RESUMEN
Patient doses cannot be limited; instead, radiological examinations should be justified and optimised to ensure the necessary diagnostic or therapeutic effect with the lowest patient dose achievable. Assessment of the radiation risks from patient exposure is important part of the justification process. Hence, medical staff within the framework of their professional activities should possess necessary information on the data on radiation risk from different types of radiological procedures. An approach has been developed that allows considering age and gender dependences of the risk coefficients of radiogenic cancer and the age and gender distribution of patients for various radiological examinations to assess the individual radiation risk for patient and collective risk for population from medical exposure. The approach is based on a new expanded use of the effective dose concept proposed in ICRP Publication 147 and demonstrated using the medical exposure in the Russian Federation as the example. For 30 radiological examinations that compose about 80% of the collective dose from medical exposure of the public in the Russian Federation radiation risk was assessed based on calculated age and gender specific risk coefficients per unit effective dose. For the rest of the examinations a simplified approach was used to assess the risk, which was based on using an age and gender specific risk coefficient determined for one of 4 anatomical regions (head, neck, chest and abdomen) or for uniform irradiation of the whole body. The proposed approach allows significantly improving the assessment of the radiation risk while continuing to use the effective dose as a dosimetric quantity within the framework of the state program in the Russian Federation. As a result the collective risk from medical examinations in the Russian Federation in 2022 was lower by the factor of 3 compared to the previous assessment based on the effective dose with the nominal risk coefficient.
Asunto(s)
Dosis de Radiación , Humanos , Medición de Riesgo , Masculino , Femenino , Protección Radiológica , Adulto , Federación de Rusia , Neoplasias Inducidas por Radiación/etiología , Exposición a la Radiación , Niño , Persona de Mediana Edad , Adolescente , Anciano , Radiografía/efectos adversosRESUMEN
This study was aimed at the estimation of the effective doses and radiation risks from dental X-ray examinations based on the data collection in St. Petersburg and the Leningrad Region. The range of mean values of effective doses for intraoral examinations on the X-ray units with film detectors was from 3.5 to 8.2 µSv and for the units with digital detectors-from 1.2 to 2.5 µSv. The mean effective doses for panoramic examinations were 22.9 µSv and for cone-beam computed tomography (CBCT)-530.6 µSv, respectively. The highest detriment-adjusted lifetime risk values were estimated for the 20-24-year-old age group: 40.8 × 10-6 in females and 32.7 × 10-6 in males for CBCT. Effective doses in St. Petersburg and Leningrad region were comparable or higher compared with the published data.
Asunto(s)
Tomografía Computarizada de Haz Cónico Espiral , Adulto , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Fantasmas de Imagen , Dosis de Radiación , Radiografía Panorámica , Adulto JovenRESUMEN
An important part of the justification process is assessment of the radiation risks caused by exposure of a patient during examination. The authors developed official national methodology both for medical doctors and sanitary inspectors called 'assessment of radiation risks of patients undergoing diagnostic examinations with the use of ionizing radiation'. The document addresses patients of various age groups and a wide spectrum of modern X-ray and nuclear medicine examinations. International scale of risk categorisation was implemented by the use of effective dose with account for age dependence of radiation risk. The survey of effective doses in radiology, including CT, mammography, and intervention radiology, and nuclear medicine, including single-photon emission tomography and positron emission tomography, for patients of various age groups from several regions of Russia was used for the risk assessment. The output of the methodology is a series of tables for each diagnostic technology with lists of examinations for three age groups (children/adolescents, adults and seniors) corresponding to various radiation risk categories.