PATIENT RADIATION DOSE MANAGEMENT CHAPTER 39 PATIENT RADIATION DOSE MANAGEMENT

MINIMIZING EXPOSURESTO THE PATIENT X-RAY EXPOSURES ARE INCREASING BY 18% EACH YEAR! NATURAL SOURCES ARE 3 mSv but x-ray is now at 3.2mSv due to???? Angiointerventional are reporting acute effects to ???

Patient dose estimation ESE See table 39-1 How are they measured? How accurate are the measurements Which nomogram is more accurate? Bone marrow –how is this measured? Table 39.2 Gonadal dose GSD- Suspected genetic effects of radiation Epidemiologic study of averaging those who have been irradiated and those who have not

Mammography ESE: 800 mR/view Dose falls off rapidly after penetrating the breast so that by midline of breast, the dose is 100 mR Any response is due to glandular dose which 15% of the ESE Glandular dose should not exceed 100 mrad per view for contact and 300 mrad/view with grid

CT Skin dose – high 10% of all studies are CT -= 70% of patient effective dose Collimation is fine No scatter Couch movement must be precise What are the typical CT dose ranges for head and body. Why do multislice images reduce patient dose? Why is shielding not advantageous?

Let’s reduce radiation? How? Examinations- let’s discuss Repeats…look at yellow box What else?

Pregnancy Time dependence Congenital abnormalities Major organogenesis Dose Dependence -percentages? Patient info