RAD 201 - CHAPTER 1, CHAPTER 2

OPTIMIZATION FOR RADIATION PROTECTION (ORP)

ALARA is synonymous with the term _____________________.

EXPOSURE

Amount of radiation produced in air when ionizing radiation is present. Measured in coulomb per kilogram (C/kg), or milliroentgen (mR).

RADIONUCLIDE

An unstable nucleus that emits one or more forms of ionizing radiation to achieve greater stability.

IMAGE WISELY CAMPAIGN

Created to address concerns about the increase of public exposure to ionizing radiation from medical imaging.

PROTONS

Positively charged components of an atom. Have a relatively small mass that, however, exceeds the mass of an electron by a factor of 1800.

ORGANIC DAMAGE

Results from significant exposure to ionizing radiation.

TIME, DISTANCE, SHIELDING

What are the 3 basic principles of radiation protection? (can be applied to the patient and radiographer).

TRUE

(TRUE/FALSE) Electromagnetic radiation is a dual nature; can travel through space in the form of a wave but can interact with matter as a particle of energy.

FALSE

(TRUE/FALSE) Ionizing radiation does not have beneficial potential, only destructive potential.

FALSE

(TRUE/FALSE) It is not the responsibility of the employer to provide the necessary resources and environment for the practice of ALARA.

TRUE

(TRUE/FALSE) The goals of radiation protection are to protect persons from both short-term and long-term effects of radiation.

IONIZING RADIATION

(x-rays, gamma rays, high-energy UV radiation [energy higher than 10eV]) can transfer sufficient energy to some orbital electrons to remove them from the atoms to which they were attached.

BACKGROUND EQUIVALENT RADIATION TIME (BERT)

- A method that can be used to improve understanding and reduce fear and anxiety for the patient. - Compares the amount of radiation received from an x-ray with natural background radiation received over a given period of time. - Based on annual US population exposure of approximately 3 mSv per year (300 millirems per year).

RADIATION DOSE

- A radiation quantity, absorbed dose, refers to the amount of kinetic energy per unit mass that has been absorbed in a material due to its interaction with ionizing radiation. (measured in milligray mGy).

UNNECESSARY RADIATION

- Any radiation exposure that does not benefit a person in terms of diagnostic information obtained for the clinical management of medical needs. - Any radiation exposure that does not enhance the quality of the study.

JUSTIFICATION AND RESPONSIBILITY FOR IMAGING PROCEDURES

- Benefit versus risk. - Patient can elect to assume the relatively small risk of exposure to ionizing radiation. - To obtain essential diagnostic medical information when illness or injury occurs. - When a specific imaging procedure for health screening purposes is prudent.

PARTICULATE RADIATION

- Considered to be another category of ionizing radiation. - Includes alpha particles, beta particles, neutrons and protons. - These are all subatomic particles that are ejected from the atoms at high speeds. - They possess sufficient kinetic energy to be capable of causing ionization by direct atomic collision. - No ionization occurs when the subatomic particles are at rest. - Vary in their ability to penetrate matter.

DIAGNOSTIC EFFICACY

- Defined as the degree to which the diagnostic study accurately reveals the presences or absences of disease in the patient. - Maximized when essential images are produced under recommended radiation protection guidelines. - Provides the basis for determining whether an imaging procedure or practice is justified.

NON-IONIZING RADIATION

- Does not have sufficient kinetic energy to eject electrons from atoms. - (UV radiation, visible light, infrared rays, microwaves, and radio waves) does not have sufficient kinetic energy to eject electrons from atoms.

ADVANTAGES OF BERT

- Does not imply radiation risk, it is a means for comparison. - Emphasizes that radiation is an innate part of our environment. - The answer given in terms of this is easy for the patient to understand.

PATIENT PROTECTION AND EDUCATION

- Educating patients about imaging procedures helps to ensure the highest quality of service. - Use appropriate and effective communication. - Answer questions about the potential risk of radiation exposure honestly. - Inform patients of what needs to be done, if anything, as a follow-up to their examination.

ALPHA PARTICLES

- Emitted from nuclei of very heavy elements such as uranium and plutonium during the process of radioactive decay. - Are less penetrating.

BETA PARTICLES

- Identical to high-speed electrons except for their origin. - 8000 times lighter than alpha particles and have only one unit of electric charge (-1) as compared with the alpha's two units of electric charge (+2).

CELLULAR DAMAGE

- May cause abnormal cell function or loss of cell function. - If excessive damage occurs, living organisms may exhibit genetic, or somatic changes such as mutations, cataracts, and leukemia.

NEXT PROGRAM AND REFERENCE VALUES

- Nationwide Evaluation of X-ray Trends (NEXT) project in place to provide data on the measurement of radiation of x-ray machines. - Reference values set at some fraction, for ex, 75% of the maximum of the distribution of dose values measure. - Levels may be used to allow individual institutions to determine where they tend with regard to standard practices at the majority of institutions.

COSMIC RAYS

- Of extraterrestrial origin. - Result of nuclear interaction that have taken place in the sun and stars. - The higher the altitude the greater the intensity. - Consists primarily of high energy protons, but because of the interactions with molecules in the earth's atmosphere, these protons are accompanied by alpha particles, atomic nuclei, mesons, gamma rays, and high energy electrons.

ALLIANCE FOR RADIATION SAFETY IN PEDIATRIC IMAGING

- Partnership of medical societies whose overall common purpose is to reduce the radiation dose for pediatric patients. - Goal: to raise awareness among non-radiology users.

IMAGE GENTLY CAMPAIGN

- Started by the alliance - Dissemination of information on pediatric CT dose reduction among the various medical specialities that refer patients for CT examinations.

EX. OF MAN-MAD RADIATION

- Surveillance cameras - Television receivers - Medical procedures - Nuclear reactors - Air travel - Nuclear fuel for generation of power - Atmospheric fallout from nuclear weapons

EFFECTIVE DOSE (EfD)

- Takes into account the dose for all types of ionizing radiation to various radiated organs or tissues in the human body; measured in millisievert mSv.

RADON

- The largest contributor to natural background radiation. - Colorless, odorless and heavy radioactive gas. - It can penetrate soil, cracks, holes, floor drains, concrete foundations. - Levels are usually higher in the winter because out homes are closed up more.

RISK IN RADIOLOGY

- The possibility of inducing a radiogenic cancer or genetic defect after being exposed to radiation. - Willingness to accept risk. - Perception that the potential benefit to be obtained is greater than the risk involved.

EQUIVALENT DOSE (EqD)

- This quantity attempts to numerically specify the differences in biologic harm that are produced by different types of radiation. - The amount of energy absorbed by human tissues is an important determinant of the extent of biologic harm that may occur. - This quantity attempts to numerically specify the difference in transferred energy and therefor, biologic harm produced by different types of radiation. (measured in millisievert mSv).

MONITORING AND REPORTING RADIATION DOSE

- Trend toward more rigorous reporting of patient dose in radiology. - CT and interventional procedures are more cognizant of patient dose recording. - Required in some states.

CONTROL OF RADIANT ENERGY

- Use knowledge of radiation-induced hazards that have been gained over many years. - Employ effective methods to eliminate those hazards. - Control radiation produced from an x-ray tube and ensure safety during all medical radiation procedures. - Limiting energy deposited in living tissue by radiation can reduce the potential for adverse effects.

PROTOCOLS FOR DOSE ALERTS

- When patient dose is predicted to or has substantially exceeded present dose levels, the staff radiologist is notified. - A medical physicist may be called upon to estimate patient doses such as effective dose, peak skin dose, or fetal dose.

TERRESTRIAL, COSMIC, RADIONUCLIDES

3 components of natural radiation: 1) ______________ radiation from radioactive material in the earth. 2) _______________ radiation from outer space; sun and beyond the solar system. 3) ___________________ deposited in the human body via natural processes.

EFFECTIVE DOSE

A quantity that is a measure of general harm in humans. Measured in millisievert (mSv).

EFFICACY

A vital part of radiation protection in the healing arts.

BIOLOGIC EFFECTS

Damage to living tissue of animals and humans exposed to radiation.

RADIATION PROTECTION

Defined as effective measures employed by radiation workers to safeguard patients, personnel, and the general public from unnecessary exposure to ionizing radiation.

RADIATION

Defined as the transfer energy that results whether because of a change occurring naturally within an atom or a process caused by the interaction of a particle with an atom.

FREQUENCY, WAVELENGTH

Electromagnetic waves are characterized by their:

FLUCTUATE

In electromagnetic waves, electric and magnetic fields _________________ rapidly as they travel through space.

RISK

In general terms, is defined as the probability of injury, ailment, or death resulting from an activity.

EFFECTIVE RADIATION PROTECTION

Measures that take into consideration both human and environmental physical determinants, technical elements, and procedural factors.

IONIZING RADIATION

Occurs when radiation passes through matter producing positively and negatively charged (particles) ions.

3.3 mSv

Of the average annual radiation exposures, approximately _________ are received by man-made radiation.

ESE, BONE MARROW DOSE, GONDAL DOSE, FETAL DOSE

Patient dose from diagnostic x-ray procedures can be indicated in terms of: 1) 2) 3) 4)

BIOLOGIC DAMAGE POTENTIAL

Produced by ionizing radiation while penetrating body tissues primarily by ejecting electrons from atoms composing the tissues. - Result of destructive radiation interaction at the atomic level (molecular, cellular and organic changes).

HIGH SPEED ELECTRONS THAT ARE NOT BETA RADIATION

Produced in radiation oncology treatment machine called a linear accelerator. (used to treat superficial skin lesions and deliver radiation boost treatments to breast tumors at tissue depths not exceeding 5-6 cm).

RADIATION

Refers to kinetic energy that passes from one location to another and can have many manifestations. This means that many types exist.

CANCER

Studies have shown that the more radiation exposure a child received the more likely for them to develop ______________ later in life.

ENERGY

The ability to do work; that is to move an object against resistance.

ABSORBED DOSE

The amount of energy that is deposited in a material per unit mass of the material. Measured in milligray (mGy).

48%

The artificial man-made radiation sources account for ______ of the total collective EfD of the U.S. population in 2006.

IONIZING

The basic concept of radiation dose is the amount of energy transferred to electrons by _______________ radiation.

3 mSv

The dose from natural background and manmade sources are both roughly __________. The total dose per year is approximately 6 mSv.

NEUTRONS

The electrically neutral components of an atom. Have approximately the same mass as a proton.

ELECTROMAGNETIC SPECTRUM

The full range of frequencies and wavelengths of electromagnetic waves.

INJURY

The production of ions is the event that may cause _____________ in normal biologic tissue.

DIAGNOSTIC MEDICAL X-RAY, NUCLEAR MEDICINE

The two largest sources of ratification radiation are: 1)_________________________ 2)_________________________

ALARA

To keep radiation exposure and consequence dose as low as possible.

IONIZING

Uranium, radium and thorium are long lived radioactive elements which emit _______________ radiation. They are classified as terrestrial radiation because the levels are determined by the geographical location.

POTASSIUM-40, CARBON-14, HYDROGEN-3

What are 3 radionuclides present in the body?

BIOLOGICAL

X-radiation may be considered a special type because of its ability to interact and cause _________________ harm to humans.

PROTECTION

X-rays are a form of ionizing radiation; therefore their use in medicine for the detection of disease and injury requires __________________ measures.

EMPLOYERS

_______________ and employees are responsible for making sure that radiation safety practices are being followed.

CHILDREN

________________ are significantly more radiation sensitive than are adults.