How Can Radiation Be Controlled And Safely Used In Medicine?

• Journal List
• Glob Cardiol Sci Pract
• v.2014(4); 2014
• PMC4355517

Glob Cardiol Sci Pract. 2014; 2014(four): 437–448.

Radiation in medicine: Origins, risks and aspirations

Mohamed Donya

^oneAswan Heart Eye, Aswan, Egypt

Marking Radford

ⁱⁱQatar Cardiovascular Research Eye, Doha, Qatar

Ahmed ElGuindy

¹Aswan Heart Centre, Aswan, Egypt

David Firmin

^threeImperial Brompton Hospital, London, Britain

Magdi H. Yacoub

²Qatar Cardiovascular Research Center, Doha, Qatar

Received 2014 Oct 31; Accustomed 2014 December 11.

Abstract

The use of radiation in medicine is now pervasive and routine. From their crude ancestry 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy accept all evolved into avant-garde techniques, and are regarded as essential tools across all branches and specialties of medicine.

The inherent properties of ionizing radiation provide many benefits, but can too cause potential damage. Its use within medical do thus involves an informed judgment regarding the risk/benefit ratio. This judgment requires not but medical knowledge, only also an agreement of radiation itself.

This piece of work provides a global perspective on radiation risks, exposure and mitigation strategies.

Introduction

Radiation is a form of free energy which travels from a source as waves or as energized particles. At the lower finish of the radiation spectrum nosotros find radio waves and microwaves, which are generally considered harmless (Figure i). Sunlight consists of radiation from long wavelength infrared to brusk wavelength ultraviolet. Beyond the ultraviolet range, the types of radiation nosotros detect have so much free energy that they tin knock electrons out of atoms, in a process known as ionization.

Comparison of wave-length and frequency for the electromagnetic spectrum.¹

We all experience low doses of ionizing radiation from infinite, from the air and from rocks and earth effectually united states. When appropriately harnessed, ionizing radiation also has a number of useful applications in medicine, which tin increment our exposure. However, in affecting the atoms of living things, this form of radiation poses a health run a risk, through potential damage to tissue, genes and DNA. Controlled exposure and the adventure/benefit equation must therefore always be at the forefront of clinical conclusion-making.¹

Historical perspective

The invention of the x-ray by Wilhem Roentgen in 1895 was a transformative moment in the history of medicine, for the kickoff time making the inner workings of the torso visible without a need to cut into the flesh.²

Roentgen, a Professor of Physics in Würzburg in Federal republic of germany, was at the fourth dimension experimenting with electrical currents through cathode ray tubes (Figure 2). Although the glass tube he was using was covered in thick blackness cardboard, and the room was completely nighttime, Roentgen noticed that a nearby screen, covered in barium platinocyanide (a fluorescent material), became illuminated. He quickly realized that this was due to radiation being emitted from his experimental apparatus. Furthermore, a number of unlike objects could be penetrated by this radiation, and a projected image of his hand on the screen showed a dissimilarity between opaque bones and translucent mankind. One week subsequently his initial discovery, Roentgen replaced the screen with a photographic plate, and x-ray imaging was built-in.³

Wilhelm Roentgen (the first person to find the potential for using electromagnetic radiation to create X-ray images) (right). The X-ray of his wife's paw with a wedding ceremony ring, first ever captured X-ray on a photographic plate (1895) (left).^two

Roentgen began lecturing on his invention in January 1896, and a few weeks afterward an X-ray was used in Canada to find a bullet in a patient's leg. Inside a year, the world'southward first Radiology Department was fix up at Glasgow Imperial Infirmary, and quickly produced images of kidney stones and of a penny lodged in a child'south pharynx. Before long later on, an American physiologist used a like system to actively trace food going through the digestive organisation.

During the twenty years following Roentgen's discovery, x-rays gained increasing popularity, both as a fairground marvel and equally a powerful diagnostic tool in the medical setting. Their utilise in the handling of wounded soldiers in the Boer State of war (1899-1902) and World War i (1914-18) cemented the utilize of X-rays at the heart of medical diagnostic practise. Roentgen was awarded the very first Nobel Prize for Physics for his discovery in 1901.³

Around the same time equally Roentgen's piece of work, scientists like Henri Becquerel and Marie and Pierre Curie were among the first to discover natural radiation, whilst investigating the backdrop of fluorescent minerals. When storing some such minerals (a uranium compound) in a drawer with photographic plates, Becquerel noticed that the latter became exposed, and ended that this must be due to a blazon of highly penetrative radiation being given off past the mineral itself.⁴ Every bit scientists began to look at this miracle more closely, they discovered that radioactive atoms are naturally unstable, and that in order to go stable, they emit particles and/or energy, in a process known equally radioactive decay. Polonium and radium were discovered by the Curies over this menstruation. Radium would become peculiarly important equally a source for gamma rays, beginning extensively used in industrial radiography during the Us Navy'southward ship-building program in World War two. Past 1946, Cobalt and iridium were developed as man-fabricated sources of gamma radiation for manufacture. Since these were cheaper to produce and more powerful than radium, they speedily replaced information technology in all industrial applications.^five

The widespread and unrestrained employ of x-rays and other radiations technologies in their early years inevitably led to serious injuries. It took time to establish a direct link betwixt radiation exposure and such injuries however, due to the slow onset of many weather, and to a lack of understanding. Thomas Edison, Nikola Tesla and William J Morton all reported eye irritation every bit a common symptom from their experimentation with ten-rays and fluorescent materials, but it would exist many years before the science of radiation protection, or 'Wellness Physics' as it is known today, properly took hold.⁶

Types of Ionizing Radiation

The major types of ionizing radiation emitted during radioactivity are alpha particles, beta particles and gamma rays (Figures 3–four). Other types, such as 10-rays, can exist both naturally occurring, or auto-produced.⁷

• •Blastoff particles

• Blastoff particles gained particular notoriety during the early days of particle physics, when they were used to bombard a variety of targets. One of the nearly celebrated experiments of this kind was conducted by Earnest Rutherford in 1917, leading to the discovery of the atom's structure. Consisting of ii protons and two neutrons, Alpha particles are relatively large in atomic terms (Figure 5). They are generally emitted from the decay of only the heaviest radioactive nuclei, such equally uranium, actinium and radium. Although very energetic, and high in ionizing properties, the weight and size of blastoff particles means they lose their free energy over relatively short distances, and tin can hands exist stopped by a layer of paper or human skin. As such, 'external' actual exposure to alpha radiation carries little risk to health. However, if somehow inhaled or ingested, alpha particles can cause highly focused ionization, releasing all their energy simply across a few cells and causing astringent damage at both cellular and genetic level. This makes alpha particles perchance the most dangerous form of radiation.^8,9

  

• •Beta particles

• Beta particles are modest, fast moving, negatively charged electron-like particles, emitted from an cantlet's nucleus during radioactive decay (Figure 6). Beta particle emission occurs when the ratio of neutrons to protons in an atom's nucleus is too high. In such cases, the backlog neutrons transform into a proton and an electron. The proton remains in the nucleus whilst the electron is ejected with high energy. Common emitters of beta particles include carbon-14 and strontium-90. Beta particles are more penetrating than alpha ones, but crusade less damage due to their ionization being spaced over a larger area. They can travel further in air, but are easily stopped by a layer of clothing or a thin sheet of aluminium. Some beta particles are capable of penetrating the skin and causing a degree of skin burn down, just on the whole, as with blastoff particles, ingestion or inhalation remains the principal cause for business concern.¹⁰

  

  Beta disuse of a Thorium 234 nucleus.¹⁰

• •Gamma rays

• Gamma rays, emitted both in radioactive decay and nuclear explosions, have the smallest wavelength and the greatest free energy of whatsoever waves known in the electromagnetic spectrum (Figure 7). Unlike alpha and beta particles, which have both energy and mass, gamma rays are just pure free energy.¹¹ The penetrative power of gamma rays is such that several inches of a textile such as lead, or several feet of concrete are required every bit a barrier to stop them. Gamma rays can pass through the whole human body easily, potentially causing severe harm to tissue and Dna. Yet, their power to kill cells has been successfully harnessed and focused past medical scientific discipline, in the form of radiation therapy for cancer.¹²

  

• •X-rays

• Due to their widespread apply in the clinical setting, 10-rays are familiar to nearly everyone. Like gamma rays, x-rays are photons of pure energy, merely they are generally less penetrating, due to their lower free energy. They share many basic properties, simply are emitted from different parts of the atom; gamma rays from within the nucleus, and ten-rays from outside. X-rays occur naturally, but tin can also be produced by machines, using electricity, as discovered by Roentgen.?Many millions of x-ray machines are in daily employ around the world, ranging from medical (x-ray and CT scans), used to make detailed images of bones and soft tissue in the body, to airport security screening and industrial inspection and procedure controls. Medical diagnostic radiology, based on 10-rays, is the single largest source of man-fabricated radiations exposure, accounting for over 40% of all radiation exposure for the average American during their lifetime.¹³

Comparison of the penetrating ability of the 3 types of radiations (Alpha, Beta, and Gamma).⁷

The major types of ionizing radiation emitted during radioactive decay.⁷

Understanding Radiation Risks

Radiation can impairment living tissue by changing cellular construction and damaging an organism'southward DNA. The amount of impairment depends on a number of variables, including the blazon and quantity of radiation absorbed and its energy.^xiv

Because radiations damage is done at cellular level, the consequence of minor or fifty-fifty moderate exposure may exist difficult to detect, and frequently can exist successfully repaired past the body. Even so, sure types of cells are more sensitive to radiations harm than others, and with greater exposures, cellular recovery might be less successful and turn cancerous. Radiations tin can kill cells outright, also as dissentious their Dna. This obviously creates a chance, but besides opportunities for medical intervention, if cellular death tin be precisely targeted (e.yard. in radiation therapy for cancer).¹⁵

Much of our knowledge of the risks of radiation is based on studies of survivors from the diminutive bombs at Hiroshima and Nagasaki in Japan at the end of the Second World War. Other studies of radiations industry workers and of people receiving loftier doses of medical radiations have added to our understanding. Today, radiation ranks among the virtually thoroughly investigated causes of disease, and more is known about the mechanisms of radiation at the molecular, cellular and organ system levels than for almost any other wellness stressor. This has immune health physicists to decide 'safe' levels of radiation to be used for medical, scientific and industrial purposes to ensure that relative risk does non exceed that associated with other commonly used technologies.¹⁶

How do we quantify radiation?

There are 4 separate but inter-related units for measuring radiations;

• •

  Radioactivity, which refers to the amount of ionizing radiation released by a material

• •

  Exposure, which measures the amount of radioactive decay travelling through the air

• •

  Absorbed dose, which describes the corporeality of radiations captivated by an object or person

• •

  Effective dose, which combines the absorbed dose and the medical effects for that type of radiations

The captivated dose tin can be calculated on the basis of full radiation energy absorbed (Joules) per unit of mass (kg) in an affected area of tissue or organ. The most common unit of measurement of measure out for this is the Gray (Gy), where 1 Grey is equivalent to 1 Joule per kilogram.

With beta and gamma radiations, the Effective Dose (expressed in Sievert, or Sv) is equivalent to the absorbed dose. For blastoff radiations nonetheless, which is more damaging to the torso, the Effective Dose is greater.¹⁷

How are the effects of radiation classified?

The biological effects observed in irradiated persons fall into one of 2 categories; Deterministic, due largely to a "kill" issue on cells, and Stochastic, related to mutations which may result in effects over time, such every bit cancer or hereditary mutations.

A) Deterministic effects, such as skin necrosis and cataract, take a practical threshold dose below which effects are negligible or non evident, but as a full general rule, severity of the furnishings increases with the radiation dose. The threshold dose is not an absolute number, but can vary betwixt individuals.

B) Stochastic effects, such as cancers and hereditary mutations, where the human relationship betwixt dosage and severity of effect is much weaker. Stochastic injuries occur when there is injury to the DNA backbone that fails to heal adequately.¹⁸ A single X-ray photon may cause this consequence, all the same the risk of acquiring such injury increases with dose/exposure (linear no-threshold hypothesis). Stochastic risk is particularly challenging to address given its delayed and cumulative upshot, lack of a "rubber" threshold dose, and absenteeism of a reliable biomarker.¹⁹

Sources of Radiations

Lifetime exposure to radiations comes from a variety of sources, both natural and man-made.

Naturally occurring (background) radiation

Well-nigh half of the radiation we are exposed to comes from the surround around the states. Many elements found in the world'due south crust emit radioactivity, including uranium, radium, polonium, thorium and potassium. Levels of exposure will depend on the brand-up of the local soil and rocks. Another natural source is cosmic radiation. Globe is constantly exposed to radiation created by processes occurring in the sunday, other stars and throughout the Universe.

Peradventure the most damaging source of natural radiations is radon, a tasteless, colorless, odorless gas produced past the decay of radium, an element present in near all rocks and soils. Radon gas seeps into buildings from cracks and other openings in floors and walls. Since radon gas emits blastoff particles, accumulated radon within buildings can pose a serious health take chances via inhalation. Radon causes an estimated 20,000 cases of lung cancer per year, and is 2d only to smoking as a cause of lung cancer death. Smokers living in a home with high radon levels are specially at chance.²⁰

Radiation in medicine

In countries with a developed clinical sector, up to a further 50% of our radiation exposure can be attributed to medical sources (Figure 8). About of this comes from the utilise of standard ten-ray and CT scan technology to diagnose injuries and disease. Other procedures such every bit radiation therapy as well employ radiation to treat patients.²¹

Chart illustrating the sources of radiation exposure in the United States (NCRP 2009).¹³

General Principles for Minimizing Radiation Hazard in Medical Use

The most effective way to reduce patient risk in radiological examinations is through appropriate examination functioning and through the optimization of radiological protection for the patient. These are primarily the responsibility of the radiologist, the nuclear medicine clinician and the health physicist.

The bones principle of patient protection requires that procedures should seek to achieve diagnostic data of satisfactory clinical quality using the lowest reasonably achievable dose. Evidence obtained from a number of countries indicates a meaning variability in entrance doses routinely administered to patients (i.e. doses measured at the body surface, at the site where the x-ray beam is entering), varying by a cistron of 100 in some cases. Equally most doses in these studies tend to cluster at the lower end of the distribution, information technology is clear that entrance doses at the higher end (say above the 70th or 80th centile) are hard to justify every bit adhering to an optimal hazard/do good ratio.²²

A benign start step towards radiation adventure-reduction for patients is therefore the development of an agreed protocol of diagnostic reference tables of appropriate radiation for different procedures and patient types (e.g. children vs. developed), at an institutional, regional or national level, based on observed international all-time exercise. An initiative of this kind provides non only a valuable learning or guidance tool, but information technology tin also assist with quality control, helping to quickly identify institutions or equipment requiring cosmetic action in order to reduce patient run a risk. Measures that strengthen communication, transparency and implementation between radiologists, wellness physicists and inspect teams can also assistance to significantly impact on radiation dose reduction for patients, whilst at the aforementioned time improving effectiveness of diagnosis.^23,24

As a matter of policy, certain procedures should exist phased out, as better alternatives become available. For example, the use of fluoroscopy or photofluorography in the screening of tuberculosis in children is no longer indicated (normal radiography is a less harmful alternative for this age group), and more than generally, fluoroscopy without electronic image intensification exposes patients to unacceptably high doses of radiation compared to alternatives. Such procedures are currently banned in most adult countries.²⁵

In parallel, the utilise of fluoroscopically-guided interventional procedures has increased dramatically over the past two decades. The number and spectrum of such procedures continue to expand across different specialties. Patients (and staff) are by and large subjected to significantly higher radiation dosages compared to diagnostic studies; averaging 15 mSv for a uncomplicated coronary intervention and 50 mSv for a complex electrophysiological procedures, equivalent to 750 and 2500 posteroanterior breast X-rays respectively. The directly benefits of these procedures unremarkably outweigh the potential hazards associated with such high doses of radiation. All the same, even with this favorable take a chance/do good ratio, efforts to minimize take a chance must apply. Quality assurance and comeback programs focusing on minimizing exposure to patients and staff, continuous education, dose monitoring, proper utilize of equipment and protective garments/shields, and adherence to radiation safety guidelines issued past various professional societies, cannot be overemphasized.²⁶

Radiations Risks and Children

Radiation command is a business concern both in the case adults and children. Notwithstanding, with regard to children and fetuses, three unique considerations apply, which must inform our deportment;

• [ane]

  Children are considerably more sensitive to radiation, as demonstrated in numerous epidemiological studies of exposed populations.

• [2]

  Children have a longer life expectancy than adults, resulting in a longer window of opportunity for radiation damage to be expressed.

• [three]

  Children may receive a higher dose of radiations than necessary, if equipment settings and dosages are non adjusted for their smaller trunk size.

Radiations-induced malformations or intellectual impairment, either in the developing fetus or children, are extremely unlikely through normal diagnostic radiology or nuclear medicine procedures. Nonetheless, a pocket-sized just pregnant risk of cancer induction does be, and must be borne in heed even at typical diagnostic levels of radiation ( < fifty mGy). The adventure of developing radiation related cancers tin can be several times higher for a immature child, compared to an adult undergoing like diagnostic or interventional procedures.

Radiations dose reduction must therefore be a priority goal especially for procedures carried out on children, or in pregnancy. In pediatric use, dose reduction is achieved in practise principally through technical factors specific to children. In nuclear medicine, the smaller size of children means that acceptable images can be achieved using smaller administered doses than for adults, whilst in diagnostic radiology, particular care must be exercised in ensuring that radiation is focused equally narrowly equally possible on the specific expanse of involvement.²⁷

Reducing fetal radiations in pregnancy

Before a diagnostic procedure is performed on a female person patient of child-begetting age, it is important to determine whether she may be significant, and if so, whether the fetus is in the chief radiations area, and whether the process might involve a relatively high dose (east.g. barium enema or pelvic CT scan). Medically-indicated diagnostic studies which are remote from the fetus (e.g. x-rays of the chest or extremities, lung scans) can exist safely carried out at any time during pregnancy, provided the equipment is in skillful working society. Unremarkably, the benefit of making an informed diagnosis outweighs the potential contra-indications of the radiations gamble in such cases.

If an examination is at the college end of diagnostic dosing, and the fetus is either in, or near, the radiation beam, the run a risk/do good equation requires doses and procedures to be minimized as much as possible whilst still retaining sufficiency for constructive diagnosis. This can be done by tailoring the examination to minimize the number of radiographs required, or in the case of nuclear medicine, by encouraging maternal hydration and rapid voiding of radiopharmaceuticals through the urinary tract, to reduce fetal exposure.²⁸

Radiation risk and CT (computed tomography) use in pediatrics

CT tin be a life-saving tool for diagnosing illness and injury in children. Between 5 and 9 million CT examinations are performed on children annually in the United States solitary, and use of this procedure is increasing steadily, both due to its utility in mutual diseases and because of technical innovation.

All the same despite its many clear advantages, CT also poses a major disadvantage in terms of meaning radiations exposure. Despite bookkeeping for only 12% of diagnostic radiological procedures in the United states, CT scans evangelize around 49% of the US population'due south collective radiation absorption from medical procedures as a whole.²⁹

The offset study to directly assess the risk of childhood cancer post-obit CT scans establish a clear dose-response relationship for both leukemia and brain tumors, with gamble growing alongside increased cumulative radiation absorption. A cumulative dose of effectually l-threescore mGy to the head was establish to increase the likelihood of brain tumors threefold in children. Likewise, exposing bone marrow to a similar dose of radiation was plant to increase the risk of leukemia by the same amount. For both findings, comparison was made with a control group having a cumulative radiation assimilation of less than v mGy to the relevant regions of the trunk. These findings mirrored estimates from studies later on the atomic bomb explosions in Japan.³⁰

The number of CT scans required to attain a cumulative threshold of l-sixty mGy depends on the equipment used, the age and size of the patient, and the scanner settings themselves. On typical current settings for pediatric CT, two to three head scans are sufficient to expose the brain to this level of cumulative radiation. In the instance of bone marrow, this threshold is reached at between 5 and 10 procedures. The to a higher place is based on accepted US scanner settings for the < fifteen age grouping.

Despite these findings, information technology is important to stress that the absolute cancer risks associated with CT scans are small. The accented lifetime chance, equally estimated in the literature, is about 1 instance of cancer per thou CT scans performed, with a maximum incidence of i in 500 patients scanned. Potent justification exists for the connected use of CT scanning in pediatrics. Notwithstanding, once once more, a conscientious assessment of the risk/do good equation remains paramount, every bit does a commitment to reducing patient exposure to medical radiation to the minimum necessary to obtain results.³¹

Where CT is used in pediatric settings, several immediate steps and long term strategies can be put in place to help safeguard patient safety. From a procedure perspective, specialists should:

• [4]

  Minimize utilize of ionizing radiation based procedures like CT on children, opting for non-ionizing options such every bit ultrasound or magnetic resonance imaging (MRI) whenever possible

• [5]

  Arrange exposure parameters for pediatric CT based on evolution of size/weight based protocols, and on the limitation of radiation to the smallest necessary area

• [6]

  Adjust settings for pediatric CT to reflect the surface area being scanned - lower mA and/or kVp settings should be considered for skeletal, lung and some angiographic and follow up scans

• [7]

  Limit scan resolution to 'adequate for diagnosis'. The highest definition images are not always necessary, simply betrayal patients to more radiation

• [8]

  Limit the use of multiple scans - usually taken at unlike phases of contrast enhancement, these are rarely necessary for diagnosis, merely considerably increase the radiations dose and hazard.

Longer term, we should encourage and strengthen the development and use of specific pediatric CT protocols, and seek to educate practitioners, increment sensation and foster information exchange through publications, conferences and professional associations. In add-on at that place is a need for continued inquiry to further analyze the human relationship between CT radiations and cancer take chances, to decide the algorithm between CT quality and dose, and to improve customization of CT scanning for individual children.³²

Magnetic resonance imaging

An alternative class of imaging that has been adult over the last 40 years is that of magnetic resonance imaging (MRI) or MR as it is often known. This uses radio frequency radiation from the far left hand end of the electromagnetic spectrum displayed earlier. This radiations is low free energy and cannot directly damage tissue or Dna. It should exist noted, nevertheless, that if enough of this radiations is introduced to the trunk then information technology tin cause tissue heating that could then cause damage and MRI scanners have strict limits on the quantity of radio frequency radiation in gild to avoid this.

For the vast majority of MRI the radiofrequency magnetic field is used to excite the hydrogen nuclei that so emit a signal that decays away in the timescale of tens of milliseconds. The signals on MR images depend firstly on the density of hydrogen nuclei or protons in the water or fat based tissues and and so on many other factors including and then chosen relaxation times, flow and diffusion. The weighting of the numerous other factors tin can exist contradistinct by modifying the so chosen MRI sequence and this gives great potential to MRI for characterising different soft tissues or measuring claret period for case.

In cardiovascular MR sequences have been adult for a broad range of applications including cine imaging for measurement of cardiac role, various methods of characterising the myocardium and identifying damaged tissues therein, measurement of myocardial perfusion, measurement of bulk claret flow and menstruum patterns in the heart and claret vessels and angiographic imaging of the vasculature.

Potentially, ane of the most important applications is the ability of MR to image and characterise illness in the vessel wall, as this could enable detection of cardiovascular disease at a much earlier stage than at present. Imaging the vessel wall is challenging particularly in the coronary arteries which move not simply during the cardiac but also the respiratory cycle. This is now possible, however, by using motion tracking techniques such equally described by Scott et al.³³ As an example, Figure 9 illustrates a unmarried slice of a 3D stack of a right coronary artery, through airplane (left) and in aeroplane (right).

A single slice of a 3D MRI stack of a correct coronary avenue through plane (left) and in airplane (right).³³

Some other heady evolution is that of improvidence tensor imaging which has the potential to investigate the micro-structural architecture of the myocardial tissue and mensurate changes brought near past illness. Measurement of the diffusion tensor is peculiarly challenging in the heart due to its movement during the cardiac and respiratory cycles. Recently, even so, methods accept been developed that have been shown to provide reproducible measures of DTI parameters³⁴. Effigy 10 illustrates, using a colour calibration, the myocardial fibre helical angle maps from a mid-ventricular short axis slice. The characteristic transition from left handed to right-handed helix is seen across the myocardial wall from epi- to endocardium.

The myocardial fiber helical bending maps from a mid ventricular short centrality slice of a diffusion tensor MR imaging is illustrated using a colour calibration.³⁴

Conclusions

The discovery of X-rays at the end of the 19th century was undoubtedly a significant milestone in the development of clinical practice. Advances in radiations based diagnostic and interventional procedures since and then have brought virtually huge do good for patients.

However, exposure to increased levels of radiation does carry some pregnant risks. Considerable endeavour has, over the past 100 years, been devoted past the research community to better sympathize and quantify these risks. Still, a number of studies take shown that this knowledge has not been consistently practical to do inside the medical community, resulting in huge variations in the levels of radiation absorption to which patients are exposed, for comparable procedures.

A guiding principle for clinicians must be the minimization of run a risk for patients during radiological procedures, counterbalanced against the need for expert quality results. Item care must likewise exist taken in relation to children.

At the policy level there is a need to develop standardized reference tables for adequate radiation levels administered in the major clinical applications, both for adult and pediatric groups. These should exist based on gold-standard practices as observed from international studies and experience.

In terms of implementation, a more rigorous application of quality command based on these standards, and linked both to capacity building and to correctional measures could significantly impact on patient safety in this context. Principles of radiation physics and biology, radiation condom, and measures to minimize exposure should proceed to exist mandatory components in the grooming and certification of all health-care professionals dealing with radiation.

Information technology is by and large accepted that from a adventure perspective, there is no such thing as an absolutely 'safety' dose of radiation. Nonetheless, bearing in listen the huge potential benefit to patients in both diagnostic and interventional settings, our focus must remain on the risk/benefit equation, and on ensuring that we go on to reduce the one-time whilst growing the latter, through continued comeback efforts in technology, in policy and practice.

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Articles from Global Cardiology Science & Practice are provided here courtesy of Magdi Yacoub Found

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How Can Radiation Be Controlled And Safely Used In Medicine?,

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355517/

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