RADIATION PROTECTION

DURING RADIOLOGICAL
PROCEDURE

UGYEN WANGCHUK
B.Sc. MIT
INTERN
 INTRODUCTION
RADIATION PROTECTION

Defined as the effective measures employed by radiation

workers to safe guard patients, personnel, and general
public from un necessary exposure to ionizing radiation.

AIM
The main objective of radiation protection (RP) is to avoid
the deterministic effects by keeping doses below the
relevant threshold and to reduce the probability of
stochastic effect as much as is reasonably achievable.
 RADIATION PROTECTION
justification – No practice involving exposure to radiation
should be adopted unless it produces positive benefit.

 Optimization - Optimization balances between

diagnostic image quality with dose to the patient.

Limitation- The effective doses to the

individuals shall not exceed the limits recommended
by the commission.
 INDIVIDUAL DOSE LIMITS

For women who declare themselves pregnant, a dose of 2

mSv at the surface of the abdomen over the remainder of the
pregnancy.
RADIATION PROTECTION IN FLUOROSCOPY UNIT
Fluoroscopy defined as:-
• Study of moving structures with the help of radiation.
• A continuous beam passes through the body and is transmitt
ed to the monitor for viewing.
• LIVE images generated by x-ray allows to examine the patient’
s internal body structures.
 Radiation protection from Fluoros
copy Exposure

1.) Patient Protection

2.) Personnel (radiation worker) Protection

BASIC RULE FOR PROTECTION OF PERSONNEL FROM EXPOSURE
 Protection of Personnel
TIME
- INTERMITTENT FLUROSCOPY - Take foot off fluo
ro pedal if physician is not viewing the TV monitor

- Use last image hold (freeze frame)

- Use of timer

- Use pulsed fluoro instead of continuous fluoro

 Protection of Personnel
DISTANCE

-Inverse Square Law

double the distance, 1/4 the dose

- One step back from tableside:

cuts exposure by factor of 4

- Lateral fluoroscopy:
5x less dose on Image Intensifier side

- Move Image Intensifier close to patient:

less patient skin exposure
less scatter
sharper image
 Protection of Personnel
SHIELDING

- Lead aprons: cut exposure by factor of 90%

(0.5 mmPb eq)

- Proper storage (hanging vs. folding)

- Thyroid collars; eye glasses; wrap aro

und aprons

- Use shielded rooms

 Radiation Protective Devices

 Thyroid sh
• Lead goggle ield
• Lead screen with
viewing window • Gonad
• Knee
shield
shield

Screen & goggle

 curtain
12
 Protection of Personnel

• Dosimeters
• use of TLD and Film badges
• collar and waist badges
• ring / wrist badges

To check the amount of radiation dose received by radiation worker

Whole Body: 5 rem/year Sk

in/Extremities:50 rem/year
Lens of Eye:15 rem/year
Fetus:500 millirem/gestation
 FACTORS AFFECTING STAFF DOSES
The main source of radiation for the sta
ff in a fluoroscopy room is the patient (sc
attered radiation).

The scattered radiation is not uniform a

round the patient.

The level of dose rate around the patient

is a complex function of a great number
of factors.
 FACTORS AFFECTING STAFFDOSES
Height of staff

Relative position with respect to the pati

ent

Irradiated patient volume

FACTORS AFFECTING STAFF DOSES

Effects of Tilt on Radiation exposure

KVp, ma and time

 FACTORS AFFECTING STAFF DOSES

Effective use of articulated shielding

Air gap and scatter

X ray tube position
 Radiationprotection
Radiation protectionofofpatients
patientsinin
fluoroscopy
fluoroscopy
1. Maximize distance between the X
ray tube and the patient to the extent
possible

2. Minimize distance between the

patient and the image receptor

3. Minimize fluoroscopy time

Keep records of fluoroscopy time and
DAP/KAP (if available) for every
patient
4. Use pulsed fluoroscopy with the
lowest frame rate possible to obtain
images of acceptable quality

5. Avoid exposing the same area

of the skin in different
projections Vary the beam
entrance port by rotating the tube
around the patient

6. Oblique projections also

increase ESD
7. Avoid the use of magnification.
Decreasing the field of view by a
factor of two increases dose rate
by a factor of four

8. Minimize number of frames and cineruns to clinically acceptable level

9. Use collimation
Collimate the X ray beam to the area of
interest
 Protection of non-radiation personnel and members of the public

“Non radiation personnel or members of the

public shall not remain in the X-Ray room
during any X-Ray procedure unless they are
required to be in attendance.”
 PRACTICAL RADIATION PROTECTION RULES
REGULAR QUALITY CONTROL CHECKS MUST BE
PROGRAMMED

DOSE RATES MUST BE KNOWN IN EACH OPERATIONA

L MODE AND FOR EACH INTENSIFIER INPUT SCREE
N SIZE

CRITERIA FOR THE CORRECT USE OF ANY GIVEN OP

ERATION MODE CAN BE ESTABLISHED
PRACTICAL RADIATION PROTECTION RULES

IMPORTANT PARAMETERS:
FOCUS-PATIENT SKIN DISTANCE
PATIENT-IMAGE INTENSIFIER DISTANCE

PATIENT DOSE WILL INCREASE IF :

THE FOCUS-SKIN DISTANCE IS SHORT
THE PATIENT-IMAGE INTENSIFIER DISTANCE IS LARG
E
 GOLDEN RULES

 Keep the Image intensifier close to the patient

Keep the Image intensifier close to the patient

DoDonot
notoveruse
overusemagnification
magnificationmodes
modes
 Keepthe
Keep thex-ray
x-raytube
tubeatatmaximal
maximaldistance
distancefrom
frompati
pati
ent
ent
 Usehigher
Use higherkVp
kVpwhere
wherepossible
possible
 Wearprotective
Wear protectiveaprons
apronsandandradiation
radiationmonitors,
monitors,an
an
d know where scatter is highest
d know where scatter is highest
 Keepyour
Keep yourdistance,
distance,asasfar
farasasisispracticable
practicable
 OTHER FACTORS IN CONTROLLING DOSE

 Ensure all staff are appropriately trained

 Use dedicated interventional equipment with corr
ect specification
 Ensure comprehensive maintenance and quality as
surance programmes are in place
 Obtain advice from a qualified radiation expert
 FOLLOW-UP
 Radiation skin injury may present late and the associ
ation not considered if no documentation
 All patients with estimated skin doses of 3 Gy should
be followed up 10-14 days after exposure
 A system to identify repeat procedures should be set
up
 SUMMARY
 The radiation risk is usually outweighed by the bene
fit of the procedure
 Both patients and staff are at risk of radiation injury
 Appropriate equipment and training are needed to
minimise this risk
 Patient counselling should be undertaken routinely,
and follow up when appropriate
 U… …
AN K
TH