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International Symposium: A Global Perspective: Radiation Effects in Radiology and Nuclear Medicine

E Lief1*, J Damilakis2*, V Tsapaki3*, C Borras4*, D Bailey5*, (1) VA Medical Center, Pelham, NY, (2) University of Crete, Crete, (3) Konstantopoulio General Hospital, Nea Ionia, Athens,(4) Washington, DC, (5) Royal North Shore Hospital & The University of Sydney, Sydney, AU


(Tuesday, 7/31/2018) 11:00 AM - 12:15 PM

Room: Davidson Ballroom A

Increased worldwide use of radiological and nuclear medicine procedures has led to higher patient radiation doses. Global awareness of the radiation doses, especially for children and pregnant patients, necessitates a careful quantitative approach to the subject. Speakers of this session present methods to tackle this problem in Europe, South America, Australia and other geographic regions.

This presentation will provide an overview of the radiation-induced cancer risks from CT. Specific groups of patients may be at greater risk from CT exposure and radiogenic risk should be considered carefully in these patients. A novel method for the estimation of patient organ doses and risks from chest CT is currently being developed in the University of Crete (Greece) as a part of MEDIRAD project. Results of this research effort will be presented in this session.

Clinical benefits of interventional cardiology are generally much higher than the radiation risk for the patients. Due to a number of reasons, there could be increased risk for tissue reactions such as skin effects or skin injuries. Examples include obese patients, complex pathologies or repeated procedures in the same patient, operator experience, old X-ray equipment, long fluoroscopy times, large number of images, or operating with non-optimal imaging technique. The presentation will provide an overview of these effects and ways to avoid them before, during and after the interventional procedure.

Methodology of the Federal University of Pernambuco in Recife, Brazil, to assess patient and staff doses from interventional radiology, using calibrated radiochromic film and TLD, and to compare the results with system-generated and displayed dose metrics, such as Kar and PKA, will be described. Angiography and artery embolizations in neuroradiological, urologic and hepatic interventions will be illustrated. The possibility of using the methodology to validate the new DICOM’s patient radiation dose structured report will be explored.

Radiation exposure from diagnostic nuclear medicine procedures has conventionally delivered, in general, radiation doses comparable with X-ray CT, and there are few reported cases of radiation-induced complications. However, the rapid proliferation of multimodality hybrid imaging, such as SPECT/CT and PET/CT, has virtually doubled total effective doses. With state-of-the-art systems today and optimization, the radiation dose from the nuclear medicine component of a hybrid imaging procedure is likely to be less than that from the CT component. Radionuclide therapy (RNT) is a fast-advancing component of nuclear medicine practice where the intention is to deliver tens of Grays of radiation to target lesions whilst minimizing exposure to organs at risk. The literature to date suggests that damage to normal organs (e.g., bone marrow, kidneys) is minimal and blood dyscrasias may be the most frequent complication from high dose RNT. In some highly targeted interventional RNTs (e.g., SIRT) complications can arise from dose being inadvertently delivered to non-target tissues.

Learning Objectives:
1. Appreciate global awareness of patient radiation doses from radiological and nuclear medicine procedures
2. Learn about the radiation-induced cancer risks from CT, based on a study in Greece
3. Understand the risk-vs-benefit problem in interventional cardiology
4. Learn about a methodology to assess patient and staff doses from interventional radiology
5. Find out about optimization of the radiation dose from the nuclear medicine and hybrid imaging procedures

Funding Support, Disclosures, and Conflict of Interest: MEDIRAD has received funding from the Euratom research and training programme 2014-2018 under grant agreement No 755523.



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