IAEA Training Material on Radiation Protection in Radiotherapy

Radiation Protection

Radiation Protection in Radiotherapy

The two aims of radiation protection

1. Prevention of deterministic effects (except

in radiotherapy those that are intentionally
produced, but including those which are
NOT intended, such as accidental medical
exposure)
2. Reduction of the probability of stochastic
effects

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 Law of Bergonie and Tribondeau

The mostsensitive
“The most sensitive cells
cells are arethat
those those that are
are undifferentiated,
well nourished, dividing
undifferentiated, quickly and highly
well nourished, active
dividing
metabolically”.
quickly and highly active metabolically.

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How does radiation damage DNA?
• Direct hit – when ionization occurs directly
within the DNA
• Indirectly – by ionization of water producing
free radicals which may react chemicaly with
DNA.

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The need for protection applies to all
dose levels

• It is generally assumed that even very small

doses of ionizing radiation can potentially
be harmful.
• Therefore, persons must be protected from
ionizing radiation at all dose levels.

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 Fundamental principles of
radiation protection
• Justification of practices
• Optimization - ALARA
• Dose limits

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 Justification

• No use of ionizing radiation is justified if

there is no benefit
• All applications must be justified
• This implies: All, even the smallest
exposures are potentially harmful and the
risk must be offset by a benefit

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 Risk/Benefit analysis

• Need to evaluate the benefits of radiation

• Radiation is the therapeutic agent
• Assessment of the risks requires the
knowledge of the dose received by persons

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 Optimization
• When radiation is to be used then the
exposure should be optimized to minimize
any possibility of detriment.
• Optimization is “doing the best you can
under the prevailing conditions”
• Need to be familiar with techniques and
options to optimize the application of
ionizing radiation

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 Optimization principle
As Low As Reasonably Achievable
This means radiation exposure should be
limited as much as possible keeping in mind
the risk-benefit relation of radiation and its
applications. For example, it is unreasonable to
refuse an X Ray after a bone fracture because
statistically this may shorten your life
expectancy by one day. The benefits of the X
Ray with its diagnostic value by far outweigh
the risk associated with the radiation exposure.

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 Dose limits
• A limit should be applied to the dose other
than from medical exposures, received by any
individual as the result of all the pracrices to
which he or she is exposed

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 Dose limits in occupational
exposure
• Effective dose limit for whole body radiation is
20mSv per calendar year averaged over a
defined period of 5 years, and with the
provision that the effective dose shall not
exceed 50mSv in any single year
- Basic Safety Standards Regulations.

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 Dose limits for pregnant women
• Dose to the fetus accumulated over the period
of confirmed pregnancy and the date of
delivery shall not exceed 1mSv.
• Same goes to members of the public.

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Radiology examination in pregnant
women

• All patients of menstrual age (typically ages 12

through 50 years) should be questioned about
pregnancy status – ACR guidelines 2008

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• If a patient can reliably answer that 1) she
cannot be pregnant and that 2) she had a
recent complete menstrual period, then it is
reasonable to proceed with a medically
indicated diagnostic X-ray.
• The last complete menstrual period should
have occurred within the previous 4 weeks.
• During this interval diagnostic radiation
represents no substantive risk to a conceptus

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• “Exposure of the embryo in the first 3 weeks
following conception is not likely to result in
deterministic or stochastic effects in the live-
born child, despite the fact that the central
nervous system and the heart are beginning to
develop in the third week.”

– ICRP publication 60

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 Basic radiation protection strategies

• Radiation cannot be seen,

heard or felt. Therefore it is
essential to know about it.
• Can be accurately
measured using
appropriate instruments
• Need appropriately
qualified expert

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Basic radiation protection strategies

• Radiation cannot be
seen, heard or felt.
Therefore it is essential to
know about it.
• Need signs

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 Basic radiation protection
strategies
–Time
–Distance
–Shielding

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 Dose is proportional to
Time
the time exposed

Dose = Dose-rate x Time

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 Consequence
• Reduce time in contact with radiation sources
as much as compatible with the task

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 Distance
Inverse square law (ISL):
Dose-rate  1/(distance)2
dose-rate

distance

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 Consequence
Reduction of radiation dose is
inversely proportional to the
square of the distance

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 Shielding
Barrier thickness

incident
radiation transmitted
radiation

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 Penetrating power of radiation

Radiation Protection in Radiotherapy

• Alpha particles
– the least penetrating of the three types of ionizing radiation.
– can be stopped by a piece of thin paper or clothing.
– an internal hazard only.
• Beta particles
– penetrate skin and tissue
– require a few millimeters of aluminum to stop them.
– can be both an external and internal hazard.
• Gamma rays
– the most penetrating type of radiation
– “penetrating radiation”.
– an internal and external hazard.

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Protection against external exposure

Radiation Protection in Radiotherapy

 Half value layer (HVL)

Radiation Protection in Radiotherapy

 Radiation Personal Protective
Equipment

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 Summary

• Humans must be protected from ionizing

radiation at all dose levels
• Exposure can occur in three different
categories:
– Occupational
– Medical
– Public

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 Summary
• The basic principles of a system of radiation
protection are:
– Justification of practices
– Dose limits to individuals
– Optimization of protection
• ALARA
• Even simple measures such as reducing the time
exposed to irradiation or keeping distance can be
effective measures to reduce exposure
Radiation Protection in Radiotherapy
 References
• International Commission of Radiation
Protection - Radiological Protection and Safety
in Medicine.
• American College of Radiology guidelines in
radiation protection in pregnant women.

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