- Email: [email protected]
[I070] US regulatory requirements for radiation protection of pregnant patients and medical staff
Abstracts / Physica Medica 52 (2018) 1–98
observed for in utero irradiated cohorts from Hiroshima/Nagasaki and Southern Urals, the numbers are small; it is not known which are the most vulnerable gestation periods. However, the cancer life time risk seems lower than that following irradiation during childhood, which in turn is much higher than in adults. On a mechanistic basis, the 2015 International Commission on Radiological Protection Report 131, suggested that because of high competition between the irradiated and non-irradiated stem cells after low doses in utero, the injured stem cells are discarded before birth, thus yielding a low cancer risk. During childhood growth, stem cell competition is less stringent (higher risk) as the stem cell/niche units increase in number to cope with the increase in tissue volume, an unnecessary mechanism in adulthood (lower risk). The presentation will end showing typical fetal doses in medical radiation procedures. https://doi.org/10.1016/j.ejmp.2018.06.140
[I069] Everything you need to know about dose management of pregnant patients in medical imaging John Damilakis * University of Crete, Medical Physics, Iraklion, Greece Corresponding author.
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Purpose. The purpose of this presentation is to provide answers to questions related to dose management of pregnant patients needing medical imaging such as ‘how safe are X-ray and nuclear medicine examinations during pregnancy?’, ‘How can we estimate conceptus radiation doses and risks associated with medical imaging?’, How can we avoid accidental irradiation of pregnant patients?’ Methods. Methods for the estimation of conceptus dose from diagnostic X-ray, interventional and nuclear medicine examinations have been developed and will be described during this presentation. Advantages and limitations of these methods will be discussed during the presentation. Results. Main actions for dose management of pregnant patients will be discussed during the presentation. The CoDE (Conceptus Dose Estimation) online software tool will be presented. CoDE allows a) calculation of conceptus radiation dose and associated risk from Xray examinations performed on the expectant mother and b) anticipation of conceptus dose for the pregnant employee who participates in fluoroscopically-guided interventional procedures. CoDE is available free of charge (embryodose.med.uoc.gr). Conclusions. The involvement of medical physicists is of paramount importance to ensure radiation protection of pregnant patients and their unborn children. https://doi.org/10.1016/j.ejmp.2018.06.141
[I070] US regulatory requirements for radiation protection of pregnant patients and medical staff Eugene Lief * Bronx Va Medical Center, Radiation Oncology, Bronx, United States Corresponding author.
⇑
Purpose. To discuss harmful effects of ionizing radiation, especially important for fast growing tissues including the human fetus. To go over the strict regulations in the US regarding occupational exposures of pregnant workers to ionizing radiation.
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Methods. Radiation protection of pregnant radiation workers includes written declaration of pregnancy which every female radiation worker can do at any time. The declaration should be done in writing and can be revoked at any time without an additional explanation. Based on this declaration, the employer should review work responsibilities of the employee and her recent radiation badge reading. In some cases, the employee could be reassigned to another type of work to further reduce her potential occupational exposure. A pregnant radiation worker receives an additional badge worn on the abdomen. This badge is being processed on a monthly basis to ensure the compliance with maximum monthly radiation exposure limit. Use of Diagnostic Radiation for pregnant patients should be limited to necessary studies urgently needed to improve the patient’s condition. That could be an acute condition or a life-saving treatment after an automobile accident etc. Before ordering an exam, the practitioner has to take into consideration the patient’s condition and potential harm to the fetus vs. the benefit from the procedure. Results. Strict rules of Radiation Safety of pregnant radiation workers allow to reduce the occupational exposure to 500 mR/year and also to 50 mR/month. Two independent radiation badges allow reliable occupational dose measurements on a monthly basis. For pregnant patients it is often possible to assess possible dose to the fetus from the suggested radiation procedure prior to its administration. At that time, the decision should be made whether the procedure should be performed. Conclusions. The US regulations regarding the occupational exposure of pregnant radiation workers allow to create a safe work environment which, in the light of the current knowledge, does not cause any harm to the worker and the fetus. https://doi.org/10.1016/j.ejmp.2018.06.142
[OA071] O-RAW: Ontology-guided radiomics analysis workflow Zhenwei Shi *, Alberto Traverso, Johan Soest, Petros Kalendralis, Leonard Wee, Andre Dekker Grow – School for Oncology and Development Biology, Maastricht University Medical Centre, Department of Radiation Oncology (Maastro Clinic), Maastricht, Netherlands ⇑ Corresponding author. Purpose. Radiomics is high-throughput computerized tumour feature extraction from medical images. This has shown potential for quantifying tumour phenotype and predicting treatment response. Three major challenges impede the pace of radiomics research and clinical adoption: (i) lack of standardized methodology for radiomics analyses, (ii) lack of universal lexicon to denote features that are semantically equivalent and (iii) flat tables for radiomics output do not sufficiently capture the methodological steps that affect feature values. These barriers hamper multi-centre validation studies applying subtly different imaging protocols, pre-processing steps and extraction software. We propose an open-source Ontology-guided Radiomics Analysis Workflow (O-RAW) to address the above challenges. Methods. O-RAW was developed in Python, which comprises three phases and uses two open-source component libraries (Py-rex and Pyradiomics). First, Py-rex takes standard DICOM-RT inputs (DICOM images and an RTSTRUCT file) and parses them as numpy arrays of voxel intensities and a binary mask for the volume of interest (VOI). Next, the numpy arrays are passed to Pyradiomics performing the feature extraction and returns a dictionary object to Py-rex.
observed for in utero irradiated cohorts from Hiroshima/Nagasaki and Southern Urals, the numbers are small; it is not known which are the most vulnerable gestation periods. However, the cancer life time risk seems lower than that following irradiation during childhood, which in turn is much higher than in adults. On a mechanistic basis, the 2015 International Commission on Radiological Protection Report 131, suggested that because of high competition between the irradiated and non-irradiated stem cells after low doses in utero, the injured stem cells are discarded before birth, thus yielding a low cancer risk. During childhood growth, stem cell competition is less stringent (higher risk) as the stem cell/niche units increase in number to cope with the increase in tissue volume, an unnecessary mechanism in adulthood (lower risk). The presentation will end showing typical fetal doses in medical radiation procedures. https://doi.org/10.1016/j.ejmp.2018.06.140
[I069] Everything you need to know about dose management of pregnant patients in medical imaging John Damilakis * University of Crete, Medical Physics, Iraklion, Greece Corresponding author.
⇑
Purpose. The purpose of this presentation is to provide answers to questions related to dose management of pregnant patients needing medical imaging such as ‘how safe are X-ray and nuclear medicine examinations during pregnancy?’, ‘How can we estimate conceptus radiation doses and risks associated with medical imaging?’, How can we avoid accidental irradiation of pregnant patients?’ Methods. Methods for the estimation of conceptus dose from diagnostic X-ray, interventional and nuclear medicine examinations have been developed and will be described during this presentation. Advantages and limitations of these methods will be discussed during the presentation. Results. Main actions for dose management of pregnant patients will be discussed during the presentation. The CoDE (Conceptus Dose Estimation) online software tool will be presented. CoDE allows a) calculation of conceptus radiation dose and associated risk from Xray examinations performed on the expectant mother and b) anticipation of conceptus dose for the pregnant employee who participates in fluoroscopically-guided interventional procedures. CoDE is available free of charge (embryodose.med.uoc.gr). Conclusions. The involvement of medical physicists is of paramount importance to ensure radiation protection of pregnant patients and their unborn children. https://doi.org/10.1016/j.ejmp.2018.06.141
[I070] US regulatory requirements for radiation protection of pregnant patients and medical staff Eugene Lief * Bronx Va Medical Center, Radiation Oncology, Bronx, United States Corresponding author.
⇑
Purpose. To discuss harmful effects of ionizing radiation, especially important for fast growing tissues including the human fetus. To go over the strict regulations in the US regarding occupational exposures of pregnant workers to ionizing radiation.
27
Methods. Radiation protection of pregnant radiation workers includes written declaration of pregnancy which every female radiation worker can do at any time. The declaration should be done in writing and can be revoked at any time without an additional explanation. Based on this declaration, the employer should review work responsibilities of the employee and her recent radiation badge reading. In some cases, the employee could be reassigned to another type of work to further reduce her potential occupational exposure. A pregnant radiation worker receives an additional badge worn on the abdomen. This badge is being processed on a monthly basis to ensure the compliance with maximum monthly radiation exposure limit. Use of Diagnostic Radiation for pregnant patients should be limited to necessary studies urgently needed to improve the patient’s condition. That could be an acute condition or a life-saving treatment after an automobile accident etc. Before ordering an exam, the practitioner has to take into consideration the patient’s condition and potential harm to the fetus vs. the benefit from the procedure. Results. Strict rules of Radiation Safety of pregnant radiation workers allow to reduce the occupational exposure to 500 mR/year and also to 50 mR/month. Two independent radiation badges allow reliable occupational dose measurements on a monthly basis. For pregnant patients it is often possible to assess possible dose to the fetus from the suggested radiation procedure prior to its administration. At that time, the decision should be made whether the procedure should be performed. Conclusions. The US regulations regarding the occupational exposure of pregnant radiation workers allow to create a safe work environment which, in the light of the current knowledge, does not cause any harm to the worker and the fetus. https://doi.org/10.1016/j.ejmp.2018.06.142
[OA071] O-RAW: Ontology-guided radiomics analysis workflow Zhenwei Shi *, Alberto Traverso, Johan Soest, Petros Kalendralis, Leonard Wee, Andre Dekker Grow – School for Oncology and Development Biology, Maastricht University Medical Centre, Department of Radiation Oncology (Maastro Clinic), Maastricht, Netherlands ⇑ Corresponding author. Purpose. Radiomics is high-throughput computerized tumour feature extraction from medical images. This has shown potential for quantifying tumour phenotype and predicting treatment response. Three major challenges impede the pace of radiomics research and clinical adoption: (i) lack of standardized methodology for radiomics analyses, (ii) lack of universal lexicon to denote features that are semantically equivalent and (iii) flat tables for radiomics output do not sufficiently capture the methodological steps that affect feature values. These barriers hamper multi-centre validation studies applying subtly different imaging protocols, pre-processing steps and extraction software. We propose an open-source Ontology-guided Radiomics Analysis Workflow (O-RAW) to address the above challenges. Methods. O-RAW was developed in Python, which comprises three phases and uses two open-source component libraries (Py-rex and Pyradiomics). First, Py-rex takes standard DICOM-RT inputs (DICOM images and an RTSTRUCT file) and parses them as numpy arrays of voxel intensities and a binary mask for the volume of interest (VOI). Next, the numpy arrays are passed to Pyradiomics performing the feature extraction and returns a dictionary object to Py-rex.