Radiological protection of patients in clinical radiology

Abstract

Patient exposure to ionising radiation must be controlled so that deterministic effects are unlikely to occur, and optimised to keep the risk of stochastic effects as low as reasonably achievable. Research on radiological protection of patients was carried out in collaboration with several hospitals and universities in Northern Ireland. The research investigated the control and optimisation of patient exposure in three fields within clinical radiology requiring special attention; paediatric radiology, interventional radiology and computed tomography. Patient radiation dose and image quality was optimised for radiography in a paediatric radiology department and it was demonstrated that European guidelines on quality criteria were a useful tool for optimisation. The potential benefit to patientsof modernising paediatric X-ray fluoroscopy equipment was also demonstrated. Measurement of patient dose from interventional neuroradiology and cardiology found that some procedures could cause deterministic effects. Methods were developed to make the operator aware of patient dose during interventional procedures. Introduction of interventional neuroradiology equipment incorporating patient dose management features led to significant reduction in patient skin dose and reduced the risk of radiation-induced injury. For computed tomography, investigation of radiation shields designed to protect organs in the scan field, but not often the organs of interest, showed that the shields could be a useful tool for dose optimisation. Study of computed tomography during preoperative planning showed that patient dose was significantly greaterthan during preoperative planning using radiography and fluoroscopy. It was concluded that computed tomography was not justified for preoperative planning of patients undergoing routine hip replacement. The work has made a significant contribution to knowledge by developing methods for minimising the risks of patients suffering deterministic and stochastic effects, and by demonstrating the reduction in patient dosepossible in a clinical setting, resulting from changes in X-ray equipment and radiological technique.

Date of Award	Jun 2009
Original language	English
Supervisor	Ciara Hughes (Supervisor) & John Winder (Supervisor)