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(a) The overhead lead perspex shield should be positioned closest to the radiologist
(b) Using an overcouch tube position minimises scattered radiation dose to staff in the room
(c) The limit on the equivalent dose to the lens of the eye is 50mSv in a calendar year
(d) Only essential staff should be working in the controlled area
(e) Lead aprons must be worn at all times by all staff working in the controlled area
(a) All radiation exposures must be justified by the IRMER practitioner prior to exposure
(b) The use of lead protection for the patient is generally advised as good practice
(c) All imaging protocols must be optimised to ensure the best image quality is obtained
(d) For fluoroscopic procedures, the patient should be positioned as close as possible to the imaging detector and as far as possible from the X-ray tube to keep the dose to the skin ALARP
(e) Removing the anti-scatter grid for smaller paediatric patients will reduce the level of exposure required
(a) Performing tasks as quickly as possible to minimise exposure time instead of using shielding that could slow the user down
(b) Using lead shielding to protect against beta emissions
(c) Performing all possible interactions with a patient before they are injected with the radiopharmaceutical
(d) Only entering controlled areas when necessary
(e) Using a dose rate meter to monitor for contamination when leaving a controlled area
(a) Consider delaying breast feeding for 2 weeks after injection for all diagnostic studies
(b) Cease breast feeding for studies using I131 iodide
(c) Seek advice from a medical physics expert (MPE)
(d) Consider using an alternative radiopharmaceutical
(e) All radiopharmaceuticals have an affinity to breast milk
(a) The organ of interest that takes up the radiopharmaceutical is referred to as the target organ
(b) Almost all the gamma ray energy is deposited inside the organ being imaged and little energy irradiates other tissues
(c) The effective half-life of a radiopharmaceutical affects the patient’s effective whole body dose
(d) The dose delivered by a planar radionuclide examination is affected by the number of images taken
(e) Nuclear medicine diagnostic reference levels (DRLs) are patient doses in mSv that must not be exceeded
(a) Increasing the pitch, where clinically appropriate
(b) Audit DLP against NDRLs and identify opportunities for dose reduction
(c) Always use lower kV available on scanner for contrast scans
(d) Use automatic tube current modulation
(e) Use prospective ECG-gated acquisition
(a) The primary source of scatter to staff in the room are the walls, ceiling and floor.
(b) Areas shielded from patient scatter are to the sides of the gantry (at 90 degrees to the patient table)
(c) A lead apron of 0.25 mm lead equivalent is suitable when undertaking CT biopsies in the controlled area.
(d) Staff doses in CT are typically higher than those for staff working in radiology.
(e) The shielding requirements of a CT room will be the same irrespective of the workload
(a) CT Brain (2 mSv), Cardiac Coronary CT Angiography (8 mSv), CT Chest (6 mSv)
*dose values vary significantly depending on protocol and technology used. The values presented are indicative values.
(b) Dose to the foetus due to CTPA on a pregnant patient (25 mSv)
*dose values vary significantly depending on protocol and technology used. The values presented are indicative values.
(c) CT Abdomen Pelvis (8 mSv), CT Chest-Abdomen-Pelvis (16 mSv)
*dose values vary significantly depending on protocol and technology used. The values presented are indicative values.
(d) Effective dose for CT Chest is approximately 30x higher than for Chest X-Ray
*dose values vary significantly depending on protocol and technology used. The values presented are indicative values.
(e) Barium Enema (6 mSv), CT Brain (9 mSv)
*dose values vary significantly depending on protocol and technology used. The values presented are indicative values.
