scholarly journals Determinación de los niveles de referencia de dosis (DRL) para diagnóstico de baja y media complejidad en Servicios Especiales de Salud Hospital Universitario de Caldas de Colombia (SES-HUC)

2021 ◽  
pp. 84-98
Author(s):  
Estefanía Amaya Ríos ◽  
Erika Tatiana Muñoz Arango
Keyword(s):  
Medical Imaging ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Icrp Publication

Objetivo: Los niveles de referencia de dosis para diagnóstico (dose reference levels - DRL) son una  herramienta útil para optimizar la protección radiológica en exposiciones médicas de diagnóstico. Su  determinación es un requisito para obtener la licencia de uso de equipos emisores de radiación ionizante en los servicios de imágenes diagnósticas de Colombia. El objetivo de este trabajo fue establecer los valores de  DRL institucionales con diversos equipos emisores de radiación ionizante para los procedimientos de  diagnósticos más comunes asociados a áreas anatómicas típicas. Metodología: Este estudio fue realizado en dos equipos de radiología convencional, un equipo de  mamografía, un equipo de tomografía computada (TC) y un equipo de fluoroscopia tipo arco en C. La  muestra estadística se clasificó de acuerdo con los tipos de estudio, las áreas anatómicas de interés, tamaño y rangos de pesos de pacientes. Los tamaños de la muestra variaron según la técnica diagnóstica, siguiendo  recomendaciones del documento técnico “Diagnostic reference levels in medical imaging. ICRP Publication  135”. Los datos de la dosis entregada a cada paciente se obtuvieron registrando el valor de dosis estimado  por el equipo de adquisición de imagen. El análisis estadístico se hizo por medio de diagramas de cajas y  distribuciones de frecuencias, donde el tercer cuartil se definió como el valor de DRL para cada técnica de  adquisición de imagen. Resultados: Los valores obtenidos de DRL para radiografía convencional fueron inferiores a 15 dGy.cm2 para pacientes con pesos entre 50-80 kg, e inferiores a 27 dGy.cm2 para pacientes de más de 80 kg. Para mamografía, los valores de DRL a través de la dosis glandular media fueron inferiores a 2,7 mGy para  proyecciones oblicuas con espesores entre 45-94 mm. Los índices de dosis en tomografía computarizada en volumen (CTDIvol) y los valores de producto dosis-longitud (DLP) fueron inferiores a 41,4 mGy y 907 mGy.cm respectivamente, obteniendo los mayores valores en cráneo y los menores en abdomen para pacientes entre50 y 80 kg. En procedimientos con arco en C, los valores obtenidos de DRL fueron iguales a 2,69 Gy.cm2 para colangiopancreatografía retrógrada endoscópica (CPRE), 2,88 Gy.cm2 para histerosalpingografía (HSG) y 9,22 Gy.cm2 para colon por enema. Conclusiones: Los niveles de referencia de dosis en procedimientos diagnósticos obtenidos en este estudio para SES-HUC, han arrojado valores comparables a los publicados por otros autores en análisis similares,  aplicando métodos de análisis sugeridos por organismos internacionales.

ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging

2017 ◽  
Vol 46 (1) ◽  
pp. 1-144 ◽  
Author(s):  
E. Vañó ◽  
D.L. Miller ◽  
C.J. Martin ◽  
M.M. Rehani ◽  
K. Kang ◽  
...  
Keyword(s):  
Medical Imaging ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Icrp Publication

scholarly journals The mandate and work of ICRP Committee 3 on radiological protection in medicine

2018 ◽  
Vol 47 (3-4) ◽  
pp. 142-151
Author(s):  
D.L. Miller ◽  
C.J. Martin ◽  
M.M. Rehani
Keyword(s):  
Computed Tomography ◽  
Medical Imaging ◽  
Ion Beam ◽  
Cone Beam ◽  
Radiological Protection ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Specific Advice ◽  
Diagnosis Therapy ◽  
Icrp Publication

The mandate of Committee 3 of the International Commission on Radiological Protection (ICRP) is concerned with the protection of persons and unborn children when ionising radiation is used in medical diagnosis, therapy, and biomedical research. Protection in veterinary medicine has been newly added to the mandate. Committee 3 develops recommendations and guidance in these areas. The most recent documents published by ICRP that relate to radiological protection in medicine are ‘Radiological protection in cone beam computed tomography’ (ICRP Publication 129) and ‘Radiological protection in ion beam radiotherapy’ (ICRP Publication 127). A report in cooperation with ICRP Committee 2 entitled ‘Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances’ (ICRP Publication 128) has also been published. ‘Diagnostic reference levels in medical imaging’ (ICRP Publication 135), published in 2017, provides specific advice on the setting and use of diagnostic reference levels for diagnostic and interventional radiology, digital imaging, computed tomography, nuclear medicine, paediatrics, and multi-modality procedures. ‘Occupational radiological protection in interventional procedures’ was published in March 2018 as ICRP Publication 139. A document on radiological protection in therapy with radiopharmaceuticals is likely to be published in 2018. Work is in progress on several other topics, including appropriate use of effective dose in collaboration with the other ICRP committees, guidance for occupational radiological protection in brachytherapy, justification in medical imaging, and radiation doses to patients from radiopharmaceuticals (an update to ICRP Publication 128). Committee 3 is also considering the development of guidance on radiological protection in medicine related to individual radiosusceptibility, in collaboration with ICRP Committee 1.

scholarly journals Paediatric Diagnostic Reference levels in low Resource Settings: A Guide for Developing Country Practitioners with excerpts from ICRP

2020 ◽  
Vol 34 (1) ◽  
pp. 37-41
Author(s):  
Flavious Nkubli ◽  
Christian Nzotta ◽  
Chigozie Nwobi ◽  
Joseph Dlama
Keyword(s):  
Medical Imaging ◽  
Imaging Modality ◽  
High Sensitivity ◽  
Reference Level ◽  
Practical Implementation ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Imaging Protocol ◽  
Body Sizes ◽  
Paediatric Imaging

Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a complex task due to their unique individuality in terms of high sensitivity to radiation, varying body sizes and presenting pathology. Hence, good knowledge of medical technology, skill to perform patient dosimetry and to analyze mage quality is required. Purpose: To provide a guide on the methodological requirements for the establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the revised and updated guidelines from the current ICRP publication 135 on Diagnostic Reference Levels (DRLs). Materials and method: An extensive review of the ICRP report Publication 135 on Diagnostic Reference levels in medical imaging with a focus on paediatric imaging and other related studies were undertaken. Results: The ICRP report 135 updates and refines the recommendations of 2001. It highlights that the application of DRLs in paediatrics alone is not sufficient for the optimization of protection. Image quality must be evaluated. Quantities used for DRLs should be appropriate to the imaging modality being evaluated, assess the amount of ionizing radiation applied to perform a medical imaging task, and be measured directly. For interventional procedures, the complexity of the procedure may be considered in setting DRLs. DRLs shall not be used for individual patients or as trigger (alert or alarm) levels for individual patients. Appropriate weight bands (generally with 5 or 10 kg intervals) are recommended for establishing paediatric DRLs and should be promoted. Conclusion: The amount of radiation used for examinations of children can vary tremendously due to great variation in patient size and weight from neonates to adult-sized adolescents. This variation in patient radiation dose is appropriate. However, variation in patient doses due to inappropriate technique or failure to child-size the imaging protocol is not appropriate. This forms the basis of the new ICRP guideline and should form the basis of developing PiDRLs.

New french diagnostic reference levels: Let's take stock of our daily practices!

2019 ◽  
Vol 46 (6) ◽  
pp. 341-342 ◽  
Author(s):  
Julien Ognard ◽  
David Bourhis ◽  
René Anxionnat ◽  
Douraied Ben Salem
Keyword(s):  
Diagnostic Reference Levels ◽  
Reference Levels

Diagnostic Reference Levels for Common Orthopedic Hand and Wrist Procedures Using Intraoperative mini C-arm Fluoroscopy

Hand ◽  
2021 ◽  
pp. 155894472199425
Author(s):  
Kiran R. Madhvani ◽  
Matthew J. R. Clark ◽  
Alex A. J. Kocheta
Keyword(s):  
Radiation Dose ◽  
Fracture Fixation ◽  
Wrist Fracture ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Audit Data ◽  
Small Joint ◽  
Open Fixation ◽  
Phalangeal Fracture

Background: Diagnostic reference levels are radiation dose levels in medical radiodiagnostic practices for typical examinations for groups of standard-sized individuals for broadly defined types of equipment. This study aimed to contribute to national diagnostic reference levels for common hand and wrist procedures using mini C-arm fluoroscopy. Small joint and digital fracture procedure diagnostic reference levels have not been reported in significant numbers previously with procedure-level stratification. Methods: Data were collected from fluoroscopy logbooks and were cross-referenced against the audit log kept on fluoroscopy machines. A total of 603 procedures were included. Results: The median radiation dose for wrist fracture open fixation was 2.73 cGycm2, Kirschner wiring (K-wiring) procedures was 2.36 cGycm2, small joint arthrodesis was 1.20 cGycm2, small joint injections was 0.58 cGycm2, and phalangeal fracture fixation was 1.05 cGycm2. Conclusions: Wrist fracture fixation used higher radiation doses than phalangeal fracture fixation, arthrodeses, and injections. Injections used significantly less radiation than the other procedures. There are significant differences in total radiation doses when comparing these procedures in hand and wrist surgery. National and international recommendations are that institutional audit data should be collected regularly and should be stratified by procedure type. This study helps to define standards for this activity by adding to the data available for wrist fracture diagnostic reference levels and defining standards for digital and injection procedures.

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