individual cases, data show a large interindividual variability, and the clinical severity category ranges from “no alterations” (H0) to severe (H3). Victims were treated with repeated blood transfusions and antibiotics. Several of them developed jaundice, and one of them died six months after the incident showing symptoms compatible with subacute liver failure. A radiochemical organ analysis revealed that only the bones were clearly contaminated with fission products. In the 1990s, many surviving crewmen were diagnosed with hepatitis C, incurred probably from blood transfusions that were often contaminated at the time, and died from hepatocellular carcinomas. Thyroid dysfunctions were not reported. The Castle Bravo case permits to study the health hazards resulting from early fallout independently from the prompt effe
{"title":"The properties and health hazards from early nuclear weapon fallout: The Castle Bravo incident revisited","authors":"A. Rump, C. Hermann, A. Lamkowski, M. Abend, M. Port","doi":"10.1051/radiopro/2022030","DOIUrl":"https://doi.org/10.1051/radiopro/2022030","url":null,"abstract":"Early fallout is defined as the fallback to the earth’s surface of radioactive particles shortly after a nuclear detonation (often arbitrarily defined within 24 h). At the difference of wide spreading global fallout, early fallout mainly consists of larger particles that are often visible. The initial mixture is rich in short- and very short-lived radionuclides associated with a very high initial activity that decreases rapidly (in 7 h, the dose rate is reduced by 90%). The main danger of early fallout results from external irradiation by highly penetrating gamma-radiation that may cause acute radiation sickness. Only in the case of the thyroid, internal irradiation by the incorporation of radioiodine may prevail. The bombings of Hiroshima and Nagasaki are examples of airbursts with many fatalities by prompt effects (blast, burns, and initial ionizing radiations), but they produced little fallout. The nuclear test code-named Castle Bravo on the Marshall Islands (1954) did not have casualties by its blast, thermal or initial radiation effects, but the inhabitants of the nearby islands and the crew of a Japanese fisherboat (Lucky Dragon) were affected by large amounts of fallout. For the inhabitants of the Rongelap Atoll, the average dose from external irradiation was assessed at 1.6 Gy. From a clinical point of view, based on hematological data using the METREPOL classification system, the acute radiation syndrome can be categorized as mild (H1). Blood transfusions were not required, and antibiotics were not administered for prophylaxis or therapy of infections related to irradiation. The equivalent dose received by the thyroid resulted mainly from internal irradiation with 7.6 Gy. The major late effects were thyroid abnormalities, including thyroid failure, nodules, and malignant tumors. The 23 Japanese crewmen seem to have been irradiated by higher doses (2.9 Gy). Compared to the hematological data of the Rongelap victims, the evolution pattern over time is quite similar. Still, the absolute values of the cell counts are lower, and on average, the acute radiation syndrome can be categorized as rather moderate (H2). Considering the individual cases, data show a large interindividual variability, and the clinical severity category ranges from “no alterations” (H0) to severe (H3). Victims were treated with repeated blood transfusions and antibiotics. Several of them developed jaundice, and one of them died six months after the incident showing symptoms compatible with subacute liver failure. A radiochemical organ analysis revealed that only the bones were clearly contaminated with fission products. In the 1990s, many surviving crewmen were diagnosed with hepatitis C, incurred probably from blood transfusions that were often contaminated at the time, and died from hepatocellular carcinomas. Thyroid dysfunctions were not reported. The Castle Bravo case permits to study the health hazards resulting from early fallout independently from the prompt effe","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76105945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1051/radiopro/2022037
M. Bourguignon
La Commission internationale de protection radiologique (CIPR) s’est récemment lancée dans un examen et une révision du système de protection radiologique qu’elle a établi et optimisé depuis sa fondation en 1928. La CIPR a publié la première déclaration d’intention correspondante dans un article intitulé «Keeping the ICRP recommandations fit for purpose » (Clément et al., 2021) qui ouvrira la voie à une nouvelle recommandation majeure devant remplacer dans quelques années la publication CIPR 103 (ICRP, 2007). Nous avons eu le plaisir de rendre cette récente déclaration disponible en français dans Radioprotection (Clément et al., 2022). Dans cet éditorial, nous souhaitons contribuer à la réflexion et aux collaborations attendues par la CIPR en proposant d’ériger le retour d’expérience en principe fondamental du système de protection radiologique afin de donner plus de force à ce pilier du système. En effet, l’idée première est de faire un retour d’expérience du système de radioprotection lui-même afin d’identifier précisément ses forces et ses faiblesses avant d’envisager une évolution. Les problèmes à résoudre sont nombreux, par exemple l’évaluation des risques après des expositions médicales d’organes spécifiques sur la base de leur dose absorbée et non sur la dose efficace, la radioprotection individualisée en raison des différences de réponse individuelle aux rayonnements ionisants (RI), la prise en compte de l’addition d’autres expositions à des facteurs génotoxiques à faibles doses (exposome) puisque leur association peut être délétère et qu’il peut être impossible d’évaluer le risque d’exposition aux RI à faible dose seul, etc. Les approches utilisées dans la protection contre les risques chimiques peuvent également apporter des enseignements pour le système de radioprotection. Ces évolutions sont parfois associées à des questionnements autres qu’en termes purement scientifiques, comme ceux sur l’éthique et l’équité de ce système. Par ailleurs, on peut aussi observer qu’un bon nombre d’articles traitant de problématiques de radioprotection aborde la question du retour d’expérience. Des exemples de retours d’expérience positifs sur la qualité de la radioprotection sont proposés dans ce numéro de Radioprotection : (i) la détermination des niveaux de référence diagnostiques nationaux pour la tomodensitométrie cérébrale chez l’enfant (Bawazeer et al., 2022), (ii) l’analyse de l’exposition externe des infirmières exerçant en médecine nucléaire utilisant un dosimètre personnel avec une fonction de tendance (Tsujiguchi et al., 2022), (iii) l’apport du « processus de co-expertise » dans la communication des risques dans la phase de réhabilitation après un accident nucléaire (Thu Zar et al., 2022). D’autres exemples pourraient être tirés des publications de ces derniers mois dans Radioprotection : (i) l’étude de référence des doctrines de gestion post-accidentelle nucléaire (Bertho et al., 2022), (ii) la pertinence du modèle linéaire sans seuil (LNT
国际辐射防护委员会(icrp)最近开始审查和修订其自1928年成立以来建立和优化的辐射防护系统。ICRP在一篇题为“保持ICRP建议有目的”的文章中发表了第一份相应的意向声明(clement et al.， 2021)，这将为一项新的主要建议铺平道路，该建议将在几年内取代ICRP 103 (ICRP, 2007)。我们很高兴在《辐射防护》(clement et al.， 2022)中提供了最近的法语声明。在这篇社论中，我们希望为icrp所期望的反思和合作作出贡献，建议将经验反馈作为辐射防护系统的基本原则，以加强该系统的这一支柱。事实上，最初的想法是对辐射防护系统本身进行反馈，以便在考虑进一步发展之前准确地确定其优缺点。需要解决的问题有很多，例如，根据特定器官的吸收剂量而不是有效剂量进行医疗照射后的风险评估，由于个人对电离辐射(ir)反应的差异而进行的个人辐射防护，考虑添加其他低剂量基因毒性因素(暴露体)，因为它们的组合可能是有害的，单独评估低剂量ir暴露的风险可能是不可能的，等等。用于防止化学危害的方法也可以为辐射防护系统提供指导。这些发展有时与纯粹科学术语以外的问题联系在一起，比如这个系统的伦理和公平性。此外，还可以观察到，许多关于辐射防护问题的文章都涉及经验反馈的问题。有关辐射防护质素的积极反馈，请参阅本期《辐射防护》:(i)测定基线水平的国家对于儿童的脑ct诊断(Bawazeer et al ., 2022年)、(二)分析外部照射对执业护士个人剂量仪在核医学与趋势函数(Tsujiguchi et al ., 2022年)、(三)注资的«co-expertise进程»在风险沟通的核事故后的康复阶段(Thu Zar et al ., 2022年)。其他例子可从最近几个月有关辐射防护的出版物中找到:(i)管理理论的基线研究核post-accidentelle Bertho et al .(2022年)、线性无阈值模型的相关性;(ii)(2000)对风险评估的放射治疗(Cosset 2022年)、(三)、辐射紧急情况的比较大规模的有关战略和Covid-19用来测试者biodosimétrie)的质量和PCR (2022 Swartz)等人,分别)。还确定了许多其他例子，所有这些例子都支持经验反馈原则作为辐射防护的基本原则。最后，icrp发起的辐射防护系统的发展应该通过一个动态的、迭代的质疑过程来丰富。我们欢迎就辐射防护系统、实施和未来可能的发展展开富有成果的讨论。
{"title":"Le retour d’expérience devrait être érigé en principe fondamental de la radioprotection / Experience feedback should be established as a fundamental principle of radiological protection","authors":"M. Bourguignon","doi":"10.1051/radiopro/2022037","DOIUrl":"https://doi.org/10.1051/radiopro/2022037","url":null,"abstract":"La Commission internationale de protection radiologique (CIPR) s’est récemment lancée dans un examen et une révision du système de protection radiologique qu’elle a établi et optimisé depuis sa fondation en 1928. La CIPR a publié la première déclaration d’intention correspondante dans un article intitulé «Keeping the ICRP recommandations fit for purpose » (Clément et al., 2021) qui ouvrira la voie à une nouvelle recommandation majeure devant remplacer dans quelques années la publication CIPR 103 (ICRP, 2007). Nous avons eu le plaisir de rendre cette récente déclaration disponible en français dans Radioprotection (Clément et al., 2022). Dans cet éditorial, nous souhaitons contribuer à la réflexion et aux collaborations attendues par la CIPR en proposant d’ériger le retour d’expérience en principe fondamental du système de protection radiologique afin de donner plus de force à ce pilier du système. En effet, l’idée première est de faire un retour d’expérience du système de radioprotection lui-même afin d’identifier précisément ses forces et ses faiblesses avant d’envisager une évolution. Les problèmes à résoudre sont nombreux, par exemple l’évaluation des risques après des expositions médicales d’organes spécifiques sur la base de leur dose absorbée et non sur la dose efficace, la radioprotection individualisée en raison des différences de réponse individuelle aux rayonnements ionisants (RI), la prise en compte de l’addition d’autres expositions à des facteurs génotoxiques à faibles doses (exposome) puisque leur association peut être délétère et qu’il peut être impossible d’évaluer le risque d’exposition aux RI à faible dose seul, etc. Les approches utilisées dans la protection contre les risques chimiques peuvent également apporter des enseignements pour le système de radioprotection. Ces évolutions sont parfois associées à des questionnements autres qu’en termes purement scientifiques, comme ceux sur l’éthique et l’équité de ce système. Par ailleurs, on peut aussi observer qu’un bon nombre d’articles traitant de problématiques de radioprotection aborde la question du retour d’expérience. Des exemples de retours d’expérience positifs sur la qualité de la radioprotection sont proposés dans ce numéro de Radioprotection : (i) la détermination des niveaux de référence diagnostiques nationaux pour la tomodensitométrie cérébrale chez l’enfant (Bawazeer et al., 2022), (ii) l’analyse de l’exposition externe des infirmières exerçant en médecine nucléaire utilisant un dosimètre personnel avec une fonction de tendance (Tsujiguchi et al., 2022), (iii) l’apport du « processus de co-expertise » dans la communication des risques dans la phase de réhabilitation après un accident nucléaire (Thu Zar et al., 2022). D’autres exemples pourraient être tirés des publications de ces derniers mois dans Radioprotection : (i) l’étude de référence des doctrines de gestion post-accidentelle nucléaire (Bertho et al., 2022), (ii) la pertinence du modèle linéaire sans seuil (LNT","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82240514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1051/radiopro/2022031
W. Thu Zar, J. Lochard, Y. Taira, N. Takamura, M. Orita, H. Matsunaga
Risk communication in post-nuclear accident situations faces many challenges related to the limited knowledge of experts about the actual situation in the affected communities, as well as of the affected people about radiological risk combined with their distrust of authorities and experts. In such an anxiety-provoking context, the co-expertise approach recommended by the ICRP combining technical expertise, citizen participation and two-way communication has shown that it was an effective approach for restoring trust between the experts and the people concerned and developing, among the latter, a practical radiological protection culture. In essence, technical-oriented risk communication is not sufficient alone. A dialogue with affected people is necessary in combination with measurements of radiation associated with their daily life in order to gain their participation in the co-expertise process and to progressively restore confidence in them and trust in authorities and experts. The article highlights the salient features of the co-expertise process in relation to risk communication.
{"title":"Risk communication in the recovery phase after a nuclear accident: the contribution of the “co-expertise process”","authors":"W. Thu Zar, J. Lochard, Y. Taira, N. Takamura, M. Orita, H. Matsunaga","doi":"10.1051/radiopro/2022031","DOIUrl":"https://doi.org/10.1051/radiopro/2022031","url":null,"abstract":"Risk communication in post-nuclear accident situations faces many challenges related to the limited knowledge of experts about the actual situation in the affected communities, as well as of the affected people about radiological risk combined with their distrust of authorities and experts. In such an anxiety-provoking context, the co-expertise approach recommended by the ICRP combining technical expertise, citizen participation and two-way communication has shown that it was an effective approach for restoring trust between the experts and the people concerned and developing, among the latter, a practical radiological protection culture. In essence, technical-oriented risk communication is not sufficient alone. A dialogue with affected people is necessary in combination with measurements of radiation associated with their daily life in order to gain their participation in the co-expertise process and to progressively restore confidence in them and trust in authorities and experts. The article highlights the salient features of the co-expertise process in relation to risk communication.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89669281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1051/radiopro/2022036
M. Ammerich, P. Barbey, L.-A. Beltrami, C. Bergeron, R. Bourdeloie, A. Cordelle, C. Guérin, D. LE DENMAT, L. Legrand, C. Luccioni, P. Ménéchal, S. Mora, D. Prieto, P. Romane, P. Sans, Y. Tancray, C. Tourneux, J. Trin, J. Vidal
En l’espace d’une cinquantaine d’année, la réglementation a fait de la personne compétente en radioprotection (PCR) l’acteur principal de la radioprotection dans les différents établissements mettant en œuvre des rayonnements ionisants pour assurer la protection des travailleurs – mais aussi depuis peu celle du public – notamment lors de l’utilisation de sources non scellées. La réglementation définit le rôle et les missions de la PCR, précise son articulation avec les autres acteurs et fixe les modalités de sa formation. Les fonctions de la PCR ont par ailleurs sensiblement évolué avec la création des conseillers en radioprotection (CRP). L’objectif de cet article est d’analyser et de comprendre l’évolution historique de la fonction de PCR, exercée actuellement par plus de 10 000 personnes en France, pour mieux en dégager les enjeux de demain.
{"title":"La personne compétente en radioprotection / le conseiller en radioprotection : historique, constats et enjeux","authors":"M. Ammerich, P. Barbey, L.-A. Beltrami, C. Bergeron, R. Bourdeloie, A. Cordelle, C. Guérin, D. LE DENMAT, L. Legrand, C. Luccioni, P. Ménéchal, S. Mora, D. Prieto, P. Romane, P. Sans, Y. Tancray, C. Tourneux, J. Trin, J. Vidal","doi":"10.1051/radiopro/2022036","DOIUrl":"https://doi.org/10.1051/radiopro/2022036","url":null,"abstract":"En l’espace d’une cinquantaine d’année, la réglementation a fait de la personne compétente en radioprotection (PCR) l’acteur principal de la radioprotection dans les différents établissements mettant en œuvre des rayonnements ionisants pour assurer la protection des travailleurs – mais aussi depuis peu celle du public – notamment lors de l’utilisation de sources non scellées. La réglementation définit le rôle et les missions de la PCR, précise son articulation avec les autres acteurs et fixe les modalités de sa formation. Les fonctions de la PCR ont par ailleurs sensiblement évolué avec la création des conseillers en radioprotection (CRP). L’objectif de cet article est d’analyser et de comprendre l’évolution historique de la fonction de PCR, exercée actuellement par plus de 10 000 personnes en France, pour mieux en dégager les enjeux de demain.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77726610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1051/radiopro/2022023
J. Cosset
Initially considered as a kind of radiobiological law, the linear no-threshold (LNT) model, which by definition supports the absence of any threshold for cancer risk induction after irradiation, is nowadays more reasonably described as a pragmatic and prudent approach by the International Organizations. However, it remains today a dogma in radiological protection. Actually, this model had been essentially developed for the radiological protection of a general population against low, and sometimes very low, doses of irradiation. Radiation oncologists are dealing with a totally different situation since they deliver, on purpose, high doses of radiations in more or less limited volumes of the body of cancer patients, patients for whom no other alternatives do exist to get rid of their malignant tumors. Simultaneously, the radiation oncologists inevitably give low and even very low doses at distance from the so-called target volumes. In such a specific situation, what is the carcinogenicity of these low doses and the relevance of the LNT model in radiotherapy? Thus, this paper addresses three critical questions: 1) what is the risk acceptability of the radiation doses delivered by radiotherapy of malignant tumors? 2) what is the real carcinogenic risk of (very) low doses delivered at distance from the target volume? 3) are the clinical radiotherapy data, i.e., the number of second primary cancers, accumulated since more than a century, consistent with the LNT model? In conclusion, the LNT model appears to be poorly adapted to the high doses locally delivered to cancer patients and dramatically overestimates, in most cases, the risk of secondary radio-induced cancers. In fine, the real risk of the LNT model in radiotherapy would be to promote radiophobia in cancer patients and to see some of them turning away from a life-saving treatment.
{"title":"Is the linear no-threshold (LNT) model relevant for radiotherapy?","authors":"J. Cosset","doi":"10.1051/radiopro/2022023","DOIUrl":"https://doi.org/10.1051/radiopro/2022023","url":null,"abstract":"Initially considered as a kind of radiobiological law, the linear no-threshold (LNT) model, which by definition supports the absence of any threshold for cancer risk induction after irradiation, is nowadays more reasonably described as a pragmatic and prudent approach by the International Organizations. However, it remains today a dogma in radiological protection. Actually, this model had been essentially developed for the radiological protection of a general population against low, and sometimes very low, doses of irradiation. Radiation oncologists are dealing with a totally different situation since they deliver, on purpose, high doses of radiations in more or less limited volumes of the body of cancer patients, patients for whom no other alternatives do exist to get rid of their malignant tumors. Simultaneously, the radiation oncologists inevitably give low and even very low doses at distance from the so-called target volumes. In such a specific situation, what is the carcinogenicity of these low doses and the relevance of the LNT model in radiotherapy? Thus, this paper addresses three critical questions: 1) what is the risk acceptability of the radiation doses delivered by radiotherapy of malignant tumors? 2) what is the real carcinogenic risk of (very) low doses delivered at distance from the target volume? 3) are the clinical radiotherapy data, i.e., the number of second primary cancers, accumulated since more than a century, consistent with the LNT model? In conclusion, the LNT model appears to be poorly adapted to the high doses locally delivered to cancer patients and dramatically overestimates, in most cases, the risk of secondary radio-induced cancers. In fine, the real risk of the LNT model in radiotherapy would be to promote radiophobia in cancer patients and to see some of them turning away from a life-saving treatment.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87588428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1051/radiopro/2022009
N. Shubayr, N. Alomairy
Trauma is one of the major indications for admission to the emergency department (ED) and Computed Tomography (CT) scan requests. Understanding of CT utilization is important to reduce unnecessary imaging and radiation exposure. This study aimed to examine the utilization pattern of CT scans for trauma patients in the ED and how often traumatic abnormalities occurred. A retrospective study was conducted over a one-year period. Data for patients who were admitted to the ED and underwent CT scans for trauma indications, type of CT procedure performed, findings, and prior radiography were collected from the picture archiving and communication system. A total of 881 trauma patients underwent a CT scan as part of their investigation. Abnormalities were identified in 527 (59.9%) of cases and proportional with prior radiography [828 (94%)]. Different types of CT procedures were performed, as requested by the ED physicians, including 450 CT scans of the head, 188 for the spine, 93 for the chest, 45 CT CAP, 29 for the whole-body, 22 for the pelvis, 16 for the chest and abdomen, 13 for the extremities, and 11 for the abdomen. CT of the head was the most common procedure performed for trauma patients with 55% positive findings and may represent an opportunity for reduction of the use of CT scans, taking into consideration validated clinical decision rules. For multiple-trauma patients, a clearly defined criterion must be established to determine which CT procedure is required for these patients based on clinical indications and presentations. Therefore, for better radiation protection practices, a review and improvement of CT protocols, as well as justification and optimization, should be considered for utilization of CT scans for trauma patients.
创伤是急诊科(ED)入院和计算机断层扫描(CT)请求的主要指征之一。了解CT的使用对于减少不必要的成像和辐射暴露是很重要的。本研究旨在探讨CT扫描在急诊科创伤患者中的应用模式以及创伤异常发生的频率。一项为期一年的回顾性研究进行了。从图像存档和通信系统中收集入急诊科并接受创伤指征、CT手术类型、结果和既往x线片扫描的患者的数据。作为调查的一部分，共有881名创伤患者接受了CT扫描。527例(59.9%)的病例发现了异常，与先前的x线摄影成正比[828例(94%)]。根据急诊科医生的要求，进行了不同类型的CT检查，包括头部450次CT扫描，脊柱188次，胸部93次，CT CAP 45次，全身29次，骨盆22次，胸部和腹部16次，四肢13次，腹部11次。头部CT检查是创伤患者最常用的检查方法，有55%的阳性结果，考虑到有效的临床决策规则，这可能意味着减少CT扫描的使用。对于多发创伤患者，必须建立一个明确定义的标准，根据临床适应症和表现来确定这些患者需要进行哪种CT检查。因此，为了更好的辐射防护实践，应考虑对CT方案的审查和改进，以及对CT扫描在创伤患者中的应用进行论证和优化。
{"title":"An analysis of trauma-related CT utilization and abnormal findings in emergency department: a one-year retrospective study","authors":"N. Shubayr, N. Alomairy","doi":"10.1051/radiopro/2022009","DOIUrl":"https://doi.org/10.1051/radiopro/2022009","url":null,"abstract":"Trauma is one of the major indications for admission to the emergency department (ED) and Computed Tomography (CT) scan requests. Understanding of CT utilization is important to reduce unnecessary imaging and radiation exposure. This study aimed to examine the utilization pattern of CT scans for trauma patients in the ED and how often traumatic abnormalities occurred. A retrospective study was conducted over a one-year period. Data for patients who were admitted to the ED and underwent CT scans for trauma indications, type of CT procedure performed, findings, and prior radiography were collected from the picture archiving and communication system. A total of 881 trauma patients underwent a CT scan as part of their investigation. Abnormalities were identified in 527 (59.9%) of cases and proportional with prior radiography [828 (94%)]. Different types of CT procedures were performed, as requested by the ED physicians, including 450 CT scans of the head, 188 for the spine, 93 for the chest, 45 CT CAP, 29 for the whole-body, 22 for the pelvis, 16 for the chest and abdomen, 13 for the extremities, and 11 for the abdomen. CT of the head was the most common procedure performed for trauma patients with 55% positive findings and may represent an opportunity for reduction of the use of CT scans, taking into consideration validated clinical decision rules. For multiple-trauma patients, a clearly defined criterion must be established to determine which CT procedure is required for these patients based on clinical indications and presentations. Therefore, for better radiation protection practices, a review and improvement of CT protocols, as well as justification and optimization, should be considered for utilization of CT scans for trauma patients.","PeriodicalId":21009,"journal":{"name":"Radioprotection","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79195586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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