Diagnostic Reference Levels (DRLs)
|
|
- Frederica Small
- 6 years ago
- Views:
Transcription
1 Section 7 Diagnostic Reference Levels (DRLs) Establishment and Use of Diagnostic Reference Levels (DRLs) The National Radiation Safety Committee (NRSC), established in November 2007, is a statutory committee appointed by the CEO, HSE to advise him on matters pertaining to medical exposure of patients to ionising radiation, in accordance with Statutory Instrument (SI) 478 (2002) (1) 22.6 The National Radiation Safety Committee shall monitor the population dosage for the health board functional area and will include their findings in an annual report. Since 2008 the HSE, on behalf of the National Radiation Safety Committee (NRSC), has been collecting and publishing statistics on population dose levels from the use of medical ionising radiation. This information is also useful for the purposes of establishing the national dose distribution for the modalities and examinations surveyed. The Population Dose and Optimisation Sub-Committee of the NRSC consider the data suitable for updating of National Diagnostic Reference Levels (NDRLs), previously set by the Medical Council in 2004 (2) DRLs are defined as dose levels in medical radio-diagnostic practices or, in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standard-sized patients or standard phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied. The standard-sized patient is defined in RP 109 (3) as one with a 20 cm AP trunk thickness and 70+-3kgweight. The APPM (4) states that the goal in medical imaging is to obtain image quality consistent with the medical imaging task.. The specific purpose of the diagnostic reference level is to provide a benchmark for comparison, not to define a maximum or minimum dose limit. A DRL is not applied to individual patients. DRLs should be applied with flexibility to allow higher doses when indicated and justified by the Radiologist. The Medical Council acknowledged that the 2004 NDRLs were established with considerable reliance on published data from U.K. and European sources due to a lack of local data. The National DRLs (2014) adopted by the NRSC are based on data from Irish hospitals (5) (6) (7) (8) both public and private. Additional sources of information for CT were taken from the literature (9) and from the National Integrated Medical Imaging System (10). National DRLs are a useful comparison tool to benchmark local practice. Local DRLs are recommended as the first step in optimisation of procedures, as they are most relevant to the patient cohort, examination type and equipment available locally. Review of DRLs Service providers are required to establish and use DRLs for each of their routine procedures. DRLs should be reviewed annually or when there is a significant change in protocol or where they are consistently exceeded. The review of DRLs should compare local with national or referenced DRLs and a note made of any significant variances to these DRLs, and the justification for it. The local DRLs can be higher or lower than the national DRLs depending on the imaging equipment available to them or the patient casemix of that location. This regular review provides opportunity to provide feedback to ensure good practice in medical exposures is maintained. A sample template to record and review CT DRLs for locations is under local documentation in this section. This template can be adapted to set DRLs for locations for all diagnostic procedures. 3
2 Definition of DRL Diagnostic reference levels means dose levels in medical radio-diagnostic practices or in the case of radio-pharmaceuticals, levels of activity, for typical examinations for groups of standardsized patients or standard phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied. National, European and International DRLs The Medical Council is required to promote the establishment of DRLs and published a position paper on DRLs in 2004 outlining DRLs for use. Since then, national surveys have collated patient dose data and from these more recent DRLs have been established for adult patients, and are outlined below. These are the national benchmarks against which local DRLs can be compared. As new surveys are produced, these national DRLs will be reviewed. 4
3 Contents Adult Computed Tomography... 6 Adult General X ray... 7 Adult Nuclear Medicine... 8 Adult Interventional and Fluoroscopy... 9 Paediatric Computed Tomography Paediatric General X ray (2) (12) Paediatric Fluoroscopy (13) Information on Patient Radiation Doses, Ireland (14), (15)... 3 Band Classification of the Typical Doses of Ionising Radiation from Common Imaging Procedures (18) Bibliography
4 Adult Computed Tomography The Dose Length Product (mgycm) was chosen as the parameter for NDRL in CT. The DRL is for specific procedures and should only be applied to those procedures, eg: CT Thorax is not a suitable DRL for CT Thorax&Liver. Examination Order Code NDRL DLP mgycm CT BRAIN 990 CT CERVICAL SPINE 600 CT KUB 370 CT PELVIS 570 CT THORAX 390 CT THORAX HIGH RESOLUTION 350 CT PA 430 CT THORAX + LIVER 460 CT THORAX AND ABDOMEN 660 CT ABDOMEN AND PELVIS 660 CT THORAX ABDOMEN AND PELVIS 850 PET WB (diagnostic quality) CT 800 PET Brain CT 290 6
5 Adult General X ray The Dose Area Product (DAP) Gycm2 was chosen as the parameter for the NDRL Examination Order Code NDRL DAP Gycm 2 Chest PA 0.16 Chest AP 0.18 Cervical Spine AP 0.22 Cervical Spine Lat 0.24 Thoracic Spine AP 0.97 Thoracic Spine Lat 2.03 Lumbar Spine AP 1.62 Lumbar Spine Lat 2.68 Full Spine (T+L) 6.6 Full Spine (C+T+L) 8.4 Abdominal AP 2.3 Pelvic AP 2.6 Single Hip AP 1.5 Both Hips 1.9 Femur AP 0.8 Femur Lat 1.0 Feet/Ankles/Wrist/Hand 0.07 Knees AP/Lateral 0.16 Mammography (2 views, single breast) 2.7 MGD (mgy) DAP dose units vary with manufacturer and local DAP values may need to be converted to Gycm 2 to compare with the NDRLs. Use this table to convert DAP Dose units to Gycm 2 Dose Units convert to Gycm 2 dgycm2 Divide by 10 cgycm2 Divide by 100 mgycm2 Divide by 1,000 μgym2 Divide by 100 7
6 Adult Nuclear Medicine The administered activity MBq was chosen as the parameter for NDRL. It is recommended that in setting Local DRLs consideration should also be given to the use of the Administration of Radioactive Substances Advisory Committee, UK (ARSAC) DRLs; levels not expected to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied. Administrations above the ARSAC (11) DRLs would only be considered as good practice in particular circumstances. Examination Order Code NDRL MBq ARSAC DRL MBq 99mTc Bone Scan mTc Thyroid Scan I Thyroid Uptake 2* I Thyroid metastases mTc V/Q Perfusion Scan mTc DTPA Renogram Scan mTc MAG3 Renogram Scan I DAT Scan I MIBG Scan In OctreoScan mTc Myocardial Scan mTc Cerebral blood flow WB PET Brain PET * The reported administered activity for 131-I uptake in the Nuclear Medicine Population Dose Surve y (6) was considerably higher than the ARSAC recommended activity (11). MERU, HSE recommended a review with regard to justification and optimisation in the small number of organisations that carry out this examination, taking into account the ARSAC Guidelines. 8
7 Adult Interventional and Fluoroscopy The Dose Area Product (DAP) Gycm 2 was chosen as the parameter for the NDRL Examination Order Code NDRL DAP Gycm 2 Abdominal Barium Meal + follow through 11 Oesophageal& Stomach & small intestine 13 Colon 23 Biliary tract 16 Orthopaedics 0.7 Cerebral procedures (e.g.: embolization s) 62 Cardiac studies 55 PTCA 75 Pacemaker 12 All Peripheral procedures 30 All Thoracic procedures 8 All Pelvic/Abdominal procedures 70 All IV lines, e.g. Hickman 3 Arthrography 0.35 DAP dose units vary with manufacturer and local DAP values may need to be converted to Gycm 2 to compare with the NDRLs. Use this table to convert DAP Dose units to Gycm 2 Dose Units convert to Gycm 2 dgycm2 Divide by 10 cgycm2 Divide by 100 mgycm2 Divide by 1,000 μgym2 Divide by 100 9
8 Paediatric DRLs. Particular attention needs to be given to establish separate DRLs for paediatrics for different ages. Below are recommended DRLs for paediatric CT based on the 2009 survey (5). There are a number of published research articles on paediatric DRLs available in Ireland (12) or internationally (13) which should be taken in to account when setting a benchmark from which to compare local DRLs. As new radiation dose surveys are produced, these national DRLs will be reviewed. Paediatric Computed Tomography Examination Order Code Paediatric Age NDRL DLP mgycm Brain Newborn years years years 850 Adult 950 Abdomen/Pelvis Newborn years years years 400 Adult
9 Paediatric General X ray (2) (12) Examination Order Code Paediatric IRISH NDRL Entrance Age Surface Dose μgy Abdomen AP 1 years 330 UK NDRL Entrance Surface Dose μgy 5 years years 2600 Chest AP/PA Newborn 70 1 year years years years Pelvis AP Newborn year years years years Skull AP 5 years 1370 Skull Lat 5 years
10 Paediatric Fluoroscopy (13) Examination Order Code Paediatric Age NDRL DAP mgycm 2 MCU newborn year years years years 4700 Barium Meal Newborn year years years years 7200 Barium Swallow newborn year years years years 4600 DAP dose units vary with manufacturer and local DAP values may need to be converted to Gycm 2 to compare with the NDRLs. Use this table to Convert DAP Dose units to Gycm 2 Dose Units convert to Gycm 2 dgycm2 Divide by 10 cgycm2 Divide by 100 mgycm2 Divide by 1,000 μgym2 Divide by
11 Information on Patient Radiation Doses, Ireland (14), (15) Typical effective doses, equivalent periods of natural background radiation and lifetime fatal cancer risks from most common diagnostic medical exposures. Ionising Radiation Typical Effective Dose* in millisieverts 2 Equivalent Period of Natural Background Radiation (15) Lifetime Additional Risk of Fatal Cancer per Single Examination (16)# Limbs and joints (excluding hip) <0.01mSv one hour <1 in 100 million Teeth, intra-oral 0.005mSv <1 day 1 in 4 million Teeth, panoramic 0.02mSv 2 days 1 in 1 million Chest PA x-ray 0.02mSv 2 days 1 in 1 million Return airplane flight Dublin Rome return 0.027mSv 2 days 1 in 750,000 Cervical spine AP& Lat. x-ray 0.07mSv 1 week 1 in 300,000 Hip x-ray 0.2mSv 3 weeks 1 in 100,000 Pelvis AP x-ray 0.3mSv 1 month 1 in 70,000 Thoracic Spine AP& Lat x-ray 0.4mSv 1.5 months 1 in 50,000 Abdomen AP x-ray 0.4mSv 1.5 months 1 in 50,000 Lumbar Spine AP& Lat x-ray 0.6mSv 2 months 1 in 35,000 Barium follow-through 1.2mSv 4 months 1 in 17,000 NM 99mTc Thyroid Scan 1.3mSv 5 months 1 in 15,000 NM 99mTc Renogram 1.3mSv 5 months 1 in 15,000 CT Brain / Head 1.7mSv 6 months 1 in 12,000 NM 99mTc Ventilation/Perfusion 3.22mSv 1 year 1 in 6,200 One year s natural background radiation Ireland 3.4mSv 1 year 1 in 5,900 NM 99mTc Bone Scan 3.5mSv 1 year 1 in 5,700 Barium enema 3.6mSv 1 years 1 in 5,500 PTCA 7mSv 2 years 1 in 3,000 CT of Chest / Thorax 7mSv 2 years 1 in 3,000 CT of Abdomen and Pelvis 8mSv 2.4 years 1 in 2,500 Interventional Radiology (abdominal) 8.5mSv 2.5 years 1 in 2,500 Interventional Cardiac 11mSv 3.2 years 1 in 2,000 CT of Chest, Abdomen and Pelvis 13mSv 3.8 years 1 in 1,500 NM 131-I Thyroid Uptake Scan 47mSv 14 years 1 in 425 Lifetime risk of cancer NOT caused by radiation (16) 1 in 3 13
12 * where Irish data is not available reference data from the UK (14) has been used #based on 5% per Sv within age group 18-64years Band Classification of the Typical Doses of Ionising Radiation from Common Imaging Procedures (18) Typical effective doses for radiological examinations and associated risks as presented in irefer Making the Best us of Clinical Radiology V Royal College of Radiologists. Symbol Typical effective dose (msv) Examples Lifetime additional risk of fatal cancer/exam None 0 US: 0 MRI <1 CXR; XR limb, pelvis, lumbar spine; mammography 1-5 IVU; NM (e.g., bone); CT head and neck CT chest or abdomen; NM (e.g., cardiac) >10 Extensive CT studies, some NM studies (e.g., some PET- CT) <1:20,000 1:20,000 1:4,000 1:4,000 1:2,000 >1:2,000 The average annual background dose in most parts of Europe falls within the 1-5mSv range ( ). Cancer risks from radiation vary considerable with age and sex, with higher risks from radiation vary considerably with age and sex, with higher risks in infants and females. Cancer risk indicated in this table is averaged for adults. This should be taken in the context of the considerably higher 1 in 3 average lifetime risk for cancer and must be balanced against the benefit of the investigation. [Key: US=ultrasound; MRI=magnetic resonance imaging; CXR=chest X-ray; XR=X-ray; IVU=intravenous urography; NM=nuclear medicine; CT=computed tomography; PET-CT=positron emission tomography coregistered with CT.] 14
13 Bibliography 1. European Communities (Medical Ionising Radiation Protection) Regulations EEC Directive 97/43/Euratom. Health Protection of Individuals against the danger of Ionising Radiation in relation to Medical Exposures. S.I. 478 (2002). 2. Medical Council. Diagnostic Reference Levels Position Paper European Commission. Guidance on Diagnostic Reference Levels for Medical Exposures American College of Radiology and American Association of Physicists in Medicine. ACR AAPM Practice Parameter for Diagnostic Referemce Levels and Achievable Doses in Medical X Ray Imaging Medical Exposure Radiation Unit, HSE. Population Dose from CT Scanning Medical Exposure Radiation Unit, HSE. Population Dose from General X ray and Nuclear Medicine Medical Exposure Radiation Unit, HSE. Population Dose from PET CT Scanning Radiological Protection Insitute of Ireland / Medical Exposure Radiation Unit, HSE. Radiation Doses Received by the Irish Population Chapter 2.7 Medical exposure of patients Establishment of CT diagnostic reference levels in Ireland. Foley S, McEntee M, Rainford L.. : BJR, 2012, BJR, Vol National Integrated Medical Imaging System. Private Communication, 75th percentile DLP values from CT examinations Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Administration of Radioactive Substances Advisory Committee Paediatric reference levels. Byrne B, Kenny P. 2002, Private Communication. 13. Doses to patients from medical X ray examinations in the UK 2000 review. Hart D., Hillier M.C., Wall B F.: NRPB, 2000, Vol. W Patient Dose Information (website). Public Health England. 15. Radiation Doses Received by the Irish Population Chapter. Radiological Protection Intitute of Ireland International Commission on Radiological Protection. The 2007 Recommendations of the ICRP. Annals of the ICRP. Publication 103, 2007, Vol National Cancer Registry of Ireland (NCRI) ( 18. Royal College of Radiologists. irefer Making the best use of clinical radiology services
Population Dose from General X-ray and Nuclear Medicine: 2010
Population Dose from General X-ray and Nuclear Medicine: 2010 Medical Exposure Radiation Unit 1 Executive Summary of Results The Health Services Executive (HSE) has a legal obligation, under Article 12
More informationROMANIA MEDICAL EXPOSURE IN 2016 IN ROMANIAN RADIOLOGICAL DEPARTMENTS. Olga GIRJOABA and Alexandra CUCU
ROMANIA MEDICAL EXPOSURE IN 2016 IN ROMANIAN RADIOLOGICAL DEPARTMENTS Olga GIRJOABA and Alexandra CUCU National Institute of Public Health, Bucharest, Romania olga.garjoaba@insp.gov.ro PURPOSE Improvement
More informationAppendix I. List of stakeholders consulted with on the Patient Radiation Protection Manual and members of the Medical Exposure Radiation Unit
References References The accuracy, quality and relevance of these works are not guaranteed or uniform and more recent information may have superseded these works. This list is not exhaustive. It does
More informationJMSCR Vol 06 Issue 12 Page December 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.80 Diagnostic Reference Levels:
More informationICRP Symposium on the International System of Radiological Protection
ICRP Symposium on the International System of Radiological Protection October 24-26, 2011 Bethesda, MD, USA M. Balonov, ICRP Committee 2, IRH, Russia P. Shrimpton, HPA, UK To be used just for regulatory
More informationTrends in examination frequency and population doses in Norway,
Workshop on European Populaltion Doses from Medical Exposure, 24-26 April 2012, Athens, Greece Trends in examination frequency and population doses in Norway, 2002-2008 OLERUD H.M. 1,2, FRIBERG E.G. 1,
More informationNational Radiation Safety Committee
National Radiation Safety Committee ANNUAL REPORT 2012 Report for the year-end 31 st December 2012 The National Radiation Safety Committee (NRSC), established in November 2007, is a statutory committee
More informationPage 1 of 5 Patient Safety: Radiation Dose in X-Ray and CT Exams What are x-rays and what do they do? X-rays are forms of radiant energy, like light or radio waves. Unlike light, x-rays can penetrate the
More informationPatti Edwards, Senior Radiographer, West Herts Hospitals, UK. February Radiation Safety
Patti Edwards, Senior Radiographer, West Herts Hospitals, UK. February 2008. Radiation Safety Sub -headings Background Radiation Effects of Radiation Safe Levels Effective Doses ALARA Principle Radiation
More informationThe activity. Suggested Answers
Teacher notes Introduction This activity encourages students to consider the principles of radiation protection and how they might apply in the nuclear industry and in medicine. They discuss and answer
More informationIonizing Radiation Exposure of the Population of the United States. David A. Schauer Executive Director
Ionizing Radiation Exposure of the Population of the United States David A. Schauer Executive Director Key Dates in NCRP s s History 1929: U.S. Advisory Committee on X-ray and Radium Protection 1946: U.S.
More informationAustralian Per Caput Doses from Diagnostic Imaging and Nuclear Medicine
Australian Per Caput Doses from Diagnostic Imaging and Nuclear Medicine A.J.M Hayton, P.N Johnston, J Baldas, P.A Marks, K Edmonds, A.B Wallace Australian Radiation Protection and Nuclear Safety Agency,
More informationRadiation exposure of the Yazd population from medical conventional X-ray examinations
Iran. J. Radiat. Res., 2007; 4 (4): 195-200 Radiation exposure of the Yazd population from medical conventional X-ray examinations F. Bouzarjomehri 1*, M.H. Dashti 2, M.H. Zare 1 1 Department of Medical
More informationIntroduction to RP154 methology for population dose estimates
Introduction to RP154 methology for population dose estimates Hilde M. Olerud (NRPA, NO) DDM 1 & DDM2 WP 3 Contract ENER/2010/NUCL/SI2.581237 Study on European Population Doses from Medical Exposure (Dose
More informationThe Fluoroscopic Technique for Monitoring Distraction of a Non-Invasive Lengthening Device in Early Onset Scoliosis
Send Orders for Reprints to reprints@benthamscience.net Open Medicine Journal, 2014, 1, 23-28 23 Open Access The Fluoroscopic Technique for Monitoring Distraction of a Non-Invasive Lengthening Device in
More information3 rd International Symposium on the System of Radiological Protection Seoul, October John Harrison
3 rd International Symposium on the System of Radiological Protection Seoul, October 2015 John Harrison UK Task Group 79 : Use of Effective Dose as a Risk-related Radiological Protection Quantity John
More informationManaging Patient Dose in Computed Tomography (CT) INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION
Managing Patient Dose in Computed Tomography (CT) International Commission on Radiological Protection Information abstracted from ICRP Publication 87 Available at www.icrp.org Task Group: M.M. Rehani,
More informationEuropean Guidelines on DRLs for Paediatric Imaging
European Guidelines on DRLs for Paediatric Imaging Final complete draft 1 1 1 1 1 1 1 1 0 1 0 1 Contents PREFACE... EXECUTIVE SUMMARY... 1. Background.... Introduction.... Purpose and scope.... Definitions...
More informationReceptor dose and Patient Dose in Radiographic exposures - a 15 year review
Receptor dose and Patient Dose in Radiographic exposures - a 15 year review D J Peet*, N Tyler, M Pryor, P Hollaway, C Strudley and L Leavesley Regional Radiation Protection Service, Royal Surrey County
More informationPeople Exposed to More Radiation from Medical Exams
People Exposed to More Radiation from Medical Exams With its release of a new report, titled Ionizing Radiation Exposure of the Population of the United States (Report No. 160, 2009), the National Council
More informationNational collection of local diagnostic reference levels in Norway and their role in optimization of X-ray examinations
National collection of local diagnostic reference levels in Norway and their role in optimization of X-ray examinations Eva Godske Friberg *, Anders Widmark and Ingrid Helen Ryste Hauge Norwegian Radiation
More informationAttention. Therefore, all the data and statements made in this presentation are preliminary and might change in the future.
Attention The aim of the Dose Datamed II workshop in Athens was to present preliminary data, collect feedback from the audience and to work towards final results and conclusions. Therefore, all the data
More informationRADIATION PROTECTION N 180
EUPEAN COMMON RADIATION ECTION N 18 Diagnostic Reference Levels in Thirty-six European Countries Part 2/2 Directorate-General for Energy Directorate D Nuclear Safety & Fuel Cycle Unit D3 Radiation Protection
More information3/5/2015. Don t Electrocute Me!: Common Misconceptions in Imaging and Radiation Safety (and What to Do About Them)
Don t Electrocute Me!: Common Misconceptions in Imaging and Radiation Safety (and What to Do About Them) Rebecca Milman Marsh, Ph.D. University of Colorado Department of Radiology Who in the Facility Works
More informationIntegrated Research Application System (IRAS)
Integrated Research Application System (IRAS) Question specific guidance Part B Section 3 Exposure to ionising radiation The following document collates all guidance for the questions in Part B: Section
More informationRecent Progress in Radiation Dosimetry for Epidemiology and Radiological Protection. John Harrison ICRP Committee 2
Recent Progress in Radiation Dosimetry for Epidemiology and Radiological Protection John Harrison ICRP Committee 2 Joint ICRP-RERF-JHPS Workshop: Tokyo, December 2017 Task Group 79 : Use of Effective Dose
More informationCT Optimisation for Paediatric SPECT/CT Examinations. Sarah Bell
CT Optimisation for Paediatric SPECT/CT Examinations Sarah Bell Sarah.bell14@nhs.net Outline 1. Introduction 2. Aims and Objectives 3. Methods 4. Results 5. Discussion 6. Conclusions 7. References Introduction
More informationDiagnostic reference levels as a quality assurance tool
Australian Institute of Radiography The Radiographer 2009; 56 (3): 32 37 Literature review Diagnostic reference levels as a quality assurance tool KD Edmonds Medical Physics Section, Medical Radiation
More informationRadiation Dose in X-Ray and CT Exams
Scan for mobile link. Patient Safety: Radiation Dose in X-Ray and CT Exams What are x-rays and what do they do? X-rays are forms of radiant energy, like light or radio waves. Unlike light, x-rays can penetrate
More informationShielding Calculation: Radiographic Room. Jerry Williams
Shielding Calculation: Radiographic Room Jerry Williams What you need to know Room use and layout DAP workload DAP averaged kv Distance to barrier Construction details Walls Ceilings/ floors Surrounding
More informationPractice and Risk at Medical Facilities in Agency Operations
Practice and Risk at Medical Facilities in Agency Operations Igor Gusev Radiation Protection Unit IAEA International Atomic Energy Agency Outline What is medical radiation exposure? Radiation sources and
More informationCOMPETENCY REQUIREMENTS for the CERTIFICATION EXAMINATION
COMPETENCY REQUIREMENTS for the 10/2013 CERTIFICATION BOARD FOR RADIOLOGY PRACTITIONER ASSISTANTS CERTIFICATION EXAMINATION Note: The competency requirements contained in this document will be in effect
More informationcreated by high-voltage devices Examples include medical and dental x-rays, light, microwaves and nuclear energy
What is radiation? Radiation is energy emitted from a source, that travels through space and can penetrate matter. Listed below are two types that we are exposed to and contribute to our overall radiation
More informationRadiology. General radiology department. X-ray
The radiology directorate provides a diagnostic, interventional and therapeutic service for its local population, and a tertiary service for the region. It also provides support to some national work such
More informationEstablishment of Dose Reference Levels for Nuclear Medicine in Sudan
Open Journal of Radiology, 2016, 6, 258-263 http://www.scirp.org/journal/ojrad ISSN Online: 2164-3032 ISSN Print: 2164-3024 Establishment of Dose Reference Levels for Nuclear Medicine in Sudan Wadah M.
More informationCT Radiation Risks and Dose Reduction
CT Radiation Risks and Dose Reduction Walter L. Robinson, M.S. D.A.B.S.N.M., D.A.B.M.P., D.A.B.R. Consultant Certified Medical Radiation Health & Diagnostic Imaging Physicist Medical Radiation and Children
More informationBackground Radiation in U.S. ~ msv/yr msv/yr ~0.02 ~0.02 msv msv/day /day (~2 m rem/day) mrem/day) NCRP 4
Patient Safety Concerns in Diagnostic Radiology? Lawrence T. Dauer, PhD, CHP Assistant Attending Health Physicist Department of Medical Physics RAMPS/GNYCHPS Spring Symposium April 30, 2010 Benefits?
More informationAsk EuroSafe Imaging Tips & Tricks. CT Working Group. CT in Pregnancy
Ask EuroSafe Imaging Tips & Tricks CT Working Group CT in Pregnancy Eileen Kelly (Galway University Hospitals, IE) Matthias Stefan May (University Hospital Erlangen, DE) Robert Bujila (Karolinska University
More informationAssessing the standard dose to standard patients for x-ray investigations
Assessing the standard dose to standard patients for x-ray investigations A. Almén and W. Leitz Swedish Radiation Protection Authority, SE-171 16 Stockholm, Sweden E-mail: anja.almen@ssi.se Abstract. The
More informationAsk EuroSafe Imaging Tips & Tricks. CT Working Group. On the use of Diagnostic Reference Levels in CT
Ask EuroSafe Imaging Tips & Tricks CT Working Group On the use of Diagnostic Reference Levels in CT Robert Bujila (Karolinska University Hospital, SE) Eileen Kelly (Galway University Hospitals, IE) Matthias
More informationRadiation exposure of the Italian population from diagnostic radiology and nuclear medicine examinations
Workshop on European Population Doses from Medical Exposure 24-26 April 2012, Athens, Greece Radiation exposure of the Italian population from diagnostic radiology and nuclear medicine examinations Gaetano
More informationIranian physicians' knowledge about radiation dose, received by patients in diagnostic radiology
Iran. J. Radiat. Res., 2009; 6 (4): 207-212 Iranian physicians' knowledge about radiation dose, received by patients in diagnostic radiology K. Ghazikhanlou Sani 1*, M. Jafari 2, M. Mohammadi 3, M. Mojiri
More informationX-rays How safe are they?
X-rays How safe are they? Patient information Thirty years ago, X-rays were the only way to see what was going on inside your body. Now other methods of medical imaging are available, some using different
More informationADI Procedure Codes. August 2016 Revised April 2017 Page 1 of 7 ADI Procedure Codes
Code Description 70450 CT Head without contrast 70460 CT Head with contrast 70470 CT Head with & without contrast 70480 CT Orbit, et al without contrast 70481 CT Orbit, et al with contrast 70482 CT Orbit,
More informationA Standardised Approach to Optimisation
The Radiographer vol. 51: 105-110 A Standardised Approach to Optimisation Helen M. Warren-Forward 1 & Ronald Beckhaus 2 ABSTRACT Purpose: Optimisation of radiographic images is said to have been obtained
More informationAssessment of radiation risk to pediatric patients undergoing conventional X-ray examinations
Radioprotection 50(1), 19-25 (2015) c EDP Sciences 2015 DOI: 10.1051/radiopro/2014023 Available online at: www.radioprotection.org Article Assessment of radiation risk to pediatric patients undergoing
More informationTHE STUDY OF PATIENT DOSES IN DIAGNOSTIC RADIOLOGY FOR ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE LEVELS
THE STUDY OF PATIENT DOSES IN DIAGNOSTIC RADIOLOGY FOR ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE LEVELS Larysa Stadnyk, Pylypenko M., Shalepa O., Nosyk O. Grigorev Institute for Medical Radiology,
More informationOutline. NCRP Scientific Committee 6-2
Magnitude of Medical Radiation Exposures to US population Mahadevappa Mahesh, MS, PhD, FAAPM. Assistant Professor of Radiology & Cardiology Chief Physicist - Johns Hopkins Hospital The Russell H. Morgan
More informationRadiation Dose To Pediatric Patients in Computed Tomography in Sudan
Radiation Dose To Pediatric Patients in Computed Tomography in Sudan Omer Osman,Saeed Medical Physics Department, ALNeelain University, Sudan Presentation outlines Introduction Objectives Materials and
More informationRadiology Codes Requiring Authorization*
70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) 70450 Computed tomography, head or brain; without contrast material 70460 Computed tomography, head or brain; with contrast material(s)
More informationRadiation Doses in Radiology: Influence of Standards and Regulations
Radiation Doses in Radiology: Influence of Standards and Regulations Beebe Symposium National Academy of Sciences December 9, 2009 Washington D.C. Orhan H Suleiman MS PhD, FAAPM Senior Science Policy Adviser
More informationManaging Radiation Risk in Pediatric CT Imaging
Managing Radiation Risk in Pediatric CT Imaging Mahadevappa Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT. Professor of Radiology and Cardiology Johns Hopkins University School of Medicine Chief Physicist
More informationCertification Review. Module 28. Medical Coding. Radiology
Module 28 is the study of x-rays, using radiant energy and other imaging techniques, such as resonance imaging or ultrasound, to diagnose illnesses and diseases. Vocabulary Barium enema (BE): lower gastrointestinal
More informationHaving a V/Q scan or CTPA scan of your lungs whilst pregnant
Having a V/Q scan or CTPA scan of your lungs whilst pregnant Department of Radiology Information for Patients i Radiology Leaflet No. 93 University Hospitals of Leicester NHS Trust Introduction This leaflet
More informationDebra Pennington, MD Director of Imaging Dell Children s Medical Center
Debra Pennington, MD Director of Imaging Dell Children s Medical Center 1 Gray (Gy) is 1 J of radiation energy/ 1 kg matter (physical quantity absorbed dose) Diagnostic imaging doses in mgy (.001 Gy)
More informationHIP RADIOLOGY PROGRAM CODE LISTS
EFFECTIVE OCTOBER 1, 2012 70336 MAGNETIC RESONANCE IMAGING TMJ 70450 COMPUTED TOMOGRAPHY HEAD/BRAIN WITHOUT 70460 COMPUTED TOMOGRAPHY HEAD/BRAIN WITH 70470 COMPUTED TOMOGRAPHY HEAD/BRAIN WITHOUT AND WITH
More informationRADIOLOGY (Management)
ULTRASOUND BETA SCAN/ U/S ORBITAL 1600 Daily U/S WHOLE ABDOMEN (Abd + Pelvis) 1200 Daily U/S PELVIS 1200 Daily U/S ABDOMEN 1200 Daily U/S BREAST 1800 Daily U/S FOLLICULAR STUDY 3000 Daily U/S FOLLICULAR
More informationManaging the imaging dose during Image-guided Radiotherapy. Martin J Murphy PhD Department of Radiation Oncology Virginia Commonwealth University
Managing the imaging dose during Image-guided Radiotherapy Martin J Murphy PhD Department of Radiation Oncology Virginia Commonwealth University Radiographic image guidance has emerged as the new paradigm
More informationHEALTHFIRST 2011 RADIOLOGY PROGRAM CODE LIST
HEALTHFIRST 2011 RADIOLOGY PROGRAM CODE LIST Outpatient Radiology utilization call Carecore at 1-877-773-6964 Modality CPT CODE Description CT SCANS 70450 CT HEAD/BRAIN W/O CONTRAST CT SCANS 70460 CT HEAD/BRAIN
More informationArteriogram An X-ray of an artery after the injection of dye.
A Abscess A localized collection of pus in any part of the body, usually surrounded by inflamed tissue. Anesthetic An agent that causes loss of sensation with or without the loss of consciousness. Angiography,
More informationCT Dose Estimation. John M. Boone, Ph.D., FAAPM, FSBI, FACR Professor and Vice Chair of Radiology. University of California Davis Medical Center
CT Dose Estimation John M. Boone, Ph.D., FAAPM, FSBI, FACR Professor and Vice Chair of Radiology 1 University of California Davis Medical Center CT Dose Estimation Introduction The CTDI Family of Metrics
More informationEstablishing a quality assurance baseline for radiological protection of patients undergoing diagnostic radiology
Establishing a quality assurance baseline for radiological protection of patients undergoing diagnostic radiology G K Korir, BSc, MSc (Nuclear Science), PhD (Radiological Science) Department of Physics
More informationRadiography Sep 2004 Page 1 of 5 Version 01.11
NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers.
More information8/18/2011. Acknowledgements. Managing Pediatric CT Patient Doses INTRODUCTION
Managing Pediatric CT Patient Doses Keith J. Strauss, MSc, FAAPM, FACR President X-Ray Computations, Inc. Boston, Massachusetts Acknowledgements Marilyn Goske, MD John Boone, PhD Cynthia McCollough, PhD
More informationEthics in Medical Radiological Protection
Ethics in Medical Radiological Protection Dr. Claire Cousins, Chair ICRP Consultant Vascular & Interventional Radiologist, Addenbrooke s Hospital, Cambridge, UK Ethics in Medical Radiological Protection
More informationManaging Patient Dose in Computed Tomography (CT)
Managing Patient Dose in Computed Tomography (CT) International Commission on Radiological Protection Information abstracted from ICRP Publication 87 Available at www.icrp.org Task Group: M.M. Rehani,
More informationAIM 2014 CPT Radiology & Cardiac Codes Requiring Review
AIM 2014 CPT Radiology & Cardiac Codes Requiring Review Modality Body Part CT Head 1 70480 CT orbit, sella or posterior fossa; w/o contrast 1 CT Head 1 70481 CT orbit, sella or posterior fossa; with CT
More informationEarly in Life. Noboru Takamura, M.D., Ph.D.
Health Risks of Radiation Exposure Early in Life Noboru Takamura, M.D., Ph.D. Diagnostic Radiologic Procedures In recent years, the largest source of general population exposure to radiation has shifted
More informationAssessment of effective dose in paediatric CT examinations
Assessment of effective dose in paediatric CT examinations E. Dougeni 1,2 CL. Chapple 1, J. Willis 1, G. Panayiotakis 2 1 Regional Medical Physics Department, Freeman Hospital, Freeman Road, Newcastle
More informationFDG-18 PET/CT - radiation dose and dose-reduction strategy
FDG-18 PET/CT - radiation dose and dose-reduction strategy Poster No.: C-1856 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit P. Nicholson, S. McSweeney, K. O'Regan; Cork/IE Radiation
More informationRadiopharmaceutical Activities Administered for Diagnostic and Therapeutic Procedures in Nuclear Medicine in Argentine: Results of a National Survey
Radiopharmaceutical Activities Administered for Diagnostic and Therapeutic Procedures in Nuclear Medicine in Argentine: Results of a National Survey A. M. Bomben, C. A. Chiliutti Autoridad Regulatoria
More informationPotential Communication Benefits by adoption of SI units in Radiation Safety
Potential Communication Benefits by adoption of SI units in Radiation Safety Steven H. King CHP, DABMP Penn State Milton S. Hershey Medical Center Radiation Protection in the 1970 s. TMI & Chernobyl changed
More informationDoses from Cervical Spine Computed Tomography (CT) examinations in the UK. John Holroyd and Sue Edyvean
Doses from Cervical Spine Computed Tomography (CT) examinations in the UK John Holroyd and Sue Edyvean Why a new dose survey? Number of enquires received concerning the current NDRL Concern that could
More informationGUIDELINES ON IONISING RADIATION DOSE LIMITS AND ANNUAL LIMITS ON INTAKE OF RADIOACTIVE MATERIAL
RADIATION PROTECTION AUTHORITY OF ZIMBABWE (RPAZ) RADIATION PROTECTION ACT [CHAPTER 15:15] GUIDELINES ON IONISING RADIATION DOSE LIMITS AND ANNUAL LIMITS ON INTAKE OF RADIOACTIVE MATERIAL Compiled by Radiation
More informationCPT CODES. Ph: (307) Fax: (307) CATSCAN IV Contrast: 87.00
Ph: (307) 382-4282 Fax: (307) 382-4291 CPT CODES CATSCAN IV Contrast: 87.00 74150 Abdomen w/o contrast $ 809.00 74160 Abdomen w/ contrast $1175.00 w/ contrast: $1262.00 74170 Abdomen w_w/o contrast $1324.00
More informationRADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGING For the Time Period : 10/01/16 and 09/30/2017
RADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGING For the Time Period : 10/01/16 and 09/30/2017 IF YOU ARE COVERED BY HEALTH INSURANCE, YOU ARE STRONGLY ENCOURAGED TO CONSULT
More informationWe Accept Care Credit
We Accept Care Credit Standard Fee Schedule Valid 1-Jan-18 to 1-July-18 **Prices Subject to Change, Call 702-222-3544 For Verification** Exam CPT PAYMENT IN FULL AT TIME OF SERVICE EKG 93000 35 TREADMILL
More information05/02/ CPT Preauthorization Groupings Effective May 2, Computerized Tomography (CT) Abdomen 6. CPT Description SEGR CT01
Computerized Tomography (CT) 6 & 101 5 Upper Extremity 11 Lower Extremity 12 Head 3 Orbit 1 Sinus 2 Neck 4 7 Cervical Spine 8 Thoracic Spine 9 Lumbar Spine 10 Colon 13 CPT Preauthorization Groupings CPT
More informationAccounting for Imaging Dose
Accounting for Imaging Dose High Profile Over-exposures Lead to Growing Concern FDA issues warning in October 2009-209 patients exposed to 8 times typical dose for CT brain perfusion scan (3-4 Gy) - Some
More informationDose Estimates for Nuclear Medicine Procedures: What are they? Where do they come from?
Dose Estimates for Nuclear Medicine Procedures: What are they? Where do they come from? SNM Continuing Education Lecture Salt Lake City, UT -- June 6, 2010 Darrell R. Fisher Pacific Northwest National
More information0081 Repeat examinations: No reduction 2004.
NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 26 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers.
More informationCumulative radiation CT dose in young traumatic patients: a single centre 5 years retrospective review
Cumulative radiation CT dose in young traumatic patients: a single centre 5 years retrospective review Poster No.: C-1604 Congress: ECR 2014 Type: Scientific Exhibit Authors: S. Salerno, C. Geraci, E.
More informationBiologic Effects of Diagnostic Imaging Modalities
Biologic Effects of Diagnostic Imaging Modalities Gerald R. Aben, MD FACR Department of Radiology College of Osteopathic Medicine 6/12/2012 DEPARTMENT OF RADIOLOGY 1 Biologic Effects 6/12/2012 DEPARTMENT
More informationRadiation Dosimetry for CT Protocols
Radiation Dosimetry for CT Protocols This document contains radiation dosimetry information from CT scans and can be used by investigators to estimate the dosimetry information required by the JRSC or
More informationRADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGIN For the Time Period : 10/01/16 and 09/30/2017
RADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGIN For the Time Period : 10/01/16 and 09/30/2017 IF YOU ARE COVERED BY HEALTH INSURANCE, YOU ARE STRONGLY ENCOURAGED TO CONSULT
More informationRadiography. 1. Introduction. 2. Documentation of Compliance. 3. Didactic Competency Requirements. 4. Clinical Competency Requirements
PRIMARY CERTIFICATION AND REGISTRATION Radiography 1. Introduction Candidates for certification and registration are required to meet the Professional Education Requirements specified in the ARRT Rules
More informationHighlights and Conclusions Thematic Area 4: Radiation of Patients
Highlights and Conclusions Thematic Area 4: Radiation of Patients by Robert H. Corbett and Eliseo Vañó Main topics: Diagnostic Radiology Interventional Radiology Nuclear Medicine Radiotherapy New Techniques
More informationTHE LEVEL OF COMPLIANCE OF SELECTED NIGERIAN X-RAY DEPARTMENTS TO EUROPEAN GUIDELINES ON GOOD RADIOGRAPHIC TECHNIQUES
IJRRAS 9 (1) October 11 www.arpapress.com/volumes/vol9issue1/ijrras_9_1_16.pdf THE LEVEL OF COMPLIANCE OF SELECTED NIGERIAN X-RAY DEPARTMENTS TO EUROPEAN GUIDELINES ON GOOD RADIOGRAPHIC TECHNIQUES Bamidele
More informationESTABLISHING DRLs in PEDIATRIC CT. Keith Strauss, MSc, FAAPM, FACR Cincinnati Children s Hospital University of Cincinnati College of Medicine
ESTABLISHING DRLs in PEDIATRIC CT Keith Strauss, MSc, FAAPM, FACR Cincinnati Children s Hospital University of Cincinnati College of Medicine CT Dose Indices CTDI INTRODUCTION CTDI 100, CTDI w, CTDI vol
More informationEXPOSURE FROM DIAGNOSTIC NUCLEAR MEDICINE PROCEDURES. 14 Victor Babes Street, RO-6600, Iasi, Romania
EXPOSURE FROM DIAGNOSTIC NUCLEAR MEDICINE PROCEDURES 1 O. Iacob, 1 C. Diaconescu, 2 R. Isac 1 Institute of Public Health- Iasi, Radiation Protection Department 14 Victor Babes Street, RO-6600, Iasi, Romania
More informationChapter 16 Worksheet Code It
Name: Class: Date: ID: A Chapter 16 Worksheet 3 2 1 Code It True/False Indicate whether the statement is true or false. 1. CT scans generate three-dimensional images. 2. An ultrasound produces images of
More informationA multicentric study on patient dose in multislice CT
A multicentric study on patient dose in multislice CT A.Stratis 1, M.Molfetas 1, S.Kottou 2, A.Louizi 2 1. Medical Physics department, Evangelismos General hospital of Athens, Athens, Greece 2. Medical
More informationBone Densitometry Radiation dose: what you need to know
Bone Densitometry Radiation dose: what you need to know John Damilakis, PhD Associate Professor and Chairman University of Crete, Iraklion, Crete, GREECE Estimation of bone status using X-rays Assessment
More informationCLINICAL RADIATION SCIENCES (CLRS)
Clinical Radiation Sciences (CLRS) 1 CLINICAL RADIATION SCIENCES (CLRS) CLRS 101. Introduction to Clinical Radiologic Sciences. 1 Hour. Semester course; 1 lecture hour. 1 credit. Presentation and discussion
More informationscreening; including image post processing CT, heart; without contrast material; with Requires authorization
0042T Cerebral perfusion analysis using CT; with ; including of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time 74263 Computed tomographic (CT) colonography,
More informationSpine MRI and Spine CT Test Request Tip Sheet
Spine MRI and Spine CT MRI is almost always preferred over CT scan; if ordering CT, CLEARLY document why MRI is not appropriate. In cases of back pain without red flags, six weeks of multimodality supervised
More informationMeasurement of organ dose in abdomen-pelvis CT exam as a function of ma, KV and scanner type by Monte Carlo method
Iran. J. Radiat. Res., 2004; 1(4): 187-194 Measurement of organ dose in abdomen-pelvis CT exam as a function of ma, KV and scanner type by Monte Carlo method M.R. Ay 1, M. Shahriari 2, S. Sarkar 3, P.
More informationIcd 10 code for ct pelvis with contrast
Icd 10 code for ct pelvis with contrast November 16, 2009. How to Code for CT Angiography. By Anthony McCallum, CPC, CCS, CIRCC, CPC-I Radiology Today Vol. 10 No. 18 P. 12. CT. procedure code and description
More information