What can I do as a Physicist?

AAPM Shares Educational Slides

The American Association of Physicists in Medicine’s ( AAPM) Working Group on Standardization of CT Nomenclature and Protocols has developed a set of teaching slides that summarizes how various protocol parameters affect the radiation dose from CT studies. They are appropriate for radiologists, radiologic technologists and medical physicists, and may be used as a resource for developing presentations on this topic.

The AAPM’s Working Group on Standardization of CT Nomenclature and Protocols membership includes academic and consulting medical physicists who specialize in CT imaging, representatives of each of the major CT scanner manufacturers, and liaisons from the American College of Radiology, American Society of Radiology Technologists, and the Food and Drug Administration.

AAPM Task Group Releases Dose Report

The AAPM Task group 204 document that now provides an estimate of patient dose within 10 - 20 percent for body CT by patient body habitus.  Click here to read Size Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations.

"Child-size” the radiation delivered to pediatric patients

Children are more sensitive to radiation and have a lifetime to manifest the effects of exposure. Currently, medical imaging (with CT scans as the largest contributor) may exceed background radiation as the single largest source of radiation for the American population (NCRP, April 2007). A 2005 report from the Biological Effects of Ionizing Radiation (BEIR) Committee of the National Academy of Sciences concluded that “the risk of cancer proceeds in a linear fashion at lower doses without a threshold and that clinical CT doses result in a potential small increased risk to humans.”

That being noted, radiology and CT scanning are critically important tools for diagnosing illnesses in children, determining treatment, and improving outcomes. Still, it is both logical and prudent to implement policies and techniques for reducing radiation dose when performing CT on children. Every member of the healthcare team should ensure that whenever an imaging study is prescribed for a child, it is completed only after careful consideration on an individual basis.

Medical physicists are responsible for maintaining imaging equipment in proper working order, for maintaining or improving image quality and for carefully managing patient dose by advising healthcare providers on appropriate techniques. As the imaging centers’ experts on radiation issues, they can provide invaluable guidance on how to “child-size” everyday protocols for radiologists and radiologic technologists who are often more accustomed to practicing in an adult environment. The knowledge and experience provided by medical physicists is vital to ensuring that young patients are imaged using radiation as low as reasonably achievable (ALARA). This website provides simple educational resources to inform radiology practices on what can be done now to improve radiation protection for children. By logging in, you have already demonstrated your commitment to this important initiative

Keith Strauss, MS
Medical Physicist - Childrens Hospital of Boston

Here are 5 simple steps to improve patient care in your everyday practice:

  1. Increase awareness for the need to decrease radiation dose to children during CT scanning.
  2. Be committed to make a change in your imaging center's daily practice by working as a team with its radiologists, technologists, referring doctors and parents to decrease the radiation dose. Sign the pledge! Click on the link on the home page to join the image gently™ campaign today.
  3. Review your imaging center’s adult CT protocols and then use the simple CT Protocols Guide on this website to “down-size” the protocols for kids as appropriate. More is not better….adult size kVp and mAs are not necessary for small bodies. Discuss your findings with your center’s CT radiologists and technologists.
  4. Single phase scans are usually adequate. Pre- and post-contrast and delayed CT scans rarely add additional information in children yet can double or triple the dose! Consider removing  multi-phase scans from your daily protocols.
  5. Scan only the indicated area. If a patient has a possible dermoid on ultrasound, there is rarely a need to scan the entire abdomen and pelvis. “Child-size” the scan and only scan the area required to obtain the necessary information.

Your patients and their families will thank you!

AAPM releases CT Terminology Lexicon

The American Association of Physicists in Medicine has released a CT Terminology Lexicon. This provides CT acquisition and reconstruction terms between different manufacturer's systems. Please use the following link to access this remarkable tool. Access the CT Terminology Lexicon

Image Gently - Digital Radiography Educational Materials

BACK TO BASICS - What does that mean?

To learn more, print the BASICS acronym by clicking here for a poster to use in your department as an image analysis tool.

PARENT BROCHURE

The Image Gently Digital Radiography writer's group has created the parent brochure entitled X-rays for Children:  What Parents Should Know About Radiation Protection in Medical Imaging".  This full color brochure was designed to be printed locally and distributed to parents and patients.  Click here to download this valuable resource now.

EDUCATIONAL RESOURCES FOR MEDICAL PROFESSIONALS

POWER POINT PRESENTATIONS

The Image Gently Digital Radiography work group has created several Power Point presentations to help you in your work with pediatric patients.  

PUBLISHED PAPERS

  • Best Practices in Digital Radiography - first author Tracy L. Herrmann, M.Ed., R.T.(R) is a member of the Image Gently DR Committee.  This white paper appears in the September 2012 Issue of Radiologic Technology, Volume 84, Number 1.  Shared here with permission from ASRT.
  • Image Gently: Using Exposure Indicators To Improve Pediatric Digital Radiography - an ASRT Special Report written by Quentin T Moore, MPH, R.T.(R)(T)(QM) and the Image Gently DR Writer's group.  This article is featured in the September 2012 Issue of Radiologic Technology, Volume 84, Number 1.  Shared here with permission from ASRT.    


The Image Gently Digital Radiography writer's group has created the parent brochure entitled X-rays for Children:  What Parents Should Know About Radiation Protection in Medical Imaging".  This full color brochure was designed to be printed locally and distributed to parents and patients.  Click here to download this valuable resource now.

 

"Child-size” the radiation delivered to pediatric patients

Children are more sensitive to radiation and have a lifetime to manifest the effects of exposure. Currently, medical imaging (with interventional radiology the third largest dose contributor in medicine following CT and nuclear medicine) may exceed background radiation as the single largest source of radiation for the American population (NCRP, 2009). It is also noteworthy that in the last 26 years the per capita dose from medicine increased by 570%. A  2005 report from the Biological Effects of Ionizing Radiation (BEIR) Committee of the National Academy of Sciences concluded that “the risk of cancer proceeds in a linear fashion at lower doses without a threshold and that clinical CT doses result in a potential small increased risk to humans.”

That being noted, interventional radiology (IR) procedures are critically important tools for diagnosing and treating illnesses in children, and improving outcomes. Still, it is both logical and prudent to implement policies and techniques for reducing radiation dose when performing IR procedures on children. Every member of the healthcare team should ensure that whenever an IR procedure is prescribed for a child, it is completed only after careful consideration on an individual basis.

Medical physicists are responsible for maintaining imaging equipment in proper working order, maintaining or improving image quality, carefully managing patient dose by advising healthcare providers on appropriate techniques, providing training/education to employees and consulting with parents and providers on radiation issues. As the experts on radiation issues, they can provide invaluable guidance on how to “child-size” everyday procedures for radiologists and radiologic technologists who may be more accustomed to practicing in an adult environment. The knowledge and experience provided by medical physicists is vital to ensuring that young patients are treated using radiation as low as reasonably achievable (ALARA). It is important to recognize that pediatric interventional radiology is a discipline in itself.  However, basic medical physics principles in adult radiology equally apply to pediatric radiology.

Interventional radiology (IR) has seen many advances in recent past such as HDR fluoroscopy, incorporation of flat-panel detector, and 3-D imaging capability with cone beam CT (CBCT). As a result, dose characterization of  modern IR machines has become very complex. IR presents not only skin burn issues (non-stochastic effect) but also stochastic risks to organs that are irradiated. At present, no definitive dose indices exist that can relate to organ doses and effective dose. Although IR dosimetry lags behind the advances of imaging equipment, new technology such as MOSFET detectors may enable  measurement of organ doses in near real-time. Numerous dose indices exist in IR but none serves as a standard dose index like CTDI in computed tomography. Medical physicists should also be cognizant of the importance of skin doses (JC reporting mandate above 15 Gy) and specific organ doses as the latter may become important in cancer risk estimation. Medical physicists should establish a networking relationship with other medical physicists as accurate dose assessment tools may not be immediately available in your institution.

The knowledge and experience provided by medical physicists is vital to ensuring that young patients are imaged using radiation as low as reasonably achievable (ALARA). Towards this goal, this website provides simple educational resources to inform radiology practices on what can be done now to improve radiation protection for children.
By logging in, you have already demonstrated your commitment to this important initiative.

Here are 5 simple steps to improve patient care in your everyday practice:

  • Increase awareness for the need to decrease radiation dose to children during IR procedures.
  • Be committed to make a change in your center's daily practice by working as a team with its radiologists, technologists, equipment engineers, manufacturers, administration, referring doctors and parents to decrease the radiation dose. Sign the pledge! Click on the link on the home page to join the image gently™ campaign today.
  • Review your imaging center’s IR procedures and equipment and then discuss the simple dose reduction steps on this website with your center’s radiologists and technologists to “down-size” the protocols for kids as appropriate.
  • Establish training program on radiation safety, equipment QA, patient dose monitoring and follow-up, and dosimetry oversight and consultation. Participate in institutional oversight activities including radiation safety and regulatory committees.
  • Network with other medical physicists working with pediatric institutions for mutual support and consultation. Join the discussion group at http://www.safety.duke.edu/RadSafety/drdl/peds_ir_network.asp. Visit the American Association of Physicists in Medicine at http://www.aapm.org/  and the Health Physics Society at http://hps.org/publicinformation/asktheexperts.cfm.

Your patients and their families will thank you

Image Gently and Nuclear Medicine

One size does not fit all...

  • There is no question - pediatric nuclear medicine helps us keep kids healthy and saves lives! 
  • When we image, radiation dose matters! 
    • Children are more sensitive to radiation. 
    • What we do now lasts their lifetime. 
  • So, when we image, let's image gently.

When a pediatric nuclear medicine study is the right thing to do:

Note:  as of July 11, 2012, The Society of Nuclear Medicine has changed its name to the Society of Nuclear Medicine and Molecular Imaging.  Click here to access their website.