1. PATIENT RADIATION DOSE MANAGEMENT
CHAPTER 39
PATIENT RADIATION DOSE MANAGEMENT

2. 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 ???

3. 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

4. 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

5. 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?

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

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