14 dose for patients undergoing dental treatment in Japan. Our results provide basic data indicating that radiation dose exposure from dental Xray examinations is tending to decrease. Methods: The dental devices used consisted of a panoramic device, a standard imaging device, a dedicated dental CT device, 64-row CT, and 320-row CT. Radiation doses were evaluated under the conditions used in clinical practice. An anthropomorphic phantom was used for measurements, and the radiation doses were calculated at each point on the surface of the entrance site and internally by using thermoluminescent dosimeters (TLDs). Results: The radiation dose from standard imaging was around 0.3 mGy at the entrance site. In panoramic imaging, it was around 0.05 mGy on the anterior surface of the dentition, 1.5 mGy to left and right, and 0.5 mGy in the posterior region. In CBCT, these figures were around 0.1 mGy, 5mGy, and 5 mGy, respectively. For 64-row CT, these were around 150 mGy, 150 mGy, and 130 mGy, while for 320-row CT, these were around 4 mGy, 5 mGy, and 20 mGy. Conclusions: The radiation dose received by dental patients was lowest when standard imaging was used, while among panoramic, CBCT, 64-row CT, and 320-row CT, which could be evaluated in the same region, the dose was highest for 64-row CT. The radiation dose at the eyes in particular was around 50 mGy. This demonstrated the need for measures to reduce the dose, such as using a protective mask, without decreasing image quality. The results of this study have enabled an assessment of the radiation dose received by patients during dental imaging in Japan. 5.18. Dose optimization in panoramic dental imaging Presenter: Anja Henner, Oulu University of Applied Sciences, Finland Authors: Anja Henner, Heli Pöyskö, Anja-Riitta Pietilä Introduction: In Finland dental radiology is common and the number of examinations is increasing. About 2,3 million intraoral and about 300 000 panoramic examinations are taken yearly and a lot of them are produced to children. It is well known that children are more sensitive to radiation than elderly people. That’s why the image quality and dose optimization is important also in dental imaging although the doses are quite low. The purpose of this study was to find out the consequence of referral to the procedure in panoramic imaging of the teeth in order to decrease the patient’s dose. The follow-up of the doses was made in order to find out how permanent is the manner of the dentists to ask the partial OPTG Methods: The dose area product (DAP) of different programs in panoramic was measured without patient and they differed a lot. E.g. when using the partial program instead of whole mandible to a seven years old child, the dose is only one third Results: After the meeting the dentists started to write better referrals with clear indications and detailed information telling what they want to see from the x-ray. On the basis of this information the radiographer can take whole or partial mandible and set the kV and mA according the required image quality. The dentists have to be reminded of this possibility to make the procedure permanent. This procedure is spreading out all over Finland. It is very easy to decrease the patient dose 5.19. Authority inspection of Cardiology departments in Norway – Are they making it great in radiation protection? Presenter: Anders Widmark, Norwegian Radiation Protection Authority, Gjøvik University College, Norway Authors: Anders Widmark, Reidun D. Silkoset, Eva G. Friberg Introduction: Interventional cardiology includes high dose procedures like percutan coronary interventions (PCI), pacemaker placements and electrophysiological procedures. Physicians performing interventional cardiology receive the highest occupational doses in Norway. In addition skin burns of patients have been reported. The level of education, training and competence in radiation protection (RP), the existence of a RP culture and the level of implementation of the RP regulation in those departments have not been fully known for the Norwegian Radiation Protection Authority (NRPA). To identify the level of RP for patients and staff and the compliance with the RP regulation, NRPA carried out inspections with all interventional cardiology departments in Norway during 2013-14. Methods: Inspections were carried out in eight departments, based on document reviews, interviews and observations. Topics: organization of RP, education and training, justification and optimization, RP of staff and patients and follow-up of high doses. Results: It was revealed that most of the departments had nonconformities in relation to the RP regulation. Most findings were associated with education in RP, follow-up of high doses and lack of assessment of eye lens doses for evaluation of the radiation risk. Other non-conformities were use of local diagnostic reference levels for optimization. Finally, inspections turned out to increase the awareness of RP and are identified as an effective tool for improving RP and minimize risk. 5.20. Radiation Exposure to Patients during ERCP: Results from a Multicenter Study in Finland Presenter: Ekaterina Saukko, Radiological Department of U-Hospital, The Medical Imaging Centre of Southwest Finland Author: Ekaterina Saukko Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is essential tool in the treatment of the hepatobiliary system. MRCP has rapidly replaced diagnostic ERCP in various pancreaticobiliary disorders. ERCP is highly technical and demanding invasive procedure which carries a potential risk of complications. With a high amount of x-ray fluoroscopy and digital radiographs performed during ERCP, makes it undoubtedly an interventional radiology procedure. However, ERCP is not generally performed by a radiologist but by a gastroenterologist or even by a general surgeon. It’s obvious, that an ERCP procedure has the potential to cause high patient dose and therefore requires attention regarding radiation protection. Radiation exposure to the patient should be optimized such that the dose is the lowest necessary to refill the clinical aim, which is known as the ALARA (as low as reasonably achievable) principle. Besides the patient, an endoscopist and the other staff in the procedure room are exposed to ionizing radiation during ERCP, as well. They may participate in several hundred procedures per year, but most of the patients undergoing maximum a few ERCP during the present year. The aim of this study was to determine the radiation doses to patients during ERCP. Furthermore, the purpose of this study was to evaluate the risk of radiation-induced injury in ERCP and to estimate the patient’s effective dose, as an indicator of the risk for stochastic effect. A multicenter study that included ten hospitals was carried out in Finland. Methods: A total of 227 patient radiation doses in ERCP were recorded during 4-month period in 2012. ESD was estimated by using thermoluminescent dosimeters (TLD) implemented in one of the hospitals. Effective dose was calculated from DAP measurements. Results: The patient radiation doses in ERCP varied significantly in this study. In therapeutic ERCP patient received a greater radiation dose compared to diagnostic ERCP. The increase in frequency and complexity of ERCP procedures indicate the possibility of an increase in radiation exposure to patient. The results suggest that efforts at optimization and dose reduction in ERCP should be made. Nevertheless, ERCP requires the same radiation protection practice as all IR procedures. 5.21. The radiation know-how of the operating theatre staff in Finland Presenter: Piia Heikkilä, University of Oulu, Finland Authors: Heikkilä Piia, Henner Anja, Ahonen Sanna-Mari, Tenkanen- Rautakoski Petra, Pirinen Markku Introduction: Nowadays, the use of radiation is an integral part of the work in the operating theatres. Fluoroscopy-guided procedures are mostly demanding and complicated, and cause quite high radiation doses for the patients and the staff. Orthopaedic, traumatology and spine surgery procedures, for example, are done in operating theatres. Nurses and practical nurses use the mobile C-arms, but they don’t necessarily have adequate skills in radiation protection. There might be lack of radiation know-how among the operating theatre staff, because of the low level of education in radiation protection. Nevertheless, various operating theatre procedures require the use of fluoroscopy. There are several studies of radiation doses of the operating theatre staff and the patients, but a few studies of the radiation know-how of the operating theatre staff. The aim of this study was to survey the radiation know-how of the operating theatre staff in Finland. The topic has not been studied in Finland before. The use of radiation in operating theatres was also an essential theme of the EMAN project. The study was implemented in cooperation with the Radiation and Nuclear Safety Authority in Finland (STUK). Methods: The radiation know-how among operating room staff was studied by an electronic questionnaire in spring 2012. The questionnaire
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