Dose and secondary cancer-risk estimation of patients undergoing high dose rate intracavitary gynaecological brachytherapy.

Dose and secondary cancer risk of the breast and thyroid during high dose rate (HDR) brachytherapy for 100 gynaecological cancer patients have been estimated. The organ doses were measured using LiF thermoluminescence dosimeters LiF (TLD-100). Patient demographic data (i.e. age and body mass index (BMI)) were also collected and analyzed. Statistical significance (p-value = 0.04; 0.01; 0.01) was observed for the correlation between age and breast dose; body mass index (BMI) and breast dose as well as BMI and thyroid dose. The average breast dose for cervical, vaginal and endometrial cancers were 7.44, 8.03 and 10.72 mGy, respectively. The average thyroid dose for cervical, vaginal and endometrial cancers were 2.32, 2.95 and 3.02 mGy, respectively. Excess absolute risk of the breast increased with attainable age and excess relative risk of the thyroid decreased with age at exposure. It is recommended to intensify post-treatment follow-ups and optimize the doses to the breast and thyroid.

National inventory of authorized diagnostic imaging equipment in Ghana: data as of September 2020.

Introduction: to address the challenge of inadequate and non-equitable distribution of diagnostic imaging equipment, countries are encouraged to evaluate the distribution of installed systems and undertake adequate monitoring to ensure equitability. Ghana´s medical imaging resources have been analyzed in this study and evaluated against the status in other countries. Methods: data on registered medical imaging equipment were retrieved from the database of the Nuclear Regulatory Authority and analyzed. The equipment/population ratio was mapped out graphically for the 16 regions of Ghana. Comparison of the equipment/population ratio was made with the situation in other countries. Results: six hundred and seventy-four diagnostic imaging equipment units from 266 medical imaging facilities (2.5 units/facility), comprising computed tomography (CT), general X-ray, dental X-ray, single-photon emission computed tomography (SPECT) gamma camera, fluoroscopy, mammography and magnetic resonance imaging (MRI) were surveyed nationally. None of the imaging systems measured above the Organization for Economic Co-operation and Development (OECD) average imaging units per million populations (u/mp). The overall equipment/population ratio estimated nationally was 21.4 u/mp. Majority of the imaging systems were general X-ray, installed in the Greater Accra and Ashanti regions. The regional estimates of equipment/population ratios were Greater Accra (49.6 u/mp), Ashanti (22.4 u/mp), Western (21.4 u/mp), Eastern (20.6 u/mp), Bono East (20.0 u/mp), Bono (19.2 u/mp), Volta (17.9 u/mp), Upper West (16.7 u/mp), Oti (12.5 u/mp), Central (11.9 u/mp), Northern (8.9 u/mp), Ahafo (8.9 u/mp), Upper East (6.9 u/mp), Western North (6.7 u/mp), Savannah (5.5 u/mp) and North-East (1.7 u/mp). Conclusion: medical imaging equipment shortfall exist across all imaging modalities in Ghana. A wide inter-regional disparity in the distribution of medical imaging equipment exists contrary to WHO´s recommendation for equitable distribution. A concerted national plan will be needed to address the disparity.

Radiation dose estimation of patients undergoing lumbar spine radiography.

Radiation dose to organs of 100 adult patients undergoing lumbar spine (LS) radiography at a University Hospital have been assessed. Free in air kerma measurement using an ionization chamber was used for the patient dosimetry. Organ and effective dose to the patients were estimated using PCXMC (version 1.5) software. The organs that recorded significant dose due to LS radiography were lungs, stomach, liver, adrenals, kidney, pancreas, spleen, galbladder, and the heart. It was observed that the stomach recorded the highest dose (48.2 ± 1.2 µGy) for LS anteroposterior (AP). The spleen also recorded the highest dose (41.2 ± 0.5 µGy) for LS lateral (LAT). The mean entrance surface air kerma (ESAK) of LS LAT (122.2 µGy) was approximately twice that of LS AP (76.3 µGy), but the effective dose for both examinations were approximately the same (LS LAT = 8.6 µSv and LS AP = 10.4 µSv). The overall stochastic health effect of radiation to patients due to LS radiography in the University Hospital is independent of the projection of the examination (AP or LAT).

Retrospective patient dose analysis of Ghana's first direct digital radiography system.

The log file generated in the flat panel detector of a direct digital x-ray machine (General Electric, Haulun Medical Systems, Serial Number 8M0392) after x-ray exposure was used to acquire data regarding the entrance surface air kerma (ESAK) for some routine x-ray examinations. The data were collected for a minimum of 10 standard adult patients undergoing each examination considered. The mean ESAK were found to be 0.25, 0.33, 0.14, 7.33, 9.76, 7.38, and 6.86 mGy for skull AP and LAT, chest AP, lumbar spine AP and LAT, pelvis AP and abdomen AP series, respectively. The mean ESAK values recorded from this study show wide variations but were below diagnostic reference levels (DRLs) of the Commission of European Communities and also compare with other recommendations. The comparisons of this study's dose levels with DRLs were undertaken as an approach to dose optimization. The study revealed that a dose audit of digital radiography systems is necessary because of the potential high doses one is likely to receive. Continuous dose evaluation in digital radiography is therefore encouraged in order to optimize doses to patients.

Status of radiation protection of medical x-ray facilities in Greater Accra region, Ghana.

The status of radiation protection and safety of diagnostic medical x-ray facilities in the Greater Accra region in Ghana have been evaluated. In all, 62 medical facilities with 86 diagnostic x-ray units were considered for the survey. Out of the 86 diagnostic units, there were 56 general radiograph, 13 dental radiography, 9 fluoroscopy, 5 computed tomography, and 3 mammography machines. The parameters evaluated include the tube voltage, type of film processor, and the required protective measures in an x-ray department. It was observed that none of the protective measures or equipment were fully present in the diagnostic units except lead aprons. The radiation protection and safety measures in the medical facilities need to be strengthened to protect patients, staff, and the general public.

Systematic approach to training occupationally exposed workers in Ghana and the rest of Africa.

The International Basic Safety Standards requires that all personnel on whom protection and safety depends be trained and qualified. The Radiation Protection Institute of the Ghana Atomic Energy Commission has adopted a systematic approach to training those occupationally exposed to ionizing radiation in the course of their work. In collaboration with the International Atomic Energy Agency several training courses have been implemented at the national level and in the African region. From 1993 to 2008, more than 400 occupationally exposed workers in Ghana were trained on radiation safety. Several African regional training events on radiation safety have also been executed with a total participation number of 583 individuals. The training events have contributed towards upgrading the safety culture within institutions that have participated.