The Journal of Korean Society for Radiation Therapy
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v.24
no.2
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pp.107-114
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2012
Purpose: Unlike the existing linear accelerator with photon, proton therapy produces a number of second radiation due to the kinds of nuclide including neutron that is produced from the interaction with matter, and more attention must be paid on the exposure level of radiation workers for this reason. Therefore, thermoluminescence dosimeter (TLD) that is being widely used to measure radiation was utilized to analyze the exposure level of the radiation workers and propose a basic data about the radiation exposure level during the proton therapy. Materials and Methods: The subjects were radiation workers who worked at the proton therapy center of National Cancer Center and TLD Badge was used to compare the measured data of exposure level. In order to check the dispersion of exposure dose on body parts from the second radiation coming out surrounding the beam line of proton, TLD (width and length: 3 mm each) was attached to on the body spots (lateral canthi, neck, nipples, umbilicus, back, wrists) and retained them for 8 working hours, and the average data was obtained after measuring them for 80 hours. Moreover, in order to look into the dispersion of spatial exposure in the treatment room, TLD was attached on the snout, PPS (Patient Positioning System), Pendant, block closet, DIPS (Digital Image Positioning System), Console, doors and measured its exposure dose level during the working hours per day. Results: As a result of measuring exposure level of TLD Badge of radiation workers, quarterly average was 0.174 mSv, yearly average was 0.543 mSv, and after measuring the exposure level of body spots, it showed that the highest exposed body spot was neck and the lowest exposed body spot was back (the middle point of a line connecting both scapula superior angles). Investigation into the spatial exposure according to the workers' movement revealed that the exposure level was highest near the snout and as the distance becomes distant, it went lower. Conclusion: Even a small amount of exposure will eventually increase cumulative dose and exposure dose on a specific body part can bring health risks if one works in a same location for a long period. Therefore, radiation workers must thoroughly manage exposure dose and try their best to minimize it according to ALARA (As Low As Reasonably Achievable) as the International Commission on Radiological Protection (ICRP) recommends.
Purpose For nuclear medicine technologists, it is difficult to stay away from or to separate from radiation sources comparing with workers who are using radiation generating devices. Nuclear medicine technologists work is recognized as an optimized way when they are familiar with work practices. The aims of this study are to measure radiation exposure of technologists working in PET and to evaluate the occupational radiation dose after implementation of strategies to lower exposure. Materials and Methods We divided into four working types by QC for PET, injection, scan and etc. in PET scan procedure. In QC of PET, we compared the radiation exposure controlling next to $^{68}Ge$ cylinder phantom directly to controlling the table in console room remotely. In injection, we compared the radiation exposure guiding patient in waiting room before injection to after injection. In scan procedure of PET, we compared the radiation exposure moving the table using the control button located next to the patient to moving the table using the control button located in the far distance. PERSONAL ELECTRONIC DOSEMETER (PED), Tracerco$^{TM}$ was used for measuring exposed radiation doses. Results The average doses of exposed radiation were $0.27{\pm}0.04{\mu}Sv$ when controlling the table directly and $0.13{\pm}0.14{\mu}Sv$ when controlling the table remotely while performing QC. The average doses of exposed radiation were $0.97{\pm}0.36{\mu}Sv$ when guiding patient after injection and $0.62{\pm}0.17{\mu}Sv$ when guiding patient before injection. The average doses of exposed radiation were $1.33{\pm}0.54{\mu}Sv$ when using the control button located next to the patient and $0.94{\pm}0.50{\mu}Sv$ when using the control button located in far distance while acquiring image. As a result, there were statistically significant differences(P<0.05). Conclusion: From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine. Conclusion From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine.
IGRT(Image Guided Radiation Therapy) in radiation therapy is a very useful technique in order to increase setup of patient and position reproducibility. Tomotherapy can increase accuracy of setup to take IGRT by MVCT, but it be for verified accuracy of Image guided, and MVCT occurs the exposure of patient. Through this study, IGRT accuracy of Tomotherapy is very accurate within 1.0mm. When MVCT using Tomotherapy phantom for QA, QC be taken, exposure dose is Fine(2mm Slice thickness) 3cGy, Normal(4mm Slice thickness) 1.5cGy, Corse(6mmSlice thickness) 1.0cGy. Measurement value of spatial resolution using AAPM CT performance phantom did't cause a big difference. As a result, ability of IGRT in Tomotherapy is very accurate. While obtaining image for IGRT, we should minimize expose range because patient's be exposed to radiation. We should make an effort to do accurate radiation therapy to minimize exposure of patient by selecting the appropriate thickness of MVCT depending on patient's body and treat area.
Purpose: X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. Materials and Methods: The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. Results: The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. Conclusion: The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.
Kerma Area Product (KAP) is best indicator of radiation monitoring on radiographic examinations. KAP can be measured differently depending on the X-ray irradiation area, air kerma, souce-skin distance, type of equipment, etc. The major factors are exposure area and the air krema. The KAP currently used only considers the exposure area with X-rays and has a problem that KAP is always excessively overestimated from the dose received by an actual subject. Therefore, in this study, in order to measure the accurate KAP, a new area dose calculation that can be calculated by dividing the area where the actual X-ray is irradiated is presented, and the KAP is the real area. We compared and analyzed how much it was overestimated compared to the dose. The Skull AP projection and seven other projection were compared and analyzed, and the KAP was overestimated in each test by 52% to 60%. In this way, the effective KAP (EKAP) calculation developed through this study should be utilized to prevent extra calculation of the existing KAP, and only the accurate patient subject area should be calculated to derive the accurate area dose value. EKAP is helpful for control the patient's exposure dose more finely, and it is useful for the quality control of medical radiation exposure.
Kim, Ki;Hong, Gun-Chul;Kwak, In-Suk;Park, Sun-Myung;Choi, Choon-Ki;Seok, Jae-Dong
The Korean Journal of Nuclear Medicine Technology
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v.14
no.2
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pp.41-44
/
2010
Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.
In this study, the radiation dose rate was measured by time and distance and evaluated whether radiation dose rate was suitable for domestic and international discharge criteria. In addition, the radiation dose emitted from the patient was measured with a glass dosimeter to evaluate the exposure dose if the caregiver stays in the isolated ward by placing a humanoid phantom instead of the caregiver at a distance of 1 m from the patient, on the second day of treatment. After 23 hours of isolation, the radiation dose rates at a distance of 1 m were 20.54 ± 6.21 µSv/h at 2.96 GBq administration and 27.94 ± 12.33 µSv/h at 3.70 GBq administration. The radiation dose rates at a distance of 1 m were 25.90 ± 2.21 µSv/h when 2.96 GBq was administered and 34.22 ± 10.06 µSv/h when 3.70 GBq was administered after 18 hours of isolation. However, if the isolation period is short may cause unnecessary radiation exposure to the third person. The reading of the attached dosimeter from the morning of the second day of treatment until removal was 0.01 to 0.95 mSv, which is a surface dose determined by the International Commission on Radiation Units and Measurements. And the depth dose was 0.01 to 0.99 mSv. On the second day of treatment, even if the patient caregivers stayed in the isolation ward, the exposure dose of the patient family did not exceed the effective dose limit of 5 mSv recommended by the ICRP and NCRP.
With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.
Lee, Min Young;Kwon, Jae;Ryu, Gang Woo;Kim, Ki Hoon;Nam, Hyung Woo;Kim, Kwang Pyo
Progress in Medical Physics
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v.30
no.4
/
pp.75-88
/
2019
Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.
As the radiological medical instruments have been competitively developed in recent years, its utilization for the patient treatment has been expanded. The medical examination using the radiation has been gradually increased, so that it is recognized as a significant factor of increasing the radiation exposure. In this study, the recognition about the radiation exposure was analyzed for 555 gynecologic patients in 8 secondary and tertiary medical centers in Gyeongbuk from November 17 to April 19, 2007. The results are followed. There was a significant difference on the recognition for the radiation by age and education (p<0.05), There was the significant difference in the recognition about the radiological instruments by age and occupation (p<0.05), and there was the significant difference in the information identification & analysis by age and occupation (p<0.05). As the result of analyzing a correlation of the radiation's harmfulness, recognition, psychological state and exposure prevention, there was the correlation of 0.572 between the harmfulness and recognition, the correlation of 0.740 between the harmfulness and the psychological state, and the correlation of 0.477 between the harmfulness and the exposure prevention. It was statistically very significant (p<0.01). But, there was no significance with the radiological instrument and information identification (p>0.05). As the result of the study, it could be known that the mental threat factor was more included than the physical threat from the position of gynecologic patients who were sensitive to the radiation. Accordingly, radiological technologist who manages the radiation needs to let the patient or its guardians recognize the degree of physical harmfulness exactly.
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