1
|
Pimenta A, Azevedo L, Ramos I, Santos J. Establishment of Diagnostic Reference Levels in Portuguese Interventional Radiology departments. Eur J Radiol 2024; 173:111377. [PMID: 38382425 DOI: 10.1016/j.ejrad.2024.111377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To establish Portuguese Diagnostic Reference Levels (DRLs), for six body fluoroscopy guided interventional procedures (FGIP). METHOD A retrospective study was conducted in five interventional departments most representative of Interventional Radiology (IR) practice. Dose values, in terms of air kerma area product (PKA in Gy.cm2), air kerma at the patient entrance reference point (Ka,r in mGy), and exposure parameters (fluoroscopy time (FT) and number of cine runs) were collected. Examinations were selected per procedure (at least 20), according to the antero-posterior and lateral diameter mean value (±5 cm), measured on previous Computed Tomography (CT) examinations. RESULTS Data of 489 body FGIP show a large variation on dose values per procedure and per department. National DRLs in terms of PKA were 20.2 Gy.cm2 for Percutaneous transhepatic biliary drainage (PTBD), 98.2 Gy.cm2 for Bronchial artery embolisation (BAE), 247.7 Gy.cm2 for Transarterial chemoembolisation (TACE), 331.6 Gy.cm2 for Inferior epigastric arteries embolisation (IEAE), 312.0 Gy.cm2 for Transjugular intrahepatic portosystemic shunt (TIPS) and 19.3 Gy.cm2 for Endovascular treatment of femoral popliteal arteries (ETFPA). CONCLUSIONS This is the first study reporting Interventional Radiology DRLs in Portugal and we propose preliminary national estimates for the six more common body FGIP. The results of this study will be presented and discussed with all Portuguese IR departments, to promote procedures optimisation.
Collapse
Affiliation(s)
- Andrea Pimenta
- University Hospital of St. John (CHUSJ), Radiology Department - Porto, Portugal.
| | - Luís Azevedo
- CINTESIS@RISE Department of Community, Information and Health Decision Sciences- MEDCIDS, Faculty of Medicine University of Porto, Porto, Portugal.
| | | | - Joana Santos
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Portugal.
| |
Collapse
|
2
|
Kiparoidze S, Nadareishvili D, Jariashvili K, Astamadze N. Effectiveness of online trainings on radiation protection in the context of the COVID-19 pandemic. RADIATION PROTECTION DOSIMETRY 2023; 199:882-885. [PMID: 37225213 DOI: 10.1093/rpd/ncad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Over 212 healthcare professionals from the country have used the online trainings on radiation protection conducted during the COVID-19 pandemic. Each training, lasting up to 10 working days, is accompanied by mandatory Google Form-based questionnaires, which includes topic key questions about each lecture as well as pre- and post-training tests and provided to participants. In addition, the ability to conduct a dialogue with patients about radiation risks, group discussions, as well as a special module for radiation protection officers were assessed online. The trainings also allow participants to focus on the most important issues from their point of view in their daily work, indicating them in pre-tests, allowing the trainers to conduct lectures more adequately for each group of participants. Analysis of the tests have shown that online training is not inferior in efficiency to face-to-face training and national regulatory body received an improved opportunity to indirectly assess this efficiency.
Collapse
Affiliation(s)
- Salome Kiparoidze
- Applied Radiation Research Laboratory, Iv. Beritashvili Center of Experimental Biomedicine, Tbilisi, Georgia
| | - Davit Nadareishvili
- Applied Radiation Research Laboratory, Iv. Beritashvili Center of Experimental Biomedicine, Tbilisi, Georgia
- Radiation Safety Center, Tbilisi, Georgia
| | - Ketevan Jariashvili
- Applied Radiation Research Laboratory, Iv. Beritashvili Center of Experimental Biomedicine, Tbilisi, Georgia
- Agency of Nuclear and Radiation Safety, Ministry of Environmental Protection and Agriculture, Tbilisi, Georgia
| | - Nino Astamadze
- Applied Radiation Research Laboratory, Iv. Beritashvili Center of Experimental Biomedicine, Tbilisi, Georgia
- Radiation Safety Center, Tbilisi, Georgia
| |
Collapse
|
3
|
Rühm W, Cho K, Larsson CM, Wojcik A, Clement C, Applegate K, Bochud F, Bouffler S, Cool D, Hirth G, Kai M, Laurier D, Liu S, Romanov S, Schneider T. Vancouver call for action to strengthen expertise in radiological protection worldwide. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2023; 62:175-180. [PMID: 37097458 DOI: 10.1007/s00411-023-01024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/25/2023] [Indexed: 05/18/2023]
Abstract
Ionising radiation has been used for over a century for peaceful purposes, revolutionising health care and promoting well-being through its application in industry, science, and medicine. For almost as long, the International Commission on Radiological Protection (ICRP) has promoted understanding of health and environmental risks of ionising radiation and developed a protection system that enables the safe use of ionising radiation in justified and beneficial practices, providing protection from all sources of radiation. However, we are concerned that a shortage of investment in training, education, research, and infrastructure seen in many sectors and countries may compromise society's ability to properly manage radiation risks, leading to unjustified exposure to or unwarranted fear of radiation, impacting the physical, mental, and social well-being of our peoples. This could unduly limit the potential for research and development in new radiation technologies (healthcare, energy, and the environment) for beneficial purposes. ICRP therefore calls for action to strengthen expertise in radiological protection worldwide through: (1) National governments and funding agencies strengthening resources for radiological protection research allocated by governments and international organisations, (2) National research laboratories and other institutions launching and sustaining long-term research programmes, (3) Universities developing undergraduate and graduate university programmes and making students aware of job opportunities in radiation-related fields, (4) Using plain language when interacting with the public and decision makers about radiological protection, and (5) Fostering general awareness of proper uses of radiation and radiological protection through education and training of information multipliers. The draft call was discussed with international organisations in formal relations with ICRP in October 2022 at the European Radiation Protection Week in Estoril, Portugal, and the final call announced at the 6th International Symposium on the System of Radiological Protection of ICRP in November 2022 in Vancouver, Canada.
Collapse
Affiliation(s)
- W Rühm
- Helmholtz Centre Munich, German Research Centre for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - K Cho
- Korea Institute of Nuclear Safety, Yuseong, 114, Daejeon, 34142, Korea
| | - C-M Larsson
- Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, VIC, 3085, Australia
| | - A Wojcik
- Centre for Radiation Protection Research, Stockholm University, Svante Arrheniusväg 20C, 106 91, Stockholm, Sweden
- Institute of Biology, Jan Kochanoski University, 25-406, Kielce, Poland
| | - C Clement
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, ON, K1P 5S9, Canada
| | - K Applegate
- University of Kentucky College Medicine, 800 Rose Street MN 150, Lexington, KY, 40506, USA
| | - F Bochud
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Rue du Grand-Pré 1, 1007, Lausanne, Switzerland
| | - S Bouffler
- Radiation Protection Sciences Division, UK Health Security Agency, Didcot, OX11 0RQ, Oxon, UK
| | - D Cool
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, ON, K1P 5S9, Canada
| | - G Hirth
- Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, VIC, 3085, Australia
| | - M Kai
- Nippon Bunri University, 1727 Ichigi, Ōita, 870-0397, Japan
| | - D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire, BP 17-92262 Fontenay-aux-Roses Cedex, 31 Avenue de la Division Leclerc , 92260, Fontenay-aux-Roses, Île-de-France, France
| | - S Liu
- China Institute of Atomic Energy, 275 (1), Beijing, 102413, People's Republic of China
| | - S Romanov
- Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russian Federation
| | - T Schneider
- Nuclear Protection Evaluation Centre, 28, rue de la Redoute, 92260, Fontenay aux Roses, France
| |
Collapse
|
4
|
Santos J, Foley S, Andersson J, Figueiredo JP, Hoeschen C, Damilakis J, Frija G, Alves F, Riklund K, Rainford L, Nestle U, McNulty J, Bacher K, Hierath M, Paulo G. Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey. Insights Imaging 2023; 14:55. [PMID: 37005914 PMCID: PMC10067777 DOI: 10.1186/s13244-023-01398-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/24/2023] [Indexed: 04/04/2023] Open
Abstract
PURPOSE To analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges. METHOD An online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research. RESULTS The majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%). CONCLUSIONS A heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.
Collapse
Affiliation(s)
- Joana Santos
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho Do Bispo, 3046-854, Coimbra, Portugal.
| | - Shane Foley
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jonas Andersson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - João Paulo Figueiredo
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho Do Bispo, 3046-854, Coimbra, Portugal
| | - Christoph Hoeschen
- Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - John Damilakis
- School of Medicine, University of Crete, Iráklion, Crete, Greece
| | | | - Francisco Alves
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho Do Bispo, 3046-854, Coimbra, Portugal
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology and Umeå Centre for Functional Brain Imaging, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Louise Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Ursula Nestle
- Department of Radiation Oncology, Kliniken Maria Hilf, Mönchengladbach, Germany
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - Jonathan McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Klaus Bacher
- Division of Medical Physics, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Monika Hierath
- European Institute for Biomedical Imaging Research (EIBIR), Vienna, Austria
| | - Graciano Paulo
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho Do Bispo, 3046-854, Coimbra, Portugal
| |
Collapse
|
5
|
Faj D, Edyvean S, Lajunen A, Katukhov A, Vassileva J. Establishment and utilization of diagnostic reference levels in medical imaging: Results from a survey and consultation under the IAEA technical cooperation programme in Europe and Central Asia. Phys Med 2023; 108:102565. [PMID: 36989975 DOI: 10.1016/j.ejmp.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/19/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
The paper presents the results of the activities under the IAEA Technical Cooperation programme in Europe and Central Asia, aiming to improve utilization of diagnostic reference levels (DRLs) in the region through identifying status, problems, and gaps in establishing and utilization of the DRLs, and suggesting potential solutions. Status was identified through a survey with two electronic questionnaires answered by the regulatory bodies for radiation protection of 26 IAEA Member States and 34 representatives of relevant professional bodies of medical physics, radiology, nuclear medicine or radiographers. Problems, good practices and potential solutions were identified as a result of the discussion during a regional workshop with 50 nominated representatives of 21 countries. Results were disseminated through open webinars. Existing gaps are related to the lack of adequate regulations in some countries, inadequate awareness of radiological professionals of DRLs as a tool for optimization, insufficient cooperation among relevant stakeholders, education, and staffing. Strengthening of the cooperation between regulatory and professional bodies could benefit the awareness and consequently the utilization of DRLs in clinical practice. The need of improved education and training of the DRL process was highlighted. Improved inspection procedures and education of inspectors would also support the process. Access to clinically qualified medical physicists was found to be critical for the DRL utilization. Suggestions were placed for continuous IAEA assistance through training, guidance and expert support.
Collapse
|
6
|
Rainford L, Santos J, Alves F, Figueiredo JP, Hoeschen C, Damilakis J, Frija G, Andersson J, McNulty J, Foley S, Bacher K, Nestle U, Hierath M, Paulo G. Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll project. Insights Imaging 2022; 13:142. [PMID: 36057698 PMCID: PMC9440860 DOI: 10.1186/s13244-022-01271-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU.
Results Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
Collapse
Affiliation(s)
- Louise Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Room A201, UCD Health Science Centre, Belfield Campus, Dublin 4, Ireland.
| | - Joana Santos
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Coimbra, Portugal
| | - Francisco Alves
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Coimbra, Portugal
| | - João Paulo Figueiredo
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Coimbra, Portugal
| | - Christoph Hoeschen
- Institute of Medical Technology, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | | | | | - Jonas Andersson
- Department of Radiation Sciences, Radiation Physics, Umeå, Sweden
| | - Jonathan McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Room A201, UCD Health Science Centre, Belfield Campus, Dublin 4, Ireland
| | - Shane Foley
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Room A201, UCD Health Science Centre, Belfield Campus, Dublin 4, Ireland
| | - Klaus Bacher
- Division of Medical Physics, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Ursula Nestle
- Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany.,Department of Radiation Oncology, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | - Monika Hierath
- European Institute for Biomedical Imaging Research (EIBIR), Vienna, Austria
| | - Graciano Paulo
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Coimbra, Portugal
| |
Collapse
|