Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the w...Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.展开更多
Objective:This study investigates the preventive and therapeutic effects of medical radiation protection spray(Bergmann)compared to triethanolamine cream in patients undergoing radiotherapy following breast cancer sur...Objective:This study investigates the preventive and therapeutic effects of medical radiation protection spray(Bergmann)compared to triethanolamine cream in patients undergoing radiotherapy following breast cancer surgery.Methods:Ninety patients with breast cancer who received postoperative radiotherapy between July 2018 and July 2021 were randomly divided into the Bergmann treatment(experimental)group and the triethanolamine cream treatment(control)group,with 45 patients in each group.Radiodermatitis severity was assessed using the RTOG radiodermatitis grading standards.Results:The radiation dose required to develop grade I radiodermatitis was significantly higher in the experimental group compared to the control group,at(36.13±1.17 Gy)and(25.38±0.63 Gy),respectively.At a radiation dose of 30 Gy,the proportion of grade I radiodermatitis cases in the experimental group was significantly lower than in the control group(P=0.002).At radiation doses of 40 Gy and 50 Gy,the proportion of grade II radiodermatitis cases in the experimental group was also significantly lower than in the control group(P<0.001).No cases of grade III or higher radiodermatitis were observed in the experimental group,while three cases of grade III radiodermatitis occurred in the control group,although the difference was not statistically significant.No patients in the experimental group discontinued treatment due to radiodermatitis or mucosal reactions,whereas two patients in the control group interrupted treatment due to these reactions but eventually completed therapy.Conclusion:Bergmann spray effectively prevents radiodermatitis in patients undergoing radiotherapy after breast cancer surgery and is more effective than triethanolamine cream in treating skin lesions.Its ease of use improves the quality of life for patients undergoing radiotherapy and ensures successful treatment completion.Bergmann is suitable for clinical promotion and application.展开更多
The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, ...The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.展开更多
Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study...Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.展开更多
Background: The medical imaging world is currently changing with the introduction of advanced modalities to help with diagnosis. There is then the need for the application of Artificial Intelligence (AI) in areas such...Background: The medical imaging world is currently changing with the introduction of advanced modalities to help with diagnosis. There is then the need for the application of Artificial Intelligence (AI) in areas such as radiation protection to improve the safety as far as radiations are concerned. This review article discusses the principles, some of the challenges of radiation protection and the possible role of Artificial Intelligence (AI) regarding radiation protection in computed tomography and fluoroscopy exams. Methods: A literature search was done using Google Scholar, Science Direct and Pubmed to search for relevant articles concerning the review topic. Results: Some of the challenges identified were outdated and old X-ray machines, lack of QA programs on the machines amongst others. It was discovered that AI could be applied in areas like scan planning and positioning, patient positioning amongst others in CT imaging to reduce radiation doses. With fluoroscopy, an AI enabled system helped in reducing radiation doses by selecting the region of interest of pathology and exposing that region. Conclusion: The application of AI will improve safety and standards of practice in medical imaging.展开更多
The purpose of this research was to propose pedagogical and didactic strategies for teaching radiation protection at higher education and university levels, with the aim of optimizing radiological safety in the Democr...The purpose of this research was to propose pedagogical and didactic strategies for teaching radiation protection at higher education and university levels, with the aim of optimizing radiological safety in the Democratic Republic of Congo (DRC). This was done after evaluating the implementation of protective measures against the harmful effects of X-rays in conventional radiology in Kinshasa hospitals. To achieve this, we conducted a survey in 23 Kinshasa hospitals with a sample of 400 health professionals, including 100 radiologists, to assess the level of implementation of radiation protection principles in order to propose pedagogical and didactic remediation in initial training where necessary. In addition to interviewing the respondents, we collected radiophysical parameters to evaluate the degree of irradiation in pediatric and adult radiology services in Kinshasa hospitals. After analyzing the data, the following results were recorded: the surveyed health personnel reported that more than 40% of requested radiology examinations are not justified. Eleven services were found to be highly irradiating in pediatrics (48%) and two radiology services in adults (9%). Finally, all surveyed radiologist health personnel in Kinshasa do not know how to evaluate the degree of irradiation in their services. In light of these results, we proposed pedagogical and didactic remediation in radiation protection teaching during initial training to enable future health professionals to demonstrate competencies for optimizing radiological safety.展开更多
Laser irradiation device for the protection of biological objects from the action of ionizing radiation to be used in practice has been manufactured （invention patent RU 2 428 228 C2）. Research of the action of y-ra...Laser irradiation device for the protection of biological objects from the action of ionizing radiation to be used in practice has been manufactured （invention patent RU 2 428 228 C2）. Research of the action of y-radiation itself as well as of the combined action of laser devices on survival, weight, skin and the general mitotic index of the bone marrow cells （mitotic index of all nucleus-containing cells of the bone marrow） of C57BL/6 experimental young mice was carried out. The mice were irradiated with ionizing （whole body irradiation） and laser radiation, separately one by one in a special frame device. Laser radiation in the dose 1 mJ/cm^2 irradiated only the back of a mouse, or both the back and the abdomen of mice. In case of combined irradiation of mice, the time interval between two types of irradiation did not exceed 30 min. First, the mice were exposed to y-radiation then to laser radiation. The method of the laser radiation-protection of biological subjects contributes to an increase in the viability of mice, prevents the damages of skin and also increases the mitotic activity of mice bone marrow cells.展开更多
Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures t...Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.展开更多
In this paper, the origin and type of radiation hazards as well as the main aspects of radiation protection for low-energy accelerators are discussed in general, and the problems of radiation protection and the experi...In this paper, the origin and type of radiation hazards as well as the main aspects of radiation protection for low-energy accelerators are discussed in general, and the problems of radiation protection and the experimental results of the operational monitoring of the five accelerators in the institute of Nuclear Science and Technology,Sichuan University, namely, one 1.2 M cyclofron, two Cockroft-waltons and two Van de Graafts, as well as a powerful electron accelerator for industrial irradiation are described. The discussion and evaluation are made according to the requirments of the National standards GB 5172-85.展开更多
The aim of this research was to assess the knowledge and practices of radiological versus non-radiological health professionals on the optimisation of radiation protection in paediatric and adult radiology in BUKAVU h...The aim of this research was to assess the knowledge and practices of radiological versus non-radiological health professionals on the optimisation of radiation protection in paediatric and adult radiology in BUKAVU hospitals. To achieve this, we surveyed a convenience sample of 73 health professionals including 23 radiologists working in the hospitals surveyed to assess knowledge and level of implementation of radiation protection principles. Also, physical parameters were taken for the calculation of entry doses in paediatric and adult radiology units for comparison with the International Commission on Radiological Protection (ICRP) diagnostic reference levels. After analysis of the data, the following was found: although radiologists have sufficient knowledge of radiation protection standards, technical constraints do not allow them to observe the dose limitation principle recommended by the ICRP. This is why several radiology departments, including those of the HPGRB, the MWANZI clinic and CIRIRI hospital, have proved to be very irradiating for children. However, radiologists and non-radiologists alike do not contribute positively to the optimisation of radiation protection in the diagnostic use of X-rays. Therefore, support in the implementation of radiation protection principles and regular monitoring of the units as well as replacement of non-standard equipment is necessary to promote patient and environmental safety by optimising radiation protection.展开更多
The ENETRAP （European Network on Education and Training in RAdiological Protection） project series, since the first edition in 2005 till the current ENETRAP III, always have been the objective to maintain a high lev...The ENETRAP （European Network on Education and Training in RAdiological Protection） project series, since the first edition in 2005 till the current ENETRAP III, always have been the objective to maintain a high level of competence in radiation protection （RP）, assuring the continued development of suitable well-trained personnel and adequate knowledge management. This objective is crucial to ensure future safe use of ionizing radiations （IR） and the development of new technologies in a safe way. A big effort and lot of work has been done in these 11 years including the new definitions in the BSS for RP Expert （RPE）, RP Officer （RPO） and Medical Physics Expert （MPE） which are the basis for future national development and implementation and adequate the high-level education and training （E＆T） in the countries. In order to manage all the valuable results of the projects and to distribute them to the society, is required a tool, developed with this specific propose, that will be the object of this paper.展开更多
The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, invo...The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, involving eight level III Hospitals (Aristide Le Dantec, Fann, Hoggy, Hear, Abass Ndao, Pikine, Touba, and Thiès) in Senegal. Sixty-one of the one hundred questionnaires were recovered (overall response rate of 61%). The population of the study was mainly female (54.1%). The average age was 38.57 with extremes ranging from 23 to 65 years old. In the places where ionizing radiation sources are handled, only at the Aristide Le Dantec Hospital did we find a “competent person in radiation protection”. This explained the lack of a classification of employees and work areas. Forty out of sixty-one (73.77%) had no knowledge of the basic principles of radiation protection (justification, optimisation, dose limitation) and had not ever taken radiation holidays. For radiovigilance, exposure time limits to ionizing radiation concerned only 29/61 or 47.54% of the study population. The inverse square law of distance was known by only 40 workers, of whom 15 had no compliance. We found the presence of dosifilms in only 7/61 or 11.47% of the workers. On the other hand, the use of lead aprons was well established and concerned 57/61 workers,<em> i.e.</em>, 93.44%. In sum, ionizing radiation causes adverse health effects. The absence of a good radiation protection culture in Senegal requires the presence of at least 4 to 5 competent persons in radiation protection for quality training of workers in radiobiology, radiopathology and radiation protection.展开更多
Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive st...Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation protection within the imaging department of the CHU Kati.展开更多
Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead apro...Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.展开更多
Objectives: To investigate the dose delivered to adult patients during cranioencephalic and abdominal-pelvic examinations in computed tomography (CT) in order to set up the Local Dosimetric Reference Levels (LDRLs) of...Objectives: To investigate the dose delivered to adult patients during cranioencephalic and abdominal-pelvic examinations in computed tomography (CT) in order to set up the Local Dosimetric Reference Levels (LDRLs) of the University Hospital of Treichville (UHT) for the radiation protection of patients undergoing CT scans. Methods: This study was prospectively performed on 153 CT images of adult patients including 120 CT images of cranioencephalic (CE) and 33 CT images of the abdominal pelvic (AP) examinations. These images were acquired on the CT system INSITUM with 64 bars, manufactured by the company SINOVISION and commissioned in 2021 at UHT. Then the volume computed tomography index (CTDIvol) and the dose-length product (DLP) were determined. Results: Based on the statistical method of 75th percentile, the obtained LDRLs as CTDIvol and DLP are 54.37 mGy and 28.07 mGy, 1716 mGy.cm and 1490.8 mGy.cm respectively for CE and AP examinations. Comparing our results with those from different international studies, CTDIvol and DLP values obtained in the present work are higher. Conclusion: LDRLs for dosimetric quantities such as CTDIvol and DLP for CE and AP examinations have been set up in this study. It will contribute with further studies to the national diagnostic reference levels of cranioencephalic and abdominal pelvis CT exams for strengthening the radiation protection of patients in Côte d’Ivoire.展开更多
Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The ...Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDI<sub>vol</sub>) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDI<sub>vol</sub> and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDI<sub>vol</sub> and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.展开更多
文摘Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.
基金supported by the Baoding City Self-Financed Fund Project(Project No.2241ZF339).
文摘Objective:This study investigates the preventive and therapeutic effects of medical radiation protection spray(Bergmann)compared to triethanolamine cream in patients undergoing radiotherapy following breast cancer surgery.Methods:Ninety patients with breast cancer who received postoperative radiotherapy between July 2018 and July 2021 were randomly divided into the Bergmann treatment(experimental)group and the triethanolamine cream treatment(control)group,with 45 patients in each group.Radiodermatitis severity was assessed using the RTOG radiodermatitis grading standards.Results:The radiation dose required to develop grade I radiodermatitis was significantly higher in the experimental group compared to the control group,at(36.13±1.17 Gy)and(25.38±0.63 Gy),respectively.At a radiation dose of 30 Gy,the proportion of grade I radiodermatitis cases in the experimental group was significantly lower than in the control group(P=0.002).At radiation doses of 40 Gy and 50 Gy,the proportion of grade II radiodermatitis cases in the experimental group was also significantly lower than in the control group(P<0.001).No cases of grade III or higher radiodermatitis were observed in the experimental group,while three cases of grade III radiodermatitis occurred in the control group,although the difference was not statistically significant.No patients in the experimental group discontinued treatment due to radiodermatitis or mucosal reactions,whereas two patients in the control group interrupted treatment due to these reactions but eventually completed therapy.Conclusion:Bergmann spray effectively prevents radiodermatitis in patients undergoing radiotherapy after breast cancer surgery and is more effective than triethanolamine cream in treating skin lesions.Its ease of use improves the quality of life for patients undergoing radiotherapy and ensures successful treatment completion.Bergmann is suitable for clinical promotion and application.
文摘The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.
文摘Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.
文摘Background: The medical imaging world is currently changing with the introduction of advanced modalities to help with diagnosis. There is then the need for the application of Artificial Intelligence (AI) in areas such as radiation protection to improve the safety as far as radiations are concerned. This review article discusses the principles, some of the challenges of radiation protection and the possible role of Artificial Intelligence (AI) regarding radiation protection in computed tomography and fluoroscopy exams. Methods: A literature search was done using Google Scholar, Science Direct and Pubmed to search for relevant articles concerning the review topic. Results: Some of the challenges identified were outdated and old X-ray machines, lack of QA programs on the machines amongst others. It was discovered that AI could be applied in areas like scan planning and positioning, patient positioning amongst others in CT imaging to reduce radiation doses. With fluoroscopy, an AI enabled system helped in reducing radiation doses by selecting the region of interest of pathology and exposing that region. Conclusion: The application of AI will improve safety and standards of practice in medical imaging.
文摘The purpose of this research was to propose pedagogical and didactic strategies for teaching radiation protection at higher education and university levels, with the aim of optimizing radiological safety in the Democratic Republic of Congo (DRC). This was done after evaluating the implementation of protective measures against the harmful effects of X-rays in conventional radiology in Kinshasa hospitals. To achieve this, we conducted a survey in 23 Kinshasa hospitals with a sample of 400 health professionals, including 100 radiologists, to assess the level of implementation of radiation protection principles in order to propose pedagogical and didactic remediation in initial training where necessary. In addition to interviewing the respondents, we collected radiophysical parameters to evaluate the degree of irradiation in pediatric and adult radiology services in Kinshasa hospitals. After analyzing the data, the following results were recorded: the surveyed health personnel reported that more than 40% of requested radiology examinations are not justified. Eleven services were found to be highly irradiating in pediatrics (48%) and two radiology services in adults (9%). Finally, all surveyed radiologist health personnel in Kinshasa do not know how to evaluate the degree of irradiation in their services. In light of these results, we proposed pedagogical and didactic remediation in radiation protection teaching during initial training to enable future health professionals to demonstrate competencies for optimizing radiological safety.
文摘Laser irradiation device for the protection of biological objects from the action of ionizing radiation to be used in practice has been manufactured （invention patent RU 2 428 228 C2）. Research of the action of y-radiation itself as well as of the combined action of laser devices on survival, weight, skin and the general mitotic index of the bone marrow cells （mitotic index of all nucleus-containing cells of the bone marrow） of C57BL/6 experimental young mice was carried out. The mice were irradiated with ionizing （whole body irradiation） and laser radiation, separately one by one in a special frame device. Laser radiation in the dose 1 mJ/cm^2 irradiated only the back of a mouse, or both the back and the abdomen of mice. In case of combined irradiation of mice, the time interval between two types of irradiation did not exceed 30 min. First, the mice were exposed to y-radiation then to laser radiation. The method of the laser radiation-protection of biological subjects contributes to an increase in the viability of mice, prevents the damages of skin and also increases the mitotic activity of mice bone marrow cells.
文摘Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.
文摘In this paper, the origin and type of radiation hazards as well as the main aspects of radiation protection for low-energy accelerators are discussed in general, and the problems of radiation protection and the experimental results of the operational monitoring of the five accelerators in the institute of Nuclear Science and Technology,Sichuan University, namely, one 1.2 M cyclofron, two Cockroft-waltons and two Van de Graafts, as well as a powerful electron accelerator for industrial irradiation are described. The discussion and evaluation are made according to the requirments of the National standards GB 5172-85.
文摘The aim of this research was to assess the knowledge and practices of radiological versus non-radiological health professionals on the optimisation of radiation protection in paediatric and adult radiology in BUKAVU hospitals. To achieve this, we surveyed a convenience sample of 73 health professionals including 23 radiologists working in the hospitals surveyed to assess knowledge and level of implementation of radiation protection principles. Also, physical parameters were taken for the calculation of entry doses in paediatric and adult radiology units for comparison with the International Commission on Radiological Protection (ICRP) diagnostic reference levels. After analysis of the data, the following was found: although radiologists have sufficient knowledge of radiation protection standards, technical constraints do not allow them to observe the dose limitation principle recommended by the ICRP. This is why several radiology departments, including those of the HPGRB, the MWANZI clinic and CIRIRI hospital, have proved to be very irradiating for children. However, radiologists and non-radiologists alike do not contribute positively to the optimisation of radiation protection in the diagnostic use of X-rays. Therefore, support in the implementation of radiation protection principles and regular monitoring of the units as well as replacement of non-standard equipment is necessary to promote patient and environmental safety by optimising radiation protection.
文摘The ENETRAP （European Network on Education and Training in RAdiological Protection） project series, since the first edition in 2005 till the current ENETRAP III, always have been the objective to maintain a high level of competence in radiation protection （RP）, assuring the continued development of suitable well-trained personnel and adequate knowledge management. This objective is crucial to ensure future safe use of ionizing radiations （IR） and the development of new technologies in a safe way. A big effort and lot of work has been done in these 11 years including the new definitions in the BSS for RP Expert （RPE）, RP Officer （RPO） and Medical Physics Expert （MPE） which are the basis for future national development and implementation and adequate the high-level education and training （E＆T） in the countries. In order to manage all the valuable results of the projects and to distribute them to the society, is required a tool, developed with this specific propose, that will be the object of this paper.
文摘The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, involving eight level III Hospitals (Aristide Le Dantec, Fann, Hoggy, Hear, Abass Ndao, Pikine, Touba, and Thiès) in Senegal. Sixty-one of the one hundred questionnaires were recovered (overall response rate of 61%). The population of the study was mainly female (54.1%). The average age was 38.57 with extremes ranging from 23 to 65 years old. In the places where ionizing radiation sources are handled, only at the Aristide Le Dantec Hospital did we find a “competent person in radiation protection”. This explained the lack of a classification of employees and work areas. Forty out of sixty-one (73.77%) had no knowledge of the basic principles of radiation protection (justification, optimisation, dose limitation) and had not ever taken radiation holidays. For radiovigilance, exposure time limits to ionizing radiation concerned only 29/61 or 47.54% of the study population. The inverse square law of distance was known by only 40 workers, of whom 15 had no compliance. We found the presence of dosifilms in only 7/61 or 11.47% of the workers. On the other hand, the use of lead aprons was well established and concerned 57/61 workers,<em> i.e.</em>, 93.44%. In sum, ionizing radiation causes adverse health effects. The absence of a good radiation protection culture in Senegal requires the presence of at least 4 to 5 competent persons in radiation protection for quality training of workers in radiobiology, radiopathology and radiation protection.
文摘Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation protection within the imaging department of the CHU Kati.
文摘Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.
文摘Objectives: To investigate the dose delivered to adult patients during cranioencephalic and abdominal-pelvic examinations in computed tomography (CT) in order to set up the Local Dosimetric Reference Levels (LDRLs) of the University Hospital of Treichville (UHT) for the radiation protection of patients undergoing CT scans. Methods: This study was prospectively performed on 153 CT images of adult patients including 120 CT images of cranioencephalic (CE) and 33 CT images of the abdominal pelvic (AP) examinations. These images were acquired on the CT system INSITUM with 64 bars, manufactured by the company SINOVISION and commissioned in 2021 at UHT. Then the volume computed tomography index (CTDIvol) and the dose-length product (DLP) were determined. Results: Based on the statistical method of 75th percentile, the obtained LDRLs as CTDIvol and DLP are 54.37 mGy and 28.07 mGy, 1716 mGy.cm and 1490.8 mGy.cm respectively for CE and AP examinations. Comparing our results with those from different international studies, CTDIvol and DLP values obtained in the present work are higher. Conclusion: LDRLs for dosimetric quantities such as CTDIvol and DLP for CE and AP examinations have been set up in this study. It will contribute with further studies to the national diagnostic reference levels of cranioencephalic and abdominal pelvis CT exams for strengthening the radiation protection of patients in Côte d’Ivoire.
文摘Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDI<sub>vol</sub>) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDI<sub>vol</sub> and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDI<sub>vol</sub> and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.
