Pub Date : 2023-12-01DOI: 10.1177/01466453241241770
Akira Endo
{"title":"A KEY ELEMENT OF INTERNAL DOSIMETRY FOR MEMBERS OF THE PUBLIC.","authors":"Akira Endo","doi":"10.1177/01466453241241770","DOIUrl":"10.1177/01466453241241770","url":null,"abstract":"","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1177/01466453231210646
<p><p>Use of medical imaging continues to increase, making the largest contribution to the exposure of populations from artificial sources of radiation worldwide. The principle of optimisation of protection is that 'the likelihood of incurring exposures, the number of people exposed, and the magnitude of their individual doses should all be kept as low as reasonably achievable (ALARA), taking into account economic and societal factors'. Optimisation for medical imaging involves more than ALARA - it requires keeping individual patient exposures to the minimum necessary to achieve the required medical objectives. In other words, the type, number, and quality of images must be adequate to obtain the information needed for diagnosis or intervention. Dose reductions for imaging or x-ray-image-guided procedures should not be used if they degrade image quality to the point where the images are inadequate for the clinical purpose. The move to digital imaging has provided versatile acquisition, post-processing, and presentation options, and enabled wide and often immediate availability of image information. However, because images are adjusted for optimal viewing, the appearance may not give any indication if the dose is higher than necessary. Nevertheless, digital images provide opportunities for further optimisation, and allow the application of artificial intelligence methods.Optimisation of radiological protection for digital radiology (radiography, fluoroscopy, and computed tomography) involves selection and installation of equipment, design and construction of facilities, choice of optimal equipment settings, day-to-day methods of operation, quality control programmes, and ensuring that all personnel receive proper initial and career-long training. The radiation dose levels that patients receive also have implications for doses to staff. As new imaging equipment incorporates more options to improve performance, it becomes more complex and less easily understood, so operators have to be given more extensive training. Ongoing monitoring, review, and analysis of performance is required that feeds back into the improvement and development of imaging protocols. Several different aspects relating to optimisation of protection that need to be developed are set out in this publication. The first is collaboration between radiologists/other radiological medical practitioners, radiographers/medical radiation technologists, and medical physicists, each of whom have key skills that can only contribute to the process effectively when individuals work together as a core team. The second is appropriate methodology and technology, with the knowledge and expertise required to use each effectively. The third relates to organisational processes which ensure that required tasks, such as equipment performance tests, patient dose surveys, and review of protocols, are carried out. There is wide variation in equipment, funding, and expertise around the world, and the majori
医学影像的使用持续增加,是全球人口受人工辐射源照射的最大来源。优化防护的原则是 "考虑到经济和社会因素,发生辐照的可能性、受辐照的人数及其个人剂量的大小都应保持在可合理达到的最低水平(ALARA)"。医学成像的优化不仅仅涉及 ALARA - 它要求将患者的个人暴露量控制在实现所需的医学目标所需的最低水平。换句话说,图像的类型、数量和质量必须足以获取诊断或干预所需的信息。如果降低成像或 X 射线成像引导程序的剂量会降低图像质量,以至于图像无法满足临床目的,则不应使用这种方法。数字成像技术的发展提供了多样化的采集、后处理和显示选项,并使图像信息的获取范围更广,而且往往可以立即获得。然而,由于图像经过调整以达到最佳观看效果,因此外观可能无法显示剂量是否高于所需的剂量。然而,数字图像为进一步优化提供了机会,并允许应用人工智能方法。数字放射学(射线照相术、透视和计算机断层扫描)放射防护的优化涉及设备的选择和安装、设施的设计和建造、最佳设备设置的选择、日常操作方法、质量控制计划,以及确保所有人员接受适当的初始和终身培训。患者接受的辐射剂量水平也会对工作人员的剂量产生影响。由于新的成像设备采用了更多的选项来提高性能,因此变得更加复杂和不易理解,因此必须对操作人员进行更广泛的培训。需要对性能进行持续监测、审查和分析,并将其反馈到成像方案的改进和发展中。本出版物阐述了与优化保护有关的几个需要发展的不同方面。首先是放射科医生/其他放射医疗从业人员、放射技师/医疗放射技术人员和医学物理学家之间的合作,他们每个人都拥有关键技能,只有当个人作为核心团队一起工作时,才能有效地促进这一过程。其次是适当的方法和技术,以及有效使用每种方法和技术所需的知识和专业技能。第三是组织流程,确保设备性能测试、患者剂量调查和协议审查等必要任务得以执行。世界各地在设备、资金和专业知识方面存在很大差异,大多数医疗机构并不具备所有工具、专业团队和专业知识,无法完全掌握优化的所有可能性。因此,本出版物为不同设施可能实现的优化方面设定了大致的等级,它们可以通过这些等级逐步实现优化:D 级--初步;C 级--基础;B 级--中级;A 级--高级。专业协会提供的指导对于帮助用户评估系统和采用最佳实践非常有价值。本手册列举了为达到不同级别而应建立的系统和开展的活动。成像机构可以对其已有的安排进行评估,并利用本出版物指导决定优化成像服务的下一步行动。
{"title":"Optimisation of Radiological Protection in Digital Radiology Techniques for Medical Imaging.","authors":"","doi":"10.1177/01466453231210646","DOIUrl":"https://doi.org/10.1177/01466453231210646","url":null,"abstract":"<p><p>Use of medical imaging continues to increase, making the largest contribution to the exposure of populations from artificial sources of radiation worldwide. The principle of optimisation of protection is that 'the likelihood of incurring exposures, the number of people exposed, and the magnitude of their individual doses should all be kept as low as reasonably achievable (ALARA), taking into account economic and societal factors'. Optimisation for medical imaging involves more than ALARA - it requires keeping individual patient exposures to the minimum necessary to achieve the required medical objectives. In other words, the type, number, and quality of images must be adequate to obtain the information needed for diagnosis or intervention. Dose reductions for imaging or x-ray-image-guided procedures should not be used if they degrade image quality to the point where the images are inadequate for the clinical purpose. The move to digital imaging has provided versatile acquisition, post-processing, and presentation options, and enabled wide and often immediate availability of image information. However, because images are adjusted for optimal viewing, the appearance may not give any indication if the dose is higher than necessary. Nevertheless, digital images provide opportunities for further optimisation, and allow the application of artificial intelligence methods.Optimisation of radiological protection for digital radiology (radiography, fluoroscopy, and computed tomography) involves selection and installation of equipment, design and construction of facilities, choice of optimal equipment settings, day-to-day methods of operation, quality control programmes, and ensuring that all personnel receive proper initial and career-long training. The radiation dose levels that patients receive also have implications for doses to staff. As new imaging equipment incorporates more options to improve performance, it becomes more complex and less easily understood, so operators have to be given more extensive training. Ongoing monitoring, review, and analysis of performance is required that feeds back into the improvement and development of imaging protocols. Several different aspects relating to optimisation of protection that need to be developed are set out in this publication. The first is collaboration between radiologists/other radiological medical practitioners, radiographers/medical radiation technologists, and medical physicists, each of whom have key skills that can only contribute to the process effectively when individuals work together as a core team. The second is appropriate methodology and technology, with the knowledge and expertise required to use each effectively. The third relates to organisational processes which ensure that required tasks, such as equipment performance tests, patient dose surveys, and review of protocols, are carried out. There is wide variation in equipment, funding, and expertise around the world, and the majori","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1177/01466453241228680
Ehsan Samei, Christopher H Clement
{"title":"Optimisation of Protection in Medical Imaging: Necessary, Challenging, and Possible.","authors":"Ehsan Samei, Christopher H Clement","doi":"10.1177/01466453241228680","DOIUrl":"https://doi.org/10.1177/01466453241228680","url":null,"abstract":"","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/01466453231211064
Christopher H Clement
{"title":"ICRP 2021<sup>+1</sup>: THE SIXTH INTERNATIONAL SYMPOSIUM ON THE SYSTEM OF RADIOLOGICAL PROTECTION.","authors":"Christopher H Clement","doi":"10.1177/01466453231211064","DOIUrl":"10.1177/01466453231211064","url":null,"abstract":"","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/01466453231211068
H Ogino
The International Commission on Radiological Protection (ICRP) is recognised as the de-facto world authority in the field of radiological protection. The ICRP Recommendations have been used as a basis for regulations and policy in almost every country, and with the current review and revision of the System of Radiological Protection, it will continue to make significant contributions in radiation safety for patients, workers, the public, and the environment. In a society undergoing significant change, it is necessary to give careful thought to which groups will be perceived as authoritative organisations by the constituents of the future. The ideal form of an authoritative organisation in the new society of the future is to continue to show how it came to make such recommendations, how it reflected the opinions of interested parties in the process, and how it discloses its records with as much transparency as possible. The question now is what we must do to ensure that decision-making advances in a way that not only makes sense to the present generation, but will be easily consumed by future generations. The path that ICRP is taking to formulate the next set of General Recommendations is doing just that, in line with the key procedural values of INCLUSIVE, ACCOUNTABLE, AND TRANSPARENT.
{"title":"The 2021 Bo Lindell Lecture: Inclusive, accountable, transparent: the direction we should take for the benefit of present and future generations.","authors":"H Ogino","doi":"10.1177/01466453231211068","DOIUrl":"10.1177/01466453231211068","url":null,"abstract":"<p><p>The International Commission on Radiological Protection (ICRP) is recognised as the de-facto world authority in the field of radiological protection. The ICRP Recommendations have been used as a basis for regulations and policy in almost every country, and with the current review and revision of the System of Radiological Protection, it will continue to make significant contributions in radiation safety for patients, workers, the public, and the environment. In a society undergoing significant change, it is necessary to give careful thought to which groups will be perceived as authoritative organisations by the constituents of the future. The ideal form of an authoritative organisation in the new society of the future is to continue to show how it came to make such recommendations, how it reflected the opinions of interested parties in the process, and how it discloses its records with as much transparency as possible. The question now is what we must do to ensure that decision-making advances in a way that not only makes sense to the present generation, but will be easily consumed by future generations. The path that ICRP is taking to formulate the next set of General Recommendations is doing just that, in line with the key procedural values of <u>I</u>NCLUSIVE, A<u>C</u>COUNTABLE, AND T<u>R</u>ANS<u>P</u>ARENT.</p>","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/01466453231211216
L Hafner, L Walsh, W Rühm
The most recent publicly available data on all solid cancer incidence from the Life Span Study (LSS) of Japanese A-bomb survivors provides colon dose contributions weighted with a relative biological effectiveness (RBE) of 10 for neutrons, relative to gammas. However, there is evidence from several investigations that the neutron RBE for A-bomb survivors may be higher than 10. The change in the shape of the corresponding dose-response curves was evaluated by Hafner and co-workers in a previous study by applying sex-specific linear-quadratic dose models to previous LSS data for all solid cancer incidence that include separate neutron and gamma absorbed doses for several organs, in contrast to the most recent data. The resulting curvature change became significantly negative for males at an RBE of 140 for colon, 100 for liver, and 80 for organ averaged dose. For females, the corresponding RBE values were 110, 80, and 60 for colon, liver, and organ averaged doses. The present study compares three different methods to calculate the 95% confidence intervals in an analysis of the curvature with increasing RBE. Further, the impact of a higher neutron RBE on the work of the International Commission on Radiological Protection, and the importance of including uncertainties and performing sensitivity analysis of different parameters in radiation risk assessment are discussed.
{"title":"Discussion of uncertainties and the impact of different neutron RBEs on all solid cancer radiation incidence risks obtained from the Japanese A-bomb survivor data.","authors":"L Hafner, L Walsh, W Rühm","doi":"10.1177/01466453231211216","DOIUrl":"10.1177/01466453231211216","url":null,"abstract":"<p><p>The most recent publicly available data on all solid cancer incidence from the Life Span Study (LSS) of Japanese A-bomb survivors provides colon dose contributions weighted with a relative biological effectiveness (RBE) of 10 for neutrons, relative to gammas. However, there is evidence from several investigations that the neutron RBE for A-bomb survivors may be higher than 10. The change in the shape of the corresponding dose-response curves was evaluated by Hafner and co-workers in a previous study by applying sex-specific linear-quadratic dose models to previous LSS data for all solid cancer incidence that include separate neutron and gamma absorbed doses for several organs, in contrast to the most recent data. The resulting curvature change became significantly negative for males at an RBE of 140 for colon, 100 for liver, and 80 for organ averaged dose. For females, the corresponding RBE values were 110, 80, and 60 for colon, liver, and organ averaged doses. The present study compares three different methods to calculate the 95% confidence intervals in an analysis of the curvature with increasing RBE. Further, the impact of a higher neutron RBE on the work of the International Commission on Radiological Protection, and the importance of including uncertainties and performing sensitivity analysis of different parameters in radiation risk assessment are discussed.</p>","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/01466453231157047
Richard John Jan Pentreath
Initially concerned with the application of ionising radiation in medicine, radiological protection has subsequently gone through many phases, and the framework developed by the Commission has evolved continually to embrace other categories of exposure and novel exposure situations. For much of the Western world, medicine is now again the principal source of additional exposures for humans, and it has therefore been the subject of considerable attention in recent years, particularly because the techniques used are advancing so rapidly. What often comes as a surprise, however, is that virtually all of these techniques are being applied increasingly in the field of veterinary medicine. Some advances, such as the use of digital radiography, are to be expected, but the use of computed tomography scanners is increasing enormously, particularly with more second-hand equipment becoming available. The whole gamut of techniques used, from interventional radiology to nuclear medicine, including unsealed source therapy as well as brachyand teletherapy, are now also applied in veterinary practice. Nevertheless, it may still be easy to consider that the subject of radiation exposure in this field is little different from that of human medical practice, given that the equipment is much the same. However, that would be a mistake for a number of reasons.
{"title":"Laying the foundations for Radiological Protection in Veterinary Practice.","authors":"Richard John Jan Pentreath","doi":"10.1177/01466453231157047","DOIUrl":"https://doi.org/10.1177/01466453231157047","url":null,"abstract":"Initially concerned with the application of ionising radiation in medicine, radiological protection has subsequently gone through many phases, and the framework developed by the Commission has evolved continually to embrace other categories of exposure and novel exposure situations. For much of the Western world, medicine is now again the principal source of additional exposures for humans, and it has therefore been the subject of considerable attention in recent years, particularly because the techniques used are advancing so rapidly. What often comes as a surprise, however, is that virtually all of these techniques are being applied increasingly in the field of veterinary medicine. Some advances, such as the use of digital radiography, are to be expected, but the use of computed tomography scanners is increasing enormously, particularly with more second-hand equipment becoming available. The whole gamut of techniques used, from interventional radiology to nuclear medicine, including unsealed source therapy as well as brachyand teletherapy, are now also applied in veterinary practice. Nevertheless, it may still be easy to consider that the subject of radiation exposure in this field is little different from that of human medical practice, given that the equipment is much the same. However, that would be a mistake for a number of reasons.","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}