Improving national and local strategies to set diagnostic reference levels following the new ICRP recommendations

Congress:

EuroSafe Imaging 2018

Poster Number:

ESI-0020

Type:

EuroSafe Imaging

Keywords:

Audit and standards, Fluoroscopy, CT, Conventional radiography, Radioprotection / Radiation dose, Action 8 - Radiation protection training and learning material, Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Education and training in medical radiation protection, Action 3 - Optimisation, diagnostic reference levels, image quality, Dosimetric comparison, Education and training

Authors:

E. Vano, J. M. Fernández Soto, R. M. Sanchez, J. I. Ten, R. Ruiz-Cruces

DOI:

10.1594/esi2018/ESI-0020

DOI-Link:

https://dx.doi.org/10.1594/esi2018/ESI-0020

Fig. 1: Spanish population for the different autonomous communities 2017 (source:...

Fig. 2: Population for the different Spanish autonomous communities 2017 (source:...

Fig. 3: DOPOES I (2011 -2014). Population doses from X-rays procedures and DRLs...

Fig. 4: DOPOES II (2018 - 2020). Population doses from X-rays procedures and DRLs...

Background/introduction

The aim of this work is to review the methodologies used in Spain to collect and to manage patient dose data setting Diagnostic Reference Levels (DRLs) for diagnostic and interventional radiology and to suggest new strategies to improve the methodology in accordance with the new recommendations of the International Commission on Radiological Protection (ICRP) in its recent Publication 135 [1]. In 2011, the Spanish Nuclear Safety Council (Consejo de Seguridad Nuclear, CSN) and the University of Málaga in cooperation with the Spanish Ministry of Health,...

Description of activity and work performed

The European and the Spanish regulations require the use of DRLs to optimize medical diagnostic and interventional procedures [8-10]. Spain has 19 Autonomous Communities and a population of 46.6 million inhabitants in 2017 (http://www.ine.es). See figs. 1-2. In Spain with 19 autonomous communities managing locally their health systems, the evaluation of national DRLs is particularly challenging. In 2010-2011, the national programme DOPOES supported by the national regulatory and health authorities launched the first national survey that resulted in Spanish DRLS. In addition, the national societies...

Conclusion and recommendations

Authors highlighted several items to improve the update of the national DRLs following the new ICRP recommendations. It should be noted that these improvements could require a graded approach as they need refinements in the identification of procedures and in the collecting data process. For interventional radiology, an additional effort to identify the complexity of the procedures will be one of the main challenges. Here are the main key issues to be considered (the paragraphs of the ICRP-135 document are referred) 1. In addition to...

Personal/organisational information

Authors: E. Vano, J.M. Fernandez, R. M. Sanchez, J.I. Ten and R. Ruiz-Cruces E. Vano is emeritus professor at the Radiology Department of the Complutense University and member of the research group of Medical Physics at the Instituto de Investigación Sanitaria Hospital Clínico San Carlos in Madrid J.M. Fernandez and R. M. Sanchez are members of the research group of Medical Physics at the Instituto de Investigación Sanitaria Hospital Clínico San Carlos and associate professors at the Radiology Department of the Complutense University in Madrid....

References

1. ICRP, 2017. Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann. ICRP 46(1). 2. Rafael Ruiz Cruces, Maria Luisa Ramírez, Sergio Cañete Hidalgo, Agustín Ruiz, Manuel Pérez Martínez, Juan Carlos Alonso-Farto y cols. Estimación de las dosis poblaciones en España por procedimientos diagnósticos de radiología y medicina nuclear. Alfa, revista de seguridad nuclear y protección radiológica. Consejo de Seguridad Nuclear. 2013. 21(II):49–59. https://www.csn.es/documents/10182/13557/Alfa+21 (accessed 6 January 2018). 3. Rafael Ruiz Cruces, Maria Luisa Ramírez, Sergio Cañete Hidalgo, Agustín Ruiz, Manuel Pérez Martínez, Juan...