Potential risk assessment: a model for quality evaluation in fluoroscopy-guided interventional procedures.

This study presented a model applied for potential risk assessment in an interventional radiology setting. The model of potential risk assessment (MARP) consisted of the creation of a scale of indicators ranging from 0 to 5. The radiation levels were categorized according to gender, kind of procedure, value of kerma air product (Pka), and accumulated radiation dose (mGy). The MARP model was applied in 121 institutions over 8 y. A total of 201 656 patient radiation doses (Dose-area product and accumulated kerma) data were launched into the system over time, with an average of 22 406 doses per year. In the context of the workers (cardiologists, radiographers, and nurses) monitored during the MARP application, 8007 cases (with an average of 890 per year) of occupational radiation doses were recorded. This study showed a strategy for quality evaluation in fluoroscopy using a model with a compulsory information system for monitoring safety.

Science-informed Policy Making for Protecting People and the Environment from Radiation.

ABSTRACT: The process to arrive at the radiation protection practices of today to protect workers, patients, and the public, including sensitive populations, has been a long and deliberative one. This paper presents an overview of the US Environmental Protection Agency's (US EPA) responsibility in protecting human health and the environment from unnecessary exposure to radiation. The origins of this responsibility can be traced back to early efforts, a century ago, to protect workers from x rays and radium. The system of radiation protection we employ today is robust and informed by the latest scientific consensus. It has helped reduce or eliminate unnecessary exposures to workers, patients, and the public while enabling the safe and beneficial uses of radiation and radioactive material in diverse areas such as energy, medicine, research, and space exploration. Periodic reviews and analyses of research on health effects of radiation by scientific bodies such as the National Academy of Sciences, National Council on Radiation Protection and Measurements, United Nations Scientific Committee on the Effects of Atomic Radiation, and the International Commission on Radiological Protection continue to inform radiation protection practices while new scientific information is gathered. As a public health agency, US EPA is keenly interested in research findings that can better elucidate the effects of exposure to low doses and low dose rates of radiation as applicable to protection of diverse populations from various sources of exposure. Professional organizations such as the Health Physics Society can provide radiation protection practitioners with continuing education programs on the state of the science and describe the key underpinnings of the system of radiological protection. Such efforts will help equip and prepare radiation protection professionals to more effectively communicate radiation health information with their stakeholders.

Secondary proton buildup in space radiation shielding.

The risk posed by prolonged exposure to space radiation represents a significant obstacle to long-duration human space exploration. Of the ion species present in the galactic cosmic ray spectrum, relativistic protons are the most abundant and as such are a relevant point of interest with regard to the radiation protection of space crews involved in future long-term missions to the Moon, Mars, and beyond. This work compared the shielding effectiveness of a number of standard and composite materials relevant to the design and development of future spacecraft or planetary surface habitats. Absorbed dose was measured using Al2O3:C optically stimulated luminescence dosimeters behind shielding targets of varying composition and depth using the 1 GeV nominal energy proton beam available at the NASA Space Radiation Laboratory at the Brookhaven National Laboratory in New York. Absorbed dose scored from computer simulations performed using the multi-purpose Monte Carlo radiation transport code FLUKA agrees well with measurements obtained via the shielding experiments. All shielding materials tested and modeled in this study were unable to reduce absorbed dose below that measured by the (unshielded) front detector, even after depths as large as 30 g/cm2. These results could be noteworthy given the broad range of proton energies present in the galactic cosmic ray spectrum, and the potential health and safety hazard such space radiation could represent to future human space exploration.

Estimation of internal-exposure contribution in radiation dose exposure for boron neutron capture therapy.

Although boron neutron capture therapy (BNCT) causes minor damage to normal cells owing to the nuclear reactions induced by neutrons with major elements of tissues such as hydrogen and nitrogen, it is useful to estimate the accurate exposure dose for radiation protection. This study aims to estimate the contribution of internal exposure in radiation exposure dose for BNCT. The study was performed by referring to clinical studies at a reactor-based BNCT facility on the basis of computational dosimetry. Five irradiation regions of head and neck were selected for the estimation. The results suggest that external exposure occurred primarily in and around the irradiation field. Furthermore, during the exposure dose estimation in BNCT, internal exposure was found to be not negligible, implying that the irradiation regions in treatment planning must be considered for avoiding damage to certain critical organs that are susceptible to internal exposure.

Phantom study of a self-shielded X-ray bone age assessment instrument against scattered radiation in children.

Hand-wrist radiography is the most common and accurate method for evaluating children's bone age. To reduce the scattered radiation of radiosensitive organs in bone age assessment, we designed a small X-ray instrument with radioprotection function by adding metal enclosure for X-ray shielding. We used a phantom operator to compare the scattered radiation doses received by sensitive organs under three different protection scenarios (proposed instrument, radiation personal protective equipment, no protection). The proposed instrument showed greater reduction in the mean dose of a single exposure compared with radiation personal protective equipment especially on the left side which was proximal to the X-ray machine (≥80.0% in eye and thyroid, ≥99.9% in breast and gonad). The proposed instrument provides a new pathway towards more convenient and efficient radioprotection.

Characterizing imaging radiation risk in a population of 8918 patients with recurrent imaging for a better effective dose.

An updated extension of effective dose was recently introduced, namely relative effective dose ( E r ), incorporating age and sex factors. In this study we extended E r application to a population of about 9000 patients who underwent multiple CT imaging exams, and we compared it with other commonly used radiation protection metrics in terms of their correlation with radiation risk. Using Monte Carlo methods, E r , dose-length-product based effective dose ( E DLP ), organ-dose based effective dose ( E OD ), and organ-dose based risk index ( RI ) were calculated for each patient. Each metric's dependency to RI was assessed in terms of its sensitivity and specificity. E r showed the best sensitivity, specificity, and agreement with RI (R2 = 0.97); while E DLP yielded the lowest specificity and, along with E OD , the lowest sensitivity. Compared to other metrics, E r provided a closer representation of patient and group risk also incorporating age and sex factors within the established framework of effective dose.

Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions.

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.

Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka.

Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.

Assessment of Radiation Doses to the General Public around Nuclear Power Plants Based on Representative Person Concept.

ABSTRACT: The International Commission on Radiological Protection recommended that the representative person concept should be used in radiation dose assessment of the general public to specify exposed individuals. The objective of this study is to assess radiation doses of the residents around nuclear power plants (NPPs) in relation to the introduction of the representative person concept. Critical group candidates and representative agro-livestock product producing areas were selected around a NPP site by considering radioactive effluents and regional meteorological data, geographical information, etc. A total of five exposure scenarios, including adult (non-fishery, fishery, and commuter), 10-y-old, and 1-y-old groups, were selected for the dose assessment. Generally, radiation doses were higher for 1-y-old, 10-y-old, and adult groups, in that sequence. There was no significant difference among the radiation doses by occupation in adult groups. Radiation dose results calculated by applying the representative person concept and dose assessment method currently used in Korea were compared. Application of the representative person concept results in lower radiation dose by 68.2% due to consideration of actual residential and agro-livestock product producing areas for the radiation dose assessment, by 13.3% due to the application method of habit data for dose calculation, and by 33.3% due to representative value of the dose results. Finally, considering all the factors above, radiation dose calculated by the current dose assessment method was 8.16 × 10 -2 mSv y -1 , while that calculated using the representative person concept was 1.40 × 10 -2 mSv y - 1 (82.8% lower). The results of this study can be used as reference data when introducing the representative person concept to the regulatory systems in Korea.

European astronaut radiation related cancer risk assessment using dosimetric calculations of organ dose equivalents.

An illustrative sample mission of a Mars swing-by mission lasting one calendar year was chosen to highlight the application of European risk assessment software to cancer (all solid cancer plus leukaemia) risks from radiation exposures in space quantified with organ dose equivalent rates from model calculations based on the quantity Radiation Attributed Decrease of Survival (RADS). The relevant dose equivalent to the colon for radiation exposures from this Mars swing-by mission were found to vary between 198 and 482 mSv. These doses depend on sex and the two other factors investigated here of: solar activity phase (maximum or minimum); and the choice of space radiation quality factor used in the calculations of dose equivalent. Such doses received at typical astronaut ages around 40 years old will result in: the probability of surviving until retirement age (65 years) being reduced by a range from 0.38% (95%CI: 0.29; 0.49) to 1.29% (95%CI: 1.06; 1.56); and the probability of surviving cancer free until retirement age being reduced by a range from 0.78% (95%CI: 0.59; 0.99) to 2.63% (95%CI: 2.16; 3.18). As expected from the features of the models applied to quantify the general dosimetric and radiation epidemiology parameters, the cancer incidence risks in terms of surviving cancer free, are higher than the cancer mortality risks in terms of surviving, the risks for females are higher than for males, and the risks at solar minimum are higher than at solar maximum.

Results from the Radiation Assessment Detector on the International Space Station: Part 1, the Charged Particle Detector.

We report the results of the first six years of measurements of the energetic particle radiation environment on the International Space Station (ISS) with the Radiation Assessment Detector (ISS-RAD), spanning the period from February 2016 to February 2022. The first RAD was designed and built for MSL, the Mars Science Laboratory rover, also known as Curiosity; it has been operating on Mars since 2012 and is referred to here as MSL-RAD. ISS-RAD combines two sensor heads, one nearly identical to the single MSL-RAD sensor head, the other with greatly enhanced sensitivity to fast neutrons. These two sensor heads are referred to as the Charged Particle Detector (CPD) and Fast Neutron Detector (FND), respectively. Despite its name, the CPD is also capable of measuring high-energy neutrons and γ-rays, as is MSL-RAD. ISS-RAD was flown to the ISS in December 2015 and was deployed in February 2016, initially in the USLab module. RAD was used as a survey instrument from January 2017 through May 2020, when the instrument was positioned in the USLab and set to a zenith-pointing orientation. The energetic particle environment on the ISS is complex and varies on short time scales owing to the orbit, which has a 51.6∘ inclination with respect to the equator and has had an altitude in the 400-440 km range in this time period. The ISS moves continuously through the geomagnetic field, the strength of which varies with latitude, longitude, and altitude. The orbit passes through the South Atlantic Anomaly (SAA) several times a day, where magnetically trapped protons and electrons produce large but transient increases in observed fluxes and absorbed dose rates. The environment inside the ISS is affected by the solar cycle, altitude, and the local shielding, which varies between different ISS modules. We report results for charged particle absorbed dose and dose equivalent rates in various positions in the ISS. In an accompanying paper, we report similar results for neutron dose equivalent rates obtained with the ISS-RAD Fast Neutron Detector.

Mathematical solutions in internal dose assessment: A comparison of Python-based differential equation solvers in biokinetic modeling.

In biokinetic modeling systems employed for radiation protection, biological retention and excretion have been modeled as a series of discretized compartments representing the organs and tissues of the human body. Fractional retention and excretion in these organ and tissue systems have been mathematically governed by a series of coupled first-order ordinary differential equations (ODEs). The coupled ODE systems comprising the biokinetic models are usually stiff due to the severe difference between rapid and slow transfers between compartments. In this study, the capabilities of solving a complex coupled system of ODEs for biokinetic modeling were evaluated by comparing different Python programming language solvers and solving methods with the motivation of establishing a framework that enables multi-level analysis. The stability of the solvers was analyzed to select the best performers for solving the biokinetic problems. A Python-based linear algebraic method was also explored to examine how the numerical methods deviated from an analytical or semi-analytical method. Results demonstrated that customized implicit methods resulted in an enhanced stable solution for the inhaled60Co (Type M) and131I (Type F) exposure scenarios for the inhalation pathway of the International Commission on Radiological Protection (ICRP) Publication 130 Human Respiratory Tract Model (HRTM). The customized implementation of the Python-based implicit solvers resulted in approximately consistent solutions with the Python-based matrix exponential method (expm). The differences generally observed between the implicit solvers andexpmare attributable to numerical precision and the order of numerical approximation of the numerical solvers. This study provides the first analysis of a list of Python ODE solvers and methods by comparing their usage for solving biokinetic models using the ICRP Publication 130 HRTM and provides a framework for the selection of the most appropriate ODE solvers and methods in Python language to implement for modeling the distribution of internal radioactivity.

Shielding analysis of the proton therapy facility at China Medical University Hospital: comparison of a simplified approach with Monte Carlo simulations.

This study comprehensively compared two approaches for analyzing the shielding design of the proton therapy facility at China Medical University Hospital. The first approach essentially involved two approximate models: one for estimating the transmitted radiation through thick shields, and one for estimating radiation streaming at locations near a maze entrance. The second approach relied on Monte Carlo simulations for predicting the radiation field in a complex environment. A total of 22 beam loss scenarios were considered, and dose rates at 32 locations around the facility were estimated using the two approaches. The comparison results demonstrated that the simplified approach proposed in this study can yield fairly accurate or conservative estimates for quickly performing shielding design or dose assessment in a real-world proton therapy facility.

Assessment of the effectiveness of Saba shielding with the composition of Cu-Bi in neck CT imaging: a phantom and patient study.

The use of computed tomography (CT) is a very well-established medical diagnostic imaging modality, however, the high radiation dose due to this imaging method is a major concern. Therefore, dose reduction methods are necessary, especially for superficial radiosensitive organs like the thyroid. The aim of this study is to construct and assess a CT shield with composition of 90% Cu and 10% Bi (Saba shield) with regard to dose reduction and image quality. The efficiency of the constructed shields for dose reduction was assessed by measuring entrance skin dose (ESD), using thermoluminescence dosimeters placed on an anthropomorphic phantom. Image quality was assessed quantitatively based on image noise and CT number accuracy by drawing regions of interest on CT images of the anthropomorphic phantom. Image quality was further investigated qualitatively in a patient study. Application of the Saba shield and 100% Bi shield with the thickness of one thickness (1T) reduced ESD by 50.2% and 51.7%, respectively, and using a three-fold thickness reduced ESD by 64.6% and 65.1%, respectively. Saba shield with thickness of 1T had no significant change in image noise in the anterior part, and image noise and mean CT number in the posterior part (P> 0.05). The statistical analysis performed did not find any meaningful difference between the study and control groups in image quality assessment of the patient study (P> 0.05). The 1T Saba shield reduced thyroid dose efficiently during neck CT imaging without causing unwanted effects on image quality.

Applicability of 'Toolkit for Safety Assessment' tool to interventional radiology using probabilistic risk assessment techniques.

Interventional radiology brings extensive benefits to patients. Nevertheless, certain procedures may result in high doses of radiation, leading to health risks to occupationally exposed individuals (OEIs). Therefore, a more comprehensive risk analysis is essential to ensuring safety and minimising radiation exposures for all OEIs. The Toolkit for Safety Assessment (TOKSA) tool performs risk assessments based on the concepts described in 'General Safety Requirements' Part 3 (Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards) and Part 4 (Safety Assessment for Facilities and Activities). This tool was developed based on the 'Ibero-American Forum of Radiological and Nuclear Regulatory Agencies' risk models and can promote the use of the risk assessment processes by OEIs. The aim of this study was to experimentally analyse the applicability of the TOKSA tool in interventional radiology with the use/support of probabilistic risk assessment techniques. The results were used to reduce the risks associated with a hemodynamics room in a hospital in Belo Horizonte, Brazil.

An assessment of radiation safety practices for transgender and gender non-binary patients in Irish radiology departments.

INTRODUCTION: Studies indicate there may be inadequate care given to transgender and non-binary (TGNB) patients in healthcare environments, with radiology departments not being equipped to cater for this group. There is currently a deficit in research concerning the use of radiation safety measures for TGNB patients. The purpose of this research was to examine opinions of Irish Radiation Safety Experts (RSE) on current status of radiation safety protocols and techniques in place for TGNB patients and consider any changes necessary. METHODOLOGY: Ten semi-structured interviews were conducted with RSEs from eight Irish hospitals, including five radiation protection officers (RPO) and five medical physicists. Question included: current radiation safety protocols for TGNB patients, potential issues and challenges with current practice, and recommendations of new measures. Coding was used to facilitate content analysis for interpretation of findings. RESULTS: No reference to TGNB patients in local policies or guidelines was evident. Interviews established key radiation safety risks including inadvertent exposure of the foetus and insensitive patient care. Prominent categories identified included additional education, gender identification at patient registration and consideration of current policies and guidelines. The extent to which RSEs promoted the implementation of further measures to radiology departments varied. CONCLUSIONS: A clear lack of guidance and instruction for radiation safety for TGNB patients is evident. Whilst there are few TGNB patients in Irish hospitals, participants believed that inclusive changes should be made concurrent with Ireland's evolving culture and in the interest of equality of patient safety. IMPLICATIONS FOR PRACTICE: Inclusive changes should be made to radiology departments concurrent with Ireland's evolving culture. However, barriers to implementing such measures include a lack of available resources, investment, and instruction from authoritative bodies.

Use of life cycle assessment (LCA) to advance optimisation of radiological protection and safety.

Life cycle assessment (LCA) is a modelling technique used to determine the cradle-to-grave environmental and human health impacts from the production of a good or the provision of a service. Radiological protection may benefit from employing tools like LCA to obtain a broader perspective and enable comparison with analyses of non-radiological systems. Despite structural similarities to other well-established decision-aiding techniques (DATs), the impact assessment within LCA (i.e. LCIA) is not commonly used in the optimisation of radiological protection process. This paper provides a brief review of LCA, including LCIA, along with more traditional DATs (such as multi-attribute utility analysis) used in the optimisation process for comparison. Basic concrete shielding was considered as a simple, illustrative example; concrete attenuates emissions from a radiation source but is also associated with a financial cost as well as costs with respect to energy, material, and water use. LCA offers quantification of these and other key resources (termed 'impact categories'). Ultimately, we offer that, depending on the circumstance, LCA can be a useful tool in radiological protection decision-making, complementing existing techniques.

Reassessing lead protective garment assessment using ICRP 103 tissue weighting factors.

Lead protective garments worn by medical staff in the presence of x-rays develop defects over time. This work proposes a novel method of assessing the protective efficacy of the garments as defects develop. The proposed method applies updated radiobiology data from ICRP 103. This work applied the as low as reasonably achievable principle to devise a formula through which a maximum allowed defect area in lead protective garments can be calculated. This formula depends on the cross-sectional areas (A) and ICRP 103 tissue weighting factors (wt) of the most radiosensitive and overlapping organs protected by the garment, the maximum allowed additional effective dose to the garment wearer due to the defects (d), and the unattenuated absorbed dose at the surface of the garment (D). The maximum allowed defect areas are separated into three regions:above the waist, below the waist, andthyroid. To be conservative, it was assumed thatD= 50 mGy yr-1, andd= 0.3 mSv yr-1. Also conservatively, transmission was assumed to be 0%, as employing a non-zero transmission factor would increase the maximum allowed defect area. Maximum allowed defect areas were as follows: 370 mm2for above the waist, 37 mm2for below the waist, and 279 mm2for the thyroid. These values can be compared to commonly published values which are 670 mm2for an apron, 15 mm2over the gonads, and 11-20 mm2for the thyroid. The proposed method for lead protective garment assessment is highly adaptable as values can be adjusted as radiobiology data are updated, and as values such as radiation dose limits vary across jurisdictions. Future works will include collection of data for unattenuated dose to apron (D) as it varies across professions, so that garments may be allowed different defect areas if relegated to individuals of specific professions.

Shielding design aspects of SR in 3 GeV ILSF.

Iranian Light Source Facility (ILSF) is an under-construction synchrotron radiation accelerator consisting of a 150 MeV linac, a booster synchrotron operating from 150 MeV to 3 GeV, and a 3 GeV storage ring that stores a maximum of 400 mA current of electrons. As the stored beam circulates, a fraction of the beam is lost due to interactions with gas molecules, interactions among beam particles, and orbital bending, which produce radiation. The bulk shielding calculation for the ILSF and the input parameters used for this analysis are discussed in this paper. The potential of skyshine neutrons to cause radiation hazards is investigated as well. Moreover, the design and shielding simulation using the FLUKA Monte Carlo code is presented for the linac beam stop and primary and scattered gas bremsstrahlung for the first optics enclosure of the ILSF spectro microscopy beamline. Our designed radiation shielding system guarantees that the annual dose in all areas around the ILSF machine does not exceed the dose limit of 1 mSv.

Radiation protection challenges in the upgrade, autopsy and disposal of the LHC beam dump.

The upgrade of the Large Hadron Collider spare beam dumps (Target Dump External, TDE) and the autopsy of the old operational TDE required to perform several activities in a high-radiation environment posing significant radiation protection challenges due to the residual activation of the equipment. To ensure high safety standards and to respect the ALARA principle, these challenges were addressed using the advanced Monte Carlo techniques to predict the residual ambient dose equivalent rate and the radionuclide inventory at different steps of the interventions. The CERN HSE-RP group makes extensive use of the FLUKA and ActiWiz codes to produce accurate estimates. This work aims to provide an overview of the radiation protection studies to optimise the interventions (ALARA) and to reduce the radiological risk for personnel and environment.