Congress:
EuroSafe Imaging 2020
Keywords:
Not applicable, Quality assurance, Education and training, Dosimetric comparison, Dosimetry, Fluoroscopy, Catheter arteriography, Radioprotection / Radiation dose, Paediatric, Interventional non-vascular, Action 7 - Radiation protection of children
Authors:
E. Vano, M. D. R. del Rosario Perez, P. Jimenez, A. Nader, R. Ramirez Garcia, P. Miranda, C. Ubeda, Y. Gonzalez
DOI:
10.26044/esi2020/ESI-03445
Description of activity and work performed
The planned activities included in OPRIPALC to fulfil the objectives are:
- To identify the health centres to be involved in the project and send a questionnaire for assessing the current situation in the region regarding paediatric IR/IC (e.g. equipment, staff, frequency of IR/IC procedures and patients doses) (fig 2) (Ubeda 2019, UNSCEAR 2013, ICRP 2013). See a summary of the questionnaire answers in figure 3.
- Prepare a basic training material on RP for paediatric interventionists and other health professionals involved (WHO 2016).
- As a starting point and based on the feedback collected, select three common IC procedures and three common IR procedures (with a brief description of the procedures to avoid the problem of using different names in the different countries).
- Define a common basic quality control of the interventional X-ray systems involved in the project, including the operational protocols and the update of the RP training for the staff. See fig 4 (Vano 2008).
- Organise a series of web teleconferences with the hospitals participating in the OPRIPALC project to obtain a consensus on the selection of these 3 + 3 procedures, to discuss the strategies to collect patient dose values and to plan the basic quality control of the X-ray systems. The agreed procedures for the initial collection of patient dose values are presented in fig. 5.
- Collect patient dose values for the selected 3 + 3 procedures at the selected hospitals and to set initial regional DRLs. This will require a centralized collection, analysis and processing of patient dose data to derive the preliminary DRLs values. In some of the hospitals, it is also expected to collect occupational doses.
- Collect results of the basic quality control of the X-ray systems, together with the patient dose values, to suggest optimisation strategies (and corrective actions if needed). Occupational doses will also be audited (and the proper use of personal dosimeters). Special attention will be paid to the follow-up of the centres with the highest patient dose values and potential corrective actions with revision (if appropriate) of the local operational protocols. In some cases, the values of staff doses would also be considered to suggest corrective actions.
- Organise a face-to-face technical meeting to review and discuss the obtained results (with preparatory e-meetings).
- Prepare a consensus document providing practical guidance for optimization in paediatric IR and IC and future actions.
- Publish a paper in a scientific journal, summarizing the methodology and obtained results and reporting the preliminary regional DRLs.
The first 5 steps have already been fulfilled: selection of 36 paediatric hospitals from 10 different countries; selection of 3 frequent procedures for IR and 3 for IC; preparation of training material on radiation protection and common basic quality control protocol for the X-ray systems.
The expected outcomes would be useful not only for the involved hospitals, but also for other medical facilities in the participating countries and ultimately for the full region (e.g. set of DRLs values, protocol for the evaluation of the interventional X-ray systems and operation protocols and to produce consensus guidance document for optimisation).