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Radprotca 141003084618 Phpapp02
Radprotca 141003084618 Phpapp02
• Why?
• From What?
• Whom to protect?
• How to protect?
Protection
• When to protect?
MEASUREMENTS!!!
RADIATION UNITS
• ROENTGEN– unit of
radiation exposure that
will liberate a charge of
2.58x10-4coulombs/kg
of air.
• Independent of the
area or field size
Absorbed dose
• Deposition of energy in pt by radiation exposure
multiply by the
RADIATION WEIGHING FACTOR Wr
OR QUALITY FACTOR
for the radiation used
EQUIVALENT DOSE
to the organ in msv
multiply by the
TISSUE WEIGHING FACTORWt
for the tissue or organ concerned
obtain the
EFFECTIVE DOSE
to the pt in msv
Protection
• Why?
• From What?
• Whom to protect?
• How to protect?
Is there
RADIATION
in this room?
Radiation - We live with
Natural Radiation: Cosmic rays, radiation within our
body, in food we eat, water we drink, house we live
in, lawn, building material etc.
Human Body: K-40, Ra-226, Ra-228
e.g. a man with 70 kg wt. 140 gm of K
140 x 0.012%
0.0168 gm of K-40
0.1 Ci of K-40
Radiation - We live with
Gy/yr
New Delhi 700
Bangalore 825
Bombay 424
Kerala 4000
(in narrow coastal strip)
Radiation – We travel with
Radiation - We eat with
Food Radioactive levels (Bq/kg)
Daily intake
Ra-226 Th-228 Pb-210 K-40
(g/d)
Rice 150 0.126 0.267 0.133 62.4
Wheat 270 0.296 0.270 0.133 142.2
Pulses 60 0.233 0.093 0.115 397.0
Other
70 0.126 0.167 -- 135.2
Vegetables
Leafy
15 0.267 0.326 -- 89.1
Vegetables
Milk 90 -- -- -- 38.1
Composite
1370 0.067 0.089 0.063 65.0
Diet
Dose equivalent=0.315 mSv/yr
Total dose from Natural sources = 1.0 to 3.0 mSv/yr
Natural and Manmade sources
SOURCES OF RADIATION
• Natural radiation:
1. External: Cosmic and gamma radiation
2. Internal: radionuclides with in the body
ingested or inhaled
• Medical procedures:
1. Diagnostic
2. Therapeutic
• Nuclear weapons/industry/accidents
Electromagnetic Waves
Microwaves
Ultra-violet
Radio Radar
waves Visible
light
Infrared X-ray
Gamma-ray
Non-ionizing radiation
Ionizing radiation
Primary Types of Ionizing Radiation
• Alpha particles
• Beta particles
• Gamma rays (or Radioactive Atom Ionizing Radiation
photons) X-ray
alpha particle
gamma ray
Direct Ionization Caused By:
• Protons
• Alpha Particles
• Beta Particles
• Positron Particles
Indirect Ionization Caused By:
• Neutrons
• Gamma Rays
• X-Rays
DO WE NEED
RADIATION
PROTECTION ?
Radiation health effects
TYPE
OF
EFFECTS
• Deterministic
(Threshold/non-stochastic)
• Existence of a dose threshold
value (below this dose, the effect
is not observable)
• Severity of the effect increases
with dose
• A large number of cells are
involved
• Temporary sterility
• males 0.15 Gy
• females 0.6 Gy dose
threshold
Stochastic Effects
• Stochastic(Non-Threshold)
– No threshold
– Probability of the effect increases with dose
– Generally occurs with a single cell
– e.g. Cancer, genetic effects
How much
DNA is
repaired ?
Repair of DNA damage
• RADIOBIOLOGIST
S ASSUME THAT
THE REPAIR
SYSTEM IS NOT
100% EFFECTIVE.
Outcomes after cell exposure
DAMAGE TO DNA
Radical formation
10-9
Diffusion, chemical reactions PHYSICO-CHEMICAL INTERACTIONS
Initial DNA damage
10-6
T I ME (sec)
100 1 second
Repair processes
103
Damage fixation
BIOLOGICAL RESPONSE
Timing of
1 hour Cell killing
1 day Mutations/transformations/aberrations events
106 Proliferation of "damaged" cells
1 year Promotion/completion leading to
109 Teratogenesis MEDICAL EFFECTS radiation
Cancer
100 years Hereditary defects effects.
CHAIN OF EVENTS FOLLOWING EXPOSURE TO IONIZING
RADIATION
exposure
ionisation
free radicals
(chemical changes)
molecular changes
(DNA,RNA, ENZYMES)
SUBCELLULAR DAMAGE
(MEMBRANES, NUCLEI, CHROMOSOMES)
CELLULAR LEVEL
• RS = Probability of a cell,
tissue or organ of suffering an
effect per unit of dose.
RS laws (Law of Bergonie & Tribondeau)
Radiosensitivity of living tissues varies with
maturation & metabolism;
1. Stem cells are radiosensitive. More mature cells
are more resistant
2. Younger tissues are more radiosensitive
3. Tissues with high metabolic activity are highly
radiosensitive
4. High proliferation and growth rate, high
radiosensitivty
Radiosensitivity
High RS Medium RS Low RS
Bone Marrow Skin Muscle
Spleen Mesoderm Bones
Thymus organs (liver, Nervous
Lymphatic heart, lungs…) system
nodes
Gonads
Eye lens
Lymphocytes
(exception to the RS laws)
RADIATION EFFECTS
DETERMINISTIC EFFECT STOCHASTIC EFFECT
• Mechanism is cell killing Mechanism is cell modification
• Has a threshold dose Has no threshold
• Deterministic in nature Probabilistic in nature
• Severity increases with dose Probability increases with dose
• Occurs only at high doses Occurs at even at low doses
• Can be completely avoided Cannot be completely avoided
• Causal relationship between Causal relationship cannot be
radiation exposure and the effect established at low doses
• Sure to occur at an adequate Occurs only among a small
dose percentage of those exposed
RADIATION EFFECTS
400
300
200
100
0
1931 1947 1977 1990
Year
Dose Limits (ICRP 60)
Occupational Public
Effective dose 20 mSv/yr averaged* 1 mSv in a yr
over 5 yrs.
Annual equivalent
dose to
• Lens of eye 150 mSv 5 mSv
• Skin 500 mSv 50 mSv
• Hands & Feet 500 mSv
* with further provision that dose in any single yr > 30 mSv (AERB) and
=50 mSv (ICRP)
WHAT IS
BASIS FOR
DOSE LIMITS?
PRINCIPLES
OF
RADIATION
PROTECTION
PRINCIPLES OF RADIATION PROTECTION
1. Justification of practices
2. Optimization of protection by
keeping exposure as low as
reasonably achievable
3. Dose limitation
Justification of procedure
versus the net benefit
U: unlikely
FLUOROSCOPY
AND
CT
Fluoroscopy
Barium study: 3-6 min/pt x 8 patients/d
= 40 min/d
ANGIOGRAPHY
• Diagnostic = 50 min/d
• Therapeutic = 2-5 hr/d
CT = 10-45 min/d
Fluoroscopy (excl. ther angio)
Risk of Staff Patient Public
Death × × ×
Skin burn × × ×
Infertility × × ×
Cataract × × ×
Cancer U U U
Genetic effect U U U
U: unlikely
X-ray tube
Primary beam
Scattered radiation
Patient
Radiation emitted by the X Ray tube
• Primary radiation: before interacting photons
• Scattered radiation: after at least one interaction;
• Leakage radiation: not absorbed by the X Ray tube
housing shielding
• Transmitted radiation: emerging after passage
through matter
X-ray Tube Position
Image Intensifier • Position the X-ray tube
under the patient not above
the patient.
• The largest amount of
scatter radiation is
produced where the x-ray
beam enters the patient.
• By positioning the x-ray
tube below the patient, you
decrease the amount of
scatter radiation that
reaches your upper body.
X-ray Tube
FACTORS AFFECTING X Ray BEAM
• TUBE CURRENT
• TUBE POTENTIAL
• HIGH OR LOW Z TARGET MATERIAL
• FILTRATION
• TYPE OF WAVEFORM
Tube current
Change of QUANTITY
NO change of quality
Change in QUANTITY
&
Change in QUALITY
- spectrum shifts to higher
Energy
- characteristic lines appear
• use of high KV technique and low mAs (using the
shortest exposure time)
• The high KV beam has higher energy photons,
which undergo a lesser degree of beam attenuation
and greater penetration of the beam through the
patient.
• Therefore the tissue deposition of photons is
reduced, which reduces the radiation dose to the
patient
A. At high KVp, majority of the photons are of high energy;
therefore minimum number of photons are deposited in the patient
(dark area).
B. At low KVp, a large number of photons are of low energy;
therefore larger number are deposited in the patient (dark area).
X Ray spectrum: Target Z
Higher Z
Number of X
Rays per unit
Energy
Lower Z
10 15 20 25 30
Energy (keV)
Tube filtration
• Inherent filtration (always present)
– reduced entrance (skin) dose to the patient (cut off the
low energy X Rays which do not contribute to the
image)
• Additional filtration (removable filter)
– further reduction of patient skin and superficial tissue
dose without loss of image quality
• Total filtration (inherent + added)
• Total filtration must be > 2.5 mm Al for a > 110 kV
generator
Filtration
Change in QUANTITY
&
Change in QUALITY
spectrum shifts to higher energy
Patient
Scattered X Rays Lead
– TIME
– DISTANCE
– SHIELDING
Time
• The exposure time is related to radiation exposure
and exposure rate (exposure per unit time) as
follows :
• Exposure time = Exposure
Exposure rate
Or
Beta
g Gamma and X-rays
Neutron
n
Four aspects of shielding in diagnostic radiology
2. Room shielding
(a) X-ray equipment room shielding
(b) Patient waiting room shielding.
3. Personnel shielding
Door sign
Warning sign
To sum up……
It consists of
• a thimble ionization
chamber with an eyepiece
and a transparent scale,
• a hollow charging rod
• a fixed and a movable fiber.
• electrometer----separate
-----built-in (self
reading type)
The ability of radiation to produce ionization in air is
the basis for radiation detection by the ionization
chamber.
• Disadvantages------
– Easily damaged
Wearing period-
• Each member of staff wears film badge for a period of 4
weeks.
– inexpensive,
– easy to use,
– permanent record of exposure,
– wide range of sensitivity ( 0.2 – 2000 msv),
– identifies type and energy of exposure,
disadvantages
• they are not sensitive enough to capture very low
levels of radiation( < 0.15 msv),
Disadvantages
• Very expensive
• No permanent record ( other than glow curves)
• Cannot distinguish radioactive contamination.
• These are
• the International Commission for Radiation
Protection ( ICRP),
• the National Commission for Radiation Protection
(NCRP ) in America,
• and the Atomic Energy Regulatory Board (AERB) in
India.
• The International Commission of Radiation
Protection (ICRP) was formed in 1928 on the
recommendation of the first International Congress
of Radiology in 1925.