Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director &...

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Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor

Transcript of Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director &...

Page 1: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Everything You Need to Know About

Radiation Protection

Kelli Haynes, MSRS, RT(R)

Program Director &

Associate Professor

Page 2: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Radiation Protection 45 questions of the 200 will be radiation

protection (22.5%) 10 -Biological Aspects of Radiation 15-Minimizing Patient Exposure 11-Personnel Protection 9-Radiation Exposure and Monitoring

Page 3: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Biological Aspects of Radiation

10 Questions

Page 4: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Cell Radiosensitivity Cells and tissues vary in

their degree of radiosensitivity Immature cells are nonspecialized-

rapid cell division Mature cells are specialized-divide

slower if at all DNA-most radiosensitive part of cell

Page 5: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.
Page 6: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

High Low

LymphocytesSpermatogoniaErythroblastsIntestinal crypt cells

Muscle cellsNerve cellsChondrocytes

Page 7: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Dose Response Relationships

Graphic representation of the relationship between the amount of radiation absorbed (dose) and the amount of damage (response)

Linear or nonlinearThreshold or nonthreshold

Page 8: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Response Response

Dos

e

Dos

e

Linear NonThreshold

LinearThreshold

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Response Response

Dos

e

Dos

e

NonLinearThreshold

NonLinearNonthreshold

Page 11: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Linear Energy Transfer (LET)

Photons deposit or transfer energy as they travel

The average energy deposited per unit of path length

Assesses potential tissue and organ damage

Page 12: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

LET

High-LET Radiation Alpha particles Beta particles

Low-LET Radiation Gamma rays X-rays

Page 13: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Relative Biologic Effectiveness

Measures biologic effectiveness of radiations having different LET’s

Influenced by radiation type, cell or tissue type, physiologic condition, and biologic result

Page 14: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Oxygen Enhancement Ratio

Response to radiation is greater when irradiated in the oxygenated state

Radiation dose required to cause response w/o O2OER= Radiation dose required to cause response w/ O2

Page 15: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Cell Survival and Recovery

LD 50/30Adults-3-4 Gy (300-400 rad)Recovery may occur

Page 16: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Somatic Effects

Biologic damage sustained by living organisms as a consequence of exposure to ionizing radiation

Classified as either early (acute) or late

Page 17: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Short-term vs. Long-term Nausea Fatigue Redness of skin Loss of hair Intestinal disorders Fever Blood disorders Shedding skin

Cancer Embryologic effects (birth defects) Formation of cataracts

Page 18: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Carcinogenesis

The production or origin of cancer

Experiments have shown that radiation induces cancer

Page 19: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Cataractogenesis Cataracts-opacity of the eye lens 2 Gy results in partial or

complete vision loss Threshold, nonlinear

dose-response

relationship

Page 20: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Sterility

Female sterility based on age

of the subject-more radiosensitive

when youngerTemporary sterility-2 Gray (200rad) Permanent sterility-5 Gray (50 rad)

Page 21: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

ACUTE RADIATION SYNDROMES

Page 22: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Hematopoietic Syndrome

Whole-body doses ranging from 1 to 10 Gy (100 to 1000 rad)

Reduction of blood cells in circulation results in a loss of the body’s ability to clot blood and fight infection

Page 23: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Gastrointestinal Syndrome

Appears at a threshold dose of approx. 6 Gy (600 rad) and peaks after a dose of 10 Gy (1000 rad)

Without treatment, a dose of 6-10 Gy may cause death in 3-10 days

Page 24: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Cerebrovascular Syndrome

Doses of 50 Gray

(5000rad)

Death within 2 hours

or up to 2 days

Page 25: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Embryonic and Fetal Risks

Fetus is very sensitive

Fetal radiosensitivity

decreases as gestation

progresses

Page 26: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Genetic Effects GSD-used to assess

the impact of gonadal dose Dose equivalent to the

reproductive organs

that would bring genetic

injury to the total population

Page 27: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

PHOTON INTERACTIONS WITH MATTER

Page 28: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Coherent Scattering Photon of low energy

interacts with atom. No net energy has

been absorbed by the atom.

Low-energy photons,1-50 kVp

Contributes to fog

Page 29: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Compton Scattering• Moderate energy x-

rays, 60-90 kVp• Interaction with outer

shell electron• Electron ejected,

Atom is ionized• Photon loses energy

and recombines with an atom

• Fog and Scatter

Page 30: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Compton Scattering

FIGURE 2-6 Compton scattering is responsible for most of the scattered radiation produced during a radiologic procedure. (From Radiobiology and radiation protection: Mosby’s radiographic instructional series, St. Louis, 1999, Mosby.)

Page 31: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Photoelectric Absorption Most important interaction

between x-ray photons and the atoms of the pt’s body for producing useful images

Higher energy x-rays (23-150 kVp), more likely to penetrate & not interact

Interaction b/t photon and inner shell electron

X-ray is absorbed Electron ejected

Page 32: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Attenuation

Process that decreases the intensity of the beam

Refers to both absorption and scatter processes

Thickness of body part (mass density) Type of tissue (atomic number)

Page 33: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Minimizing Patient Exposure

15 Questions

Page 34: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Exposure Factors

kVp

mAs

Page 35: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Shielding

Protects gonads when w/i 5 cm of collimated beam

Females receive

more exposure due

to location

of organs

Page 36: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Types of Shields

Flat contact shields

Shadow shieldsShaped contact

shieldsClear lead

Page 37: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Beam Restriction

Purpose-confine useful beam

Reduce scatter

Types Cones Collimators

Page 38: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.
Page 39: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

FiltrationEffect on skin and

organ exposure

Effect on beam energy

Page 40: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

NCRP Report #102

The useful beam shall be

limited to the smallest area

practicable and consistent

with the objectives of the

radiological or fluoroscopic examination.

Page 41: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Exposure Reduction

Patient positioning

AECPatient

CommunicationALARA

Page 42: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Image Receptors

Film-screen systemsIntensifying screensDigital Image receptorsCR and DRFilm speed

Page 43: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Image Receptors

Digital CT, CR, DR, DF, NM, MR, & US Photons on a detector Electronic image Matrix Patient dose

Film Intensifying screens convert photons and

expose film Analog image Patient dose

Page 45: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Fluoroscopy

Pulsed or

IntermittentExposure factorsPositioningFluoroscopy

time

Page 46: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Personnel Protection

11 Questions

Page 47: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Sources of Radiation Exposure (3)

Primary x-ray beamSecondary radiation

1. Scatter

2. Leakage Patient

Page 49: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Protective Devices Protective structural shielding

Primary Barriers

Secondary Barriers

Lead Shields

Page 51: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Portable (mobile) units

Lead apparelExposure cordStand at right

angles to the

patient

Page 52: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Fluoroscopy

Protective curtainBucky slot coverCumulative timer

Page 53: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

NCRP Report #102

Fluoroscopy Exposure Rates General Purpose: 10 R per minute Non-image Intensified: 5 R per minute High Level Control: 20 R per minute

Exposure Switch Guidelines Switch must be of the dead-man type

Page 54: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Radiation Exposure and Monitoring

9 Questions

Page 55: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Units of MeasurementQuantity SI Traditional

Exposure Coulomb/kg roentgen

Absorbed dose gray rad

Dose equivalent sievert rem

Page 56: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Dosimeters

Page 57: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Film Badge

EconomicalPartsMonitors x and

gamma raysTemperature and

humidity can cause fog

Page 58: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Pocket Ionization Chambers

Most sensitiveMust be charged

to zeroAccurate from

0-200 mR

Page 59: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

OSL Dosimeter Aluminum oxide

detector Optically stimulated

luminosity occurs when struck by laser light

Accurate reading as low as 1mrem

Page 60: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

TLD’s

Look similar to film badge

Lithium fluoride Ionization causes

crystal to change

Page 61: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

NCRP #116

Annual occupational

effective dose- 50 mSv

(5rem) Public Exposure- 1 mSv Embryo/fetus exposure-

50 mSv/month Dosimetry records

Page 62: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

NCRP #160

Typical effective dose per exam; varies from 0.1 mSv for a chest xray to 1.5 for a lumbar spine

Interventional- ~3mSv CT- range from 2mSv

for a head to 10 mSv for a spine

Page 63: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

That’s All Folks!

www.ARRT.org

[email protected]

Page 64: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

What is the most radiosensitive part of the cell?

Which is more radiosensitive, immature or mature cells?

Page 65: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

This is a picture of what?

Page 66: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

What is LET? What is LD 50/30? What is an example of an early somatic

effect? Late somatic effect? What is carcinogenesis?

Page 67: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

What is the threshold dose for cataracts? What is the threshold dose for temporary

sterility? What is the threshold dose for

permanent sterility? What is the threshold dose for

cerebrovascular syndrome?

Page 68: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

What is the threshold dose for hematopoietic syndrome?

What is the threshold dose for gastrointestinal syndrome?

What are some types of shields? What is filtration? What does NCRP Report # 102 state?

Page 69: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

Why do we use a grid? What are the 3 sources of radiation

exposure? What is the SI unit of measurement for

exposure? What is the SI unit of measurement for

absorbed dose?

Page 70: Everything You Need to Know About Radiation Protection Kelli Haynes, MSRS, RT(R) Program Director & Associate Professor.

Review Questions

What is the traditional unit of measurement for dose equivalent?

What is the sensing material in an OSL dosimeter?

What is the sensing material in a TLD dosimeter?

What does NCRP # 116 state?