EURADOS education and training activities.

This paper provides a summary of the Education and Training (E&T) activities that have been developed and organised by the European Radiation Dosimetry Group (EURADOS) in recent years and in the case of Training Courses over the last decade. These E&T actions include short duration Training Courses on well-established topics organised within the activity of EURADOS Working Groups (WGs), or one-day events integrated in the EURADOS Annual Meeting (workshops, winter schools, the intercomparison participants' sessions and the learning network, among others). Moreover, EURADOS has recently established a Young Scientist Grant and a Young Scientist Award. The Grant supports young scientists by encouraging them to perform research projects at other laboratories of the EURADOS network. The Award is given in recognition of excellent work developed within the WGs' work programme. Additionally, EURADOS supports the dissemination of knowledge in radiation dosimetry by promoting and endorsing conferences such as the individual monitoring (IM) series, the neutron and ion dosimetry symposia (NEUDOS) and contributions to E&T sessions at specific events.

Efficiency of radiation protection equipment in interventional radiology: a systematic Monte Carlo study of eye lens and whole body doses.

Monte Carlo calculations were used to investigate the efficiency of radiation protection equipment in reducing eye and whole body doses during fluoroscopically guided interventional procedures. Eye lens doses were determined considering different models of eyewear with various shapes, sizes and lead thickness. The origin of scattered radiation reaching the eyes was also assessed to explain the variation in the protection efficiency of the different eyewear models with exposure conditions. The work also investigates the variation of eye and whole body doses with ceiling-suspended shields of various shapes and positioning. For all simulations, a broad spectrum of configurations typical for most interventional procedures was considered. Calculations showed that 'wrap around' glasses are the most efficient eyewear models reducing, on average, the dose by 74% and 21% for the left and right eyes respectively. The air gap between the glasses and the eyes was found to be the primary source of scattered radiation reaching the eyes. The ceiling-suspended screens were more efficient when positioned close to the patient's skin and to the x-ray field. With the use of such shields, the Hp(10) values recorded at the collar, chest and waist level and the Hp(3) values for both eyes were reduced on average by 47%, 37%, 20% and 56% respectively. Finally, simulations proved that beam quality and lead thickness have little influence on eye dose while beam projection, the position and head orientation of the operator as well as the distance between the image detector and the patient are key parameters affecting eye and whole body doses.

Secondary neutron doses received by paediatric patients during intracranial proton therapy treatments.

This paper's goal is to assess secondary neutron doses received by paediatric patients treated for intracranial tumours using a 178 MeV proton beam. The MCNPX Monte Carlo model of the proton therapy facility, previously validated through experimental measurements for both proton and neutron dosimetry, was used. First, absorbed dose was calculated for organs located outside the clinical target volume using a series of hybrid computational phantoms for different ages and considering a realistic treatment plan. In general, secondary neutron dose was found to decrease as the distance to the treatment field increases and as the patient age increases. In addition, secondary neutron doses were studied as a function of the beam incidence. Next, neutron equivalent dose was assessed using organ-specific energy-dependent radiation weighting factors determined from Monte Carlo simulations of neutron spectra at each organ. The equivalent dose was found to reach a maximum value of ∼155 mSv at the level of the breasts for a delivery of 49 proton Gy to an intracranial tumour of a one-year-old female patient. Finally, a thorough comparison of the calculation results with published data demonstrated the dependence of neutron dose on the treatment configuration and proved the need for facility-specific and treatment-dependent neutron dose calculations.

Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals.

Occupational radiation doses from interventional procedures have the potential to be relatively high. The requirement to optimise these doses encourages the use of electronic or active personal dosimeters (APDs) which are now increasingly used in hospitals. They are typically used in tandem with a routine passive dosimetry monitoring programme, with APDs used for real-time readings, for training purposes and when new imaging technology is introduced. However, there are limitations when using APDs. A survey in hospitals to identify issues related to the use of APDs was recently completed, along with an extensive series of APD tests by the EURADOS Working Group 12 on Dosimetry for Medical Imaging. The aim of this review paper is to summarise the state of the art regarding the use of APDs. We also used the results of our survey and our tests to develop a set of recommendations for the use of APDs in the clinical interventional radiology/cardiology settings, and draw attention to some of the current challenges.

EURADOS STRATEGIC RESEARCH AGENDA 2020: VISION FOR THE DOSIMETRY OF IONISING RADIATION.

Since 2012, the European Radiation Dosimetry Group (EURADOS) has developed its Strategic Research Agenda (SRA), which contributes to the identification of future research needs in radiation dosimetry in Europe. Continued scientific developments in this field necessitate regular updates and, consequently, this paper summarises the latest revision of the SRA, with input regarding the state of the art and vision for the future contributed by EURADOS Working Groups and through a stakeholder workshop. Five visions define key issues in dosimetry research that are considered important over at least the next decade. They include scientific objectives and developments in (i) updated fundamental dose concepts and quantities, (ii) improved radiation risk estimates deduced from epidemiological cohorts, (iii) efficient dose assessment for radiological emergencies, (iv) integrated personalised dosimetry in medical applications and (v) improved radiation protection of workers and the public. This SRA will be used as a guideline for future activities of EURADOS Working Groups but can also be used as guidance for research in radiation dosimetry by the wider community. It will also be used as input for a general European research roadmap for radiation protection, following similar previous contributions to the European Joint Programme for the Integration of Radiation Protection Research, under the Horizon 2020 programme (CONCERT). The full version of the SRA is available as a EURADOS report (www.eurados.org).

THE USE OF ACTIVE PERSONAL DOSEMETERS IN INTERVENTIONAL WORKPLACES IN HOSPITALS: COMPARISON BETWEEN ACTIVE AND PASSIVE DOSEMETERS WORN SIMULTANEOUSLY BY MEDICAL STAFF.

Medical staff in interventional procedures are among the professionals with the highest occupational doses. Active personal dosemeters (APDs) can help in optimizing the exposure during interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field and because of the pulsed nature of the radiation. Many parameters like the type of interventional procedure, personal habits and working techniques, protection tools used and X-ray field characteristics influence the occupational exposure and the scattered radiation around the patient. In this paper, we compare the results from three types of APDs with a passive personal dosimetry system while being used in real clinical environment by the interventional staff. The results show that there is a large spread in the ratios of the passive and active devices.

Lessons from recent accidents in radiation therapy in France.

Many accidents in radiotherapy have been reported in France over the last years. This is due to the recent legal obligation to declare to the national safety authorities any significant incident relative to the use of ionising radiation including medical applications. The causes and consequences of the most serious events in radiotherapy are presented in this paper. Lessons can be learned from possible technical dysfunctions, from human errors or organisational weaknesses as to how such events can be prevented. The technical aspects are addressed here: in particular, dosimetric issues.

Evaluation of the calibration procedure of active personal dosemeters for interventional radiology.

An overview of the use of active personal dosemeters (APD) in interventional radiology is presented. It is based on the work done by the working package 7 of the CONRAD coordinated action supported by the EC within the frame of the 6th FP. This study was done in collaboration with the working package 4 of CONRAD to deal with the calculations required for studying the new calibration facility. The main requirements of the standard for the APD and the difficulties caused by the use of pulsed radiations are presented through the results of an intercomparison organised in a realistic calibration facility similar to the workplace situation in interventional radiology. The main characteristics of this facility are presented.

Characterisation of two new radiochromic gel dosimeters TruView™ and ClearView™ in combination with the vista™ optical CT scanner: A feasibility study.

PURPOSE: This study aims at characterising the properties of TruView™ and ClearView™ two new gel dosimeters (Modus Medical Devices Inc.) and at studying the feasibility of relative dosimetry using these dosimeters and the Vista™ Optical CT scanner to accurately evaluate dose. METHODS: In this work, we investigated key dosimetric aspects (dose response, energy and dose rate dependence) and stability of these radiochromic gels initiated in preliminary works (Huet et al., 2017; Colnot et al., 2017) using spectrophotometric measurements. Moreover, by mean of optical CT scanning (Vista™), their performances to measure relative depth dose (PDD) and cross profiles were analysed. RESULTS: TruView™ and ClearView™ present a linear dose response up to 20 Gy and up to 80 Gy respectively, independent of both photon beam energy (4-18 MV) and dose rate (up to 9.9 Gy/min) (Huet et al., 2017; Colnot et al., 2017). ClearView™ response proves to be stable for a week post-irradiation and uniform within the batch whereas TruView™ presents an unstable but uniform response. Optical CT scanning generates errors due to stray light that need to be corrected in order to use these gels; ClearView™ scanning particularly requires important precautions. After corrections, those gels used in combination with the Vista™ scanner show promising spatial and dosimetric precision (dose difference <5%). Finally, TruView™ is reusable and presents excellent reproducible response (maximum 3% difference) and the ClearView™ dosimeter presents good spatial stability (0.5% difference after 6 days). CONCLUSION: This study provides important knowledge about two gel dosimeters presenting interesting dosimetric properties. A study is ongoing to benchmark those promising candidates for clinical dose verification.

EURADOS 2016 INTERCOMPARISON EXERCISE OF EYE LENS DOSEMETERS.

In the context of a new annual eye lens dose limit for occupational exposure equal to 20 mSv, European Radiation Dosimetry Group (EURADOS) organized an intercomparison dedicated to eye lens dosemeters, including photon and beta radiations. The objective was to complete the first intercomparison recently organized by EURADOS for photons and to update the overview of eye lens dosemeters available in Europe. The dosemeters provided by the 22 participants coming from 12 countries were all composed of thermoluminescent detectors. The dosemeters were irradiated with photon and beta fields defined in relevant standards. The results, provided by participants in terms of Hp(3), were compared to the reference delivered doses. Results are globally satisfactory for photons since 90% of the data are in accordance to the ISO 14146 standard requirements. The respective values for betas stress the fact that dosemeters designed for Hp(0.07) are not suitable to monitor the eye lens dose in case of betas.

Protocol for emergency EPR dosimetry in fingernails.

There is an increased need for after-the-fact dosimetry because of the high risk of radiation exposures due to terrorism or accidents. In case of such an event, a method is needed to make measurements of dose in a large number of individuals rapidly and with sufficient accuracy to facilitate effective medical triage. Dosimetry based on EPR measurements of fingernails potentially could be an effective tool for this purpose. This paper presents the first operational protocols for EPR fingernail dosimetry, including guidelines for collection and storage of samples, parameters for EPR measurements, and the method of dose assessment. In a blinded test of this protocol application was carried out on nails freshly sampled and irradiated to 4 and 20 Gy; this protocol gave dose estimates with an error of less than 30%.

EPR dosimetry in chemically treated fingernails.

By using EPR measurements of radiation-induced radicals it is possible to utilize human fingernails to estimate radiation dose after-the-fact. One of the potentially limiting factors in this approach is the presence of artifacts due to mechanically induced EPR signals (MIS) caused by mechanical stress during the collection and preparation of the samples and the so-called background (non-radiation) signal (BKS). The MIS and BKS have spectral parameters (shape, g-factor and linewidth) that overlap with the radiation-induced signal (RIS) and therefore, if not taken into account properly, could result in a considerable overestimation of the dose. We have investigated the use of different treatments of fingernails with chemical reagents to reduce the MIS and BKS. The most promising chemical treatment (20 min with 0.1 M dithiothreitol aqueous solution) reduced the contribution of MIS and BKS to the total intensity of EPR signal of irradiated fingernails by a factor of 10. This makes it potentially feasible to measure doses as low as 1 Gy almost immediately after irradiation. However, the chemical treatment reduces the intensity of the RIS and modifies dose dependence. This can be compensated by use of an appropriate calibration curve for assessment of dose. On the basis of obtained results it appears feasible to develop a field-deployable protocol that could use EPR measurements of samples of fingernails to assist in the triage of individuals with potential exposure to clinically significant doses of radiation.

A phantom for effective dose measurement: organ dose distribution assessment based on a numerical approach.

ICRP 60 has defined the personal dose equivalent Hp(10) as an estimator of the effective dose E. Personal dosimeters, worn on the trunk, allow the measurement of the quantity Hp(10). However, the characteristics of the instrumentation and the definition of Hp(10) itself can generate differences between the two quantities, depending on the energies and on the directional distribution of the incident radiation. The objective of this study is to evaluate the possibility of the measurement of the effective dose E using an instrumented anthropomorphic phantom at workplaces. In the first step of this study, calculations of the effective dose for standard configurations are made using the Monte Carlo code MCNPX. This paper presents the model of the numerical anthropomorphic phantom and the results for whole body irradiations by broad unidirectional or plane-parallel photon beams. The results agree with those calculated by Zankl et al., so confirming the good suitability of the code and the phantom used. Then, the dose distributions inside some organs are presented and the locations of future detectors for the instrumented phantom are discussed.

Relation between organ and whole body doses and local doses measured by ESR for standard and realistic neutron and photon external overexposures.

In the case of a radiological accident due to external exposure, the assessment of the organs and whole body dose received by the victim is fundamental information for therapeutic strategy. Two complementary dosimetric techniques based on physical means are used in routine practice in the laboratory: Monte Carlo (MC) calculations and ESR spectroscopy performed on materials removed from the victim. The aim of the present study is to provide data relevant for a quick assessment of the dose distribution in case of accidental overexposure using dose ESR measurements performed on one or several points of the body. The chosen configurations were, on the one hand, standard homogeneous exposures (ICPR 74) and, on the other hand, exposures typical of accidental situations (source at 1m, in a pocket, in a hand and contaminated floor). The study was performed for monoenergetic photons and neutrons, and several sources (60Co, 137Cs, 192Ir, 252Cf and AmBe).

IRSN methodological guide to conducting workplace studies in compliance with French regulations.

Under French regulations governing radiation protection of workers, dosimetric workplace studies are mandatory. However, their practical implementation is not described. IRSN has developed a guide to help stakeholders in the radiological protection of workers conduct such studies. It proposes a general methodology applicable to most cases and 'workplace sheets', which apply this methodology to specific occupational settings. At present, two sheets are available: conventional radiology and interventional radiology.

An operational approach for aircraft crew dosimetry: the SIEVERT system.

The study of naturally occurring radiation and its associated risk is one of the preoccupations of bodies responsible for radiation protection. Cosmic particle flux is significantly higher on-board the aircraft that at ground level. Furthermore, its intensity depends on solar activity and eruptions. Due to their professional activity, flight crews and frequent flyers may receive an annual dose of some millisieverts. This is why the European directive adopted in 1996 requires the aircraft operators to assess the dose and to inform their flight crews about the risk. The effective dose is to be estimated using various experimental and calculation means. In France, the computerised system for flight assessment of exposure to cosmic radiation in air transport (SIEVERT) is delivered to airlines for assisting them in the application of the European directive. This professional service is available on an Internet server accessible to companies with a public section. The system provides doses that consider the routes flown by aircraft. Various results obtained are presented.

ESR investigation of joint use of dentin and tooth enamel to estimate photon and neutron dose components of a mixed field.

In the case of mixed photon and neutron field, estimation of photon and neutron dose components from the ESR signal of tooth enamel alone is impossible. To differentiate neutron and photon components using the method described in ICRU 26 for twin chambers, enamel and dentin sensitivities to photon and to neutron were investigated. Enamel and dentin relative sensitivities were, respectively, estimated at 0.03 +/- 0.02 and 0.14 +/- 0.10 for fission neutrons. Basing on this result, calculation of neutron and photon doses was performed in realistic case of criticality accident. Estimation of neutron and photon dose components was found in good agreement with reference dosimetry.

Study of materials for mixed field dosimetry by EPR spectroscopy.

EPR dose reconstruction after accidental photon exposure based on materials irradiated in the vicinity of the victim (sucrose, medicine tablets, etc.) was used successfully in several cases referenced in the literature. However, accidental exposure may also occur with a neutron component such as in the Tokai-Mura criticality accident. The aim of this work is to investigate the potentiality of EPR dosimetry for mixed photon and neutron field exposure with different organic materials already used for photon exposure (sucrose) or with potential dosimetric properties (ascorbic acid, sorbitol, glucose, galactose, fructose, lactose and mannose). To assess the neutron sensitivity, the materials were exposed to a mixed radiation field of an experimental reactor with different neutron to photon ratios. The relative neutron sensitivity was found to range from 12 to 43% according to the materials. The potentiality of these materials for mixed field EPR dosimetry is discussed.

Risk of eye lens radiation exposure for members of the public.

In 2011, the International Commission on Radiological Protection (ICRP) reviewed its recommendation concerning the equivalent dose limit for the eye lens, lowering it to 20 mSv in a year, for occupational exposure in planned exposure situations. The ICRP's statement does not contain any explicit recommendations regarding the organ dose limit for the eye lens for public exposure. For the moment, no change is proposed. But, to be coherent in the overall approach, the current equivalent limit for the public might be lowered. A similar yardstick than in the former recommendation may be used, that is to say a reduction of 10 times lower than that for occupational exposure. In this context, additional data on potential scenarios for public exposure of the eye lens are necessary. This paper, mainly based on a literature study, aims to provide, as far as possible, an exhaustive list of the situations in which members of the public can be exposed at the level of the eye lens. Once these situations have been defined, some calculations, made to assess the associated doses to the eye lens, are presented. This literature study did not reveal any current situations where members of the public would receive significant radiation doses to the eye lens. Indeed, the situations in which the dose to the eye lens might reach around 1 mSv per year for the public are extremely rare.

The influence of operator position, height and body orientation on eye lens dose in interventional radiology and cardiology: Monte Carlo simulations versus realistic clinical measurements.

OBJECTIVE: This paper aims to provide some practical recommendations to reduce eye lens dose for workers exposed to X-rays in interventional cardiology and radiology and also to propose an eye lens correction factor when lead glasses are used. METHODS: Monte Carlo simulations are used to study the variation of eye lens exposure with operator position, height and body orientation with respect to the patient and the X-ray tube. The paper also looks into the efficiency of wraparound lead glasses using simulations. Computation results are compared with experimental measurements performed in Spanish hospitals using eye lens dosemeters as well as with data from available literature. RESULTS: Simulations showed that left eye exposure is generally higher than the right eye, when the operator stands on the right side of the patient. Operator height can induce a strong dose decrease by up to a factor of 2 for the left eye for 10-cm-taller operators. Body rotation of the operator away from the tube by 45°-60° reduces eye exposure by a factor of 2. The calculation-based correction factor of 0.3 for wraparound type lead glasses was found to agree reasonably well with experimental data. CONCLUSIONS: Simple precautions, such as the positioning of the image screen away from the X-ray source, lead to a significant reduction of the eye lens dose. Measurements and simulations performed in this work also show that a general eye lens correction factor of 0.5 can be used when lead glasses are worn regardless of operator position, height and body orientation.