EF 2 - Radiation incidents and accidents in medical imaging and their management (part II)
EF 2 - Radiation incidents and accidents in medical imaging and their management (part II)Friday, March 3, 10:30 - 12:00 Room: G Session Type: EFOMP Workshop: Radiation incidents and accidents in medical imaging: can we prevent them? Topics: Radiographers, Nuclear Medicine, EuroSafe Imaging, Physics in Medical Imaging Moderators: M. Brambilla (Novara/IT), D. J. Lurie (Aberdeen/UK) Add session to my schedule In your schedule (remove)
1. To learn about the common reasons for radiation incidents and accidents in MRI and nuclear medicine departments.
2. To appreciate why we need to manage radiation incidents and accidents properly.
This session will review the current safety issues related to MRI and nuclear medicine environment for both the patients as well as the staff members. Hazards intrinsic to the MRI and nuclear medicine environment must be understood, acknowledged and respected. Incidents occurring in imaging departments shall be properly documented and reported. An overview of incidents and accidents in MRI and nuclear medicine will be provided together with a critical discussion of the lessons learnt from these incidents and accidents. Information and guidelines will be provided on how to properly manage and report incidents and accidents. Finally, the role of the medical physicist in managing incidents and accidents in imaging departments will be outlined by identifying duties and responsibilities of medical physicists associated with the management of radiation incidents and accidents.
1. To give an overview of radiation incidents and accidents in MRI.
2. To discuss the lessons learnt from these incidents and accidents.
3. To learn how to manage incidents and accidents in MRI.
MRI is considered “safe”, due to the lack of ionising radiation and the absence of cumulative “dose” from the scanner’s static, switched and radiofrequency magnetic fields. Nevertheless, hazards associated with MR scanning exist and accidents and incidents of varying severity do occur. The most obvious hazard arises from the “missile effect”, whereby large ferromagnetic objects (chairs, compressed gas tanks) are accelerated into the magnet bore. More common, and harder to control, are the effects of the static magnetic field on small, treatment-related objects (e.g. endotracheal tube components) and on non-MR-safe implanted devices including pacemakers, stents, aneurysm clips or capsule-endoscopy devices. The most significant hazard from MRI is associated with radiofrequency pulses transmitted by the scanner. Non-resonant absorption of energy can potentially cause overheating of tissues, but these effects are well controlled by scanner software. Burns may arise from the unintended concentration of radiofrequency fields. This may be caused by conductive (non-ferromagnetic) objects within or near to the patient, including implanted pacemaker leads (remaining after pacemaker removal), non-MR-compatible or wrongly placed ECG leads, and drug-delivery patches. Burns may also arise from malfunction or incorrect setup of radiofrequency coils. The primary means of minimising adverse incidents are the design and control of MR facilities, education of all staff (from radiologists to cleaners) with regular updates, patient screening techniques and the flagging of patient notes and request forms. It is vital that all incidents are recorded and discussed locally and that lessons learned are disseminated to the wider MRI community.
1. To give an overview of radiation incidents and accidents in nuclear medicine.
2. To discuss the lessons learnt from these incidents and accidents.
3. To learn how to manage incidents and accidents in nuclear medicine.
In addition to hazards associated with every imaging modality, such as patient’s over or underexposure due to non-optimized acquisition protocols, defective equipment, wrong manoeuvres, there are specific hazards in nuclear medicine procedures associated with the storage, manipulation and administration of unsealed radioactive sources, targeted with radiopharmaceuticals. As a consequence, accidents of varying severity do occur which involves not only patients but also staff workers. All the steps involved in the nuclear medicine workflow are subjected to potential accidents: from patient reception, to patient preparation, radiopharmaceutical preparation, administration and uptake phase of the examination, examination and quality controls of the equipment. The potential accidents must be understood, acknowledged and respected. The most diffuse accidents in nuclear medicine are contamination events, followed by overexposure of patients and failure in the managements of radioactive materials. The primary means of minimising adverse accidents are education of all staff (from nuclear medicine doctors, to radiographers and nurses) with regular updates, blank or dry tests during radiopharmaceutical preparation, clear identification of duties and responsibilities of the staff involved, traceability of procedural steps from patient reception to patient leaving the department, and the flagging of patient notes and request forms. Incident reporting is crucial. Accidents should be discussed locally and lessons learned should be disseminated to the wider NM community. Nuclear medicine departments may also be involved in the health managements of nuclear incidents and accidents in emergency scenarios occurring in nuclear power plants and during radioactive transportation.
Management of incidents and accidents in imaging departments: the role and responsibilities of medical physicists
1. To provide information about the role of medical physicists in managing incidents and accidents in imaging departments.
2. To identify the duties and responsibilities of medical physicists associated with the management of radiation incidents and accidents.
Modern imaging systems such as CT, MR, nuclear medicine machines and other interventional x-ray equipment are widely used by clinicians to pledge a more successful clinical outcome. There are occasionally cases, though, that incidents and accidents can occur during the use of these highly sophisticated systems. Medical physicists are working with technologists, radiologists, regulators, as well as various imaging systems manufacturers to ensure that such incidents and/or accidents do not occur in imaging departments. They are also cooperating closely with x-ray technologists and radiologists, cardiologists and other related physicians to reduce the radiation dose to the patient as well as to the staff. The role of medical physicists in ensuring high-quality and low-risk management system is vital in the attempt to build up a robust safety structure and culture and reduce or prevent radiation incidents/accidents or reduce hazards in MR departments both for the patients and also for the staff. All these issues will be discussed in more detail in the particular lecture. A number of recommendations will be given to guide all related imaging department personnel on the responsibilities of medical physicists regarding the management of incidents and accidents in imaging departments.