|Year : 2010 | Volume
| Issue : 3 | Page : 182-186
News Editor, JMP, Acting Chief Medical Physicist, Department of Radiation Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
|Date of Web Publication||26-Jul-2010|
News Editor, JMP, Acting Chief Medical Physicist, Department of Radiation Oncology, King Fahad Specialist Hospital, Dammam
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ganesh T. News. J Med Phys 2010;35:182-6
FDA launches initiatives to rein in medical radiation
The U.S. Food and Drug Administration (FDA) announced an initiative to reduce unnecessary radiation exposure from computed tomography (CT), fluoroscopy and nuclear medicine tests. This move closely follows reports of rising exposure to medical radiation in the U.S. population.
The FDA's three-prong initiative is intended to promote the safe use of medical imaging devices, support informed clinical decision-making and increase patient awareness of medical radiation. The FDA plans to use its existing authority to regulate medical imaging devices and will also collaborate with other federal agencies and healthcare professional groups. The FDA sent letters to 93 makers of radiation treatment devices to address the issue of patient exposures to excess radiation from medical treatments. The agency stated that it received a total of 1,182 reports in the 10-year period, with linacs accounting for 74% of complaints and the treatment planning systems accounting for 19%.
Meanwhile, the United States (US) Congress is holding hearings to learn more about radiation dose exposure from radiology and radiation oncology procedures. These hearings followed some sensational coverage of medical radiation incidents/ errors by New York Times in its issues dated January 24 and 27, 2010, and subsequent responses to them from diverse sections, including those from professional bodies like the American Society of Radiation Oncology (ASTRO) and American Association of Physicists in Medicine (AAPM). While asserting that such medical errors should have been avoided, ASTRO and AAPM reassured the public that radiation therapy remains one of the safest forms of treatment, and all professionals involved are working harder than ever before to prevent such incidences from occurring again.
From: http://www.auntminnie.com and several other sources
Delhi University disposed off research irradiator containing decayed cobalt-60 in unsafe manner leading to one death and injuries to several others
A gamma cell irradiator belonging to the Department of Chemistry, Delhi University, was sold off by the university as scrap material to scrap dealers in the capital's Mayapuri industrial area. The irradiator containing cobalt-60 sources was bought in the early 70s for university's research activities and was not in use for more than 2 decades. Without following rules, the irradiator containing significant activity of cobalt-60 was auctioned and sold to scrap dealers in February 2010, who dismantled it to the core. In the first week of April, the radiation accident was discovered following typical radiation injuries to the workers involved. While one exposed worker subsequently died due to hematopoietic syndrome, others recovered in a remarkable manner due to the excellent healthcare provided to them.
Experts from units of the Department of Atomic Energy, Atomic Energy Regulatory Board (AERB); and National Disaster Response Force successfully recovered all the sources and brought the situation under control. The university has been issued a show-cause notice by AERB for its violation of Radiation Protection Rules.
World's highest- energy particle accelerator sets yet another new record
The European Organization for Nuclear Research Large Hadron Collider (LHC) facility, near Geneva, Switzerland, under the Swiss-French border, keeps setting up new records. On March 19, 2010, the operators at the world's largest atom smasher ramped up their massive machine to three times the energy ever previously achieved, in the run-up to experiments probing the secrets of the universe.
Beams of protons circulated at 3.5 trillion electron volts (TeV) in both directions around the 27-km tunnel housing, dwarfing the already eclipsed record of the "next most powerful machine," achieved by the Tevatron at Fermilab outside Chicago, which achieved a value little less than 1 TeV. On March 30, beams collided at 7 TeV (3.5 TeV per beam), marking the start of the LHC research program.
Scientists hope to approach on a tiny scale what happened in the first split seconds after the Big Bang, which they theorize was the creation of the universe some 14 billion years ago.
From: http://www.press.web.cern.ch/press/PressReleases/Releases2010/PR07.10E.html dated March 30, 2010
Johns Hopkins University levied with hefty fine for radiation safety violations
The state of Maryland fined Johns Hopkins University and Johns Hopkins Hospital to the tune of US $370,000 for the university's alleged failures to properly secure radioactive materials and failure to prevent unauthorized access to rooms containing medical devices using radiation. Other alleged violations included lack of a documented policy to respond to radioactive materials, not wearing radiation-monitoring devices, failure to keep the radiation-measuring equipment calibrated in time, failure to label radioactive waste, besides few more.
Johns Hopkins Hospital was fined for a violation, viz., administering radiation treatment to the incorrect area of a cancer patient in May 2009. The error was made when a patient with two anatomical areas for treatment received the radiation dose prescribed for the second area in the first area.
From: http://www.auntminnie.com dated March 24, 2010
b>Nuclear Regulatory Commission (NRC) proposes fine on Veterans Affairs Medical Center (VAMC), Philadelphia, for medical errors in prostate brachytherapy
NRC conducted an extensive investigation for the last several months relating to incorrect placement of iodine-125 brachytherapy seeds to treat prostate cancer diagnosed in military veterans at the Philadelphia VAMC from 2002 until 2008. It has been reported that out of 116 procedures performed, 97 were executed incorrectly, although the VAMC subsequently said that the number should be reduced to 19.
The principal violations were associated with a lack of written procedures to provide high confidence that each treatment was implemented as prescribed, and also the lack of a procedure to verify that treatments were implemented correctly. According to the NRC, which wanted to send a strong message, the levied fine is one of the largest ever proposed by the agency for medical errors. Additional violations involve the wrong dose of radioactive seeds being ordered and implanted, and an alleged lack of training for staff according to the NRC's definition of a medical event. In addition, the NRC stated that it found it imperative to make an assessment regarding the National Health Physics Program's effectiveness as a regulator.
From: http://www.dotmed.com dated March 22, 2010
International Atomic Energy Agency (IAEA) Director General calls for cooperation to solve radioisotope shipping problems
The IAEA established an International Steering Committee on the Denial of Shipment of Radioactive Material, which includes industry and transport sector representatives, to address the problems caused by transport restrictions. Informing that restrictions and denial of transport of medical radiation sources like cobalt-60 by airlines and shipping companies were causing serious problems in maintaining adequate radiotherapy services. IAEA Director General Yukiya Amano urged all the member states to cooperate in resolving such issues.
IAEA Deputy Director General Tomihiro Taniguchi stated that denial of shipments had a direct link to individuals receiving treatment of cancer. He announced that the agency had set 2013 as the target date for eliminating obstacles in shipping radioactive material.
Since late 2007, the IAEA Denial of Shipment Database recorded 87 incidents of refusal to transport cobalt-60, used to treat cancer or sterilize medical equipment, besides other incidents involving molybdenum-99. Many other shipping denials go unnoticed and unreported. While emphasizing that the crux of the solution to denial of shipments lies in developing strong national networks, Mr. Taniguchi said there can be no blindness to the role of safety and security in the transport of radioactive material.
From: http://www.iaea.org/NewsCenter/News/2010/life savingrsources.html dated March 1, 2010
Medical imaging manufacturers unveil eight key principles to reduce unnecessary radiation exposure and medical errors: Plan addresses CT and radiation therapy
The Medical Imaging and Technology Alliance (MITA), the leading association representing the manufacturers, innovators and developers of medical imaging and radiation therapy systems, endorsed eight key principles to reduce exposure to unnecessary medical radiation, further minimize medical errors and improve reporting of adverse events.
As part of its ongoing commitment to ensuring safe, appropriate and effective medical imaging and radiation therapy, MITA announced new radiation dose safeguards on CT technology.
A new radiation dose check feature will provide an alert to CT machine operators when a certain "reference dose" - a threshold dose level (reference dose values) as determined by clinicians, hospitals and imaging centers - will be exceeded. Further, additional safeguard feature preventing CT scanning at higher, potentially dangerous radiation levels would also be included.
From: http://www.medicalimaging.org/news/20100212b.cfm and http://www.medicalimaging.org/news/20100301a.cfm dated Feb 12, 2010, and March 1, 2010
Patients who underwent stereotactic irradiation overdosed in a US hospital
On February 24, a hospital in Missouri acknowledged that 76 out of 152 patients treated by stereotactic technique between 2004 and 2009 received overdoses of radiation - the latest incident in what has become a series of errors regarding the medical use of radiation.
CoxHealth of Springfield attributed the error to a medical physicist who used a wrong chamber to calibrate a stereotactic radiation therapy system resulting in patients receiving too much dose until the error was discovered in September 2009. The patients received 50% more dose, on an average, according to the hospital. It added that the error was discovered in September 2009, when a second CoxHealth physicist received training on the system and the initial programming calibrations were recalculated. An external physics audit confirmed the hospital's findings. The hospital said that no patient had reported symptoms of radiation exposure during the period in question. In addition to suspending the stereotactic program, the hospital is reviewing all the technology and equipment used in both its radiation oncology and radiology departments.
From: http://www.auntminnie.com dated February 25, 2010
The American College of Radiology (ACR) has revised its requirements for medical physicists and magnetic resonance scientists - Calls for mandatory accreditation
The ACR's changes include board certification or degree and experience requirements to enhance accreditation programs and bring them in line with the existing ACR practice guidelines and technical standards for each modality. The modifications are designed to promote the ACR's goals for quality and safety as the organization prepares accreditation programs for approval by the U.S. Centers for Medicare and Medicaid Services (CMS) under the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008.
The ACR will also call for mandatory accreditation of all providers of advanced imaging and radiation oncology providers regardless of setting.
From: http://www.auntminnie.com dated December 15, 2009, and February 25, 2010
World Health Organization (WHO) warns of increase in cancer deaths
In a message ahead of World Cancer Day on February 4, the WHO warned that annual global cancer deaths would jump to 17 million by 2030 from a projected 7.6 million this year if people do not take urgent action to avoid risk factors. Each year over 12 million people around the world are newly diagnosed with cancer.
According to the message, cancer accounts for one in eight deaths worldwide - more than AIDS, tuberculosis and malaria combined - but many of these deaths can be avoided, citing smoking as the single largest preventable cause of cancer.
In the Western Pacific region, the WHO said close to 3.7 million new cancer cases occurred in 2008 - 2.2 million in men and 1.5 million in women. Nearly 2.6 million in the region died from cancer that year, it added.
From: http://www.beta.thehindu.com/health/article99406.ece dated February 2, 2010
Full-body scanners at more number of airports across the globe
London Heathrow airport recently joined the list of airports having full-body X-ray scanners even though privacy concerns have been raised against them by campaigners of civil liberties. Currently many airports in US have this sophisticated security device. The trials at the Heathrow will use two different technologies that see through passengers' clothing. One trial will involve "backscatter" technology, which exposes travelers to low-level X-rays. The second type of machine uses a "millimeter wave" system, which bounces radio waves off the human body to form a 3D image of the passenger.
From: http://www.guardian.co.uk/uk/2010/jan/26/new-body-scanners-heathrow?CMP=AFCYAH dated January 26, 2010
Iraq littered with high levels of nuclear and dioxins contamination
A joint official study by the environment, health and science ministries of Iraq found 42 sites across the country that were contaminated with high levels of ionizing radiation and dioxins - leftovers of the first Gulf war. Najaf, Basra and Falluja - Iraq's largest towns and cities - account for 25% of the contaminated sites. Incidentally these were the areas from where increased rates of cancer and birth defects over the past five years have been reported. A government official said, high levels of dioxins on agricultural lands in southern Iraq, in particular, were increasingly thought to be a key factor in a general decline in the health of people living in the poorest parts of the country.
Ten of these sites have been classified by Iraq's nuclear decommissioning body as having high levels of radiation, which included the sites of three former nuclear reactors at the Tuwaitha facility, as well as former research centers around the capital that were either bombed or dismantled between the two Gulf wars.
From: http://www.guardian.co.uk/world/2010/jan/22/iraq-nuclear-contaminated-sites?CMP=AFCYAH dated January 22, 2010
Integrating the Healthcare Enterprise - Radiation Oncology (IHE-RO)
IHE-RO was established in 2004, as a domain of the larger "Integrating the Healthcare Enterprise" (IHE) program, an initiative created by healthcare professionals and industry to improve the way computer systems in healthcare share information.
Recently ten companies participated in an ASTRO-hosted Connectathon event held at Fairfax, VA, to test the integration of their equipment and prove they can meet interconnectivity standards and operate with each other. According to the participants, the event was getting more difficult, albeit in a good way. The participating companies must demonstrate, for each aspect of their products being tested, three successful interactions with complementary systems to pass the event. Once passed, they release an integration statement to show potential customers that their equipment has been tested for compatibility with other vendors' equipment. More and more centers are insisting that vendors must show proof that they have passed an IHE-RO Connectathon before their products can be considered for purchase.
From: ASTRO News dated December 30, 2009
Silicon technology to enable clearest X-ray view of violent space
A European Space Agency (ESA)-led effort is all set to use silicon technology to enable astronomy's clearest X-ray view yet of the most violent regions of space. Observing the sky in X-rays reveals a violent universe of exploding stars, black holes and incandescent gas clouds. With temperatures of millions of degrees, such high-energy objects shine at X-ray wavelengths but not in visible light. However, an X-ray telescope is much different and technologically more demanding than its optical counterpart. The ESA is focusing on silicon pore optics, based around commercial silicon wafers, in the design of X-ray space observatory.
From: http://www.beta.thehindu.com/sci-tech/technology/article68735.ece dated December 22, 2009
Studies spotlight high CT radiation dose
Two studies appearing in December 2009 issue of the Archives of Internal Medicine revealed higher-than-expected radiation dose in clinical CT studies, mainly in abdominal and pelvic scans, and projected increased lifetime potential cancer risks. An estimated 72 million CT scans were performed in 2007 alone in the United States. At a minimum, the U.S.-funded studies suggest that dose-reduction efforts have not spread widely enough across the U.S. Another important finding was that the radiation doses varied significantly between different types of CT studies and within the same types of CT studies, both within and across institutions.
However, radiology's defenders have questioned the projections of increased lifetime potential cancer risks (based on the extrapolation of atomic bomb survivor study). Due to lack of evidence , the conclusion that growth in the number of scans is leading to more cancers has been challenged . They have also highlighted the value of clinical decisions made possible by CT scans, and the risks of not performing clinically indicated studies.
From: http://www.auntminnie.com dated December 14, 2009
A new medical physics classifieds website
A graduate student in medical physics has created a new Medical Physics Classifieds website bringing together all countries practicing all fields of medical physics for the purpose of posting free advertisements covering therapeutic radiological physics, diagnostic radiological physics, medical nuclear physics and medical health physics.
From finding a spare part to disposing off your unused items and from continuing education to finding a job, and much more, the site has many features.
You can visit the website at http://www.medphysclassifieds.com/.
Recent publications of interest from IAEA
Patient dose optimization in fluoroscopically guided interventional procedures - Final report of a coordinated research project
IAEA TECDOC Series No. 1641
This publication reports the results of a recent IAEA-coordinated research project on patient dose optimization in fluoroscopically guided interventional procedures. The summary presents detailed information on the assessment of high skin doses, analyzes the factors causing radiation skin injury and makes recommendations on how to avoid or reduce the likelihood of such complications.
Setting authorized limits for radioactive discharges: Practical issues to consider report for discussion
IAEA TECDOC Series No. 1638
Radioactive waste is generated in a broad range of activities involving a wide variety of materials. The wastes arising from these activities have differing physical, chemical and radiological characteristics. This publication gives guidance on the storage of solid, liquid and gaseous radioactive wastes in a wide range of facilities, including those at which waste is generated, treated and conditioned.
Implementation of the International Code of Practice on Dosimetry in Radiotherapy (TRS 98): Review of Testing Results
IAEA TECDOC CD Series No. 1455
Competency-based hospital radiopharmacy training
Training Course Series No. 39
Comprehensive clinical audits of diagnostic radiology practices: A tool for quality improvement
Quality assurance audit for diagnostic radiology improvement and learning (QUAADRIL)
IAEA Human Health Series No. 4
This publication includes a structured set of standards appropriate for diagnostic radiology, an audit guide to their clinical review and data collection sheets for the rapid production of reports in audit situations. It will be a useful guide for diagnostic radiology facilities wishing to improve their service to patients through timely diagnosis with minimal radiation dose.
Clinical training of medical physicists specializing in radiation oncology
Training Course Series No. 37
IAEA syllabus for the education and training of radiation oncologists endorsed by the American Society for Radiation Oncology (ASTRO) and the European Society for Therapeutic Radiology and Oncology (ESTRO)
Training Course Series No. 36
Radiation biology: A handbook for teachers and students
Training Course Series No. 42
Transition from 2-D radiotherapy to 3-D conformal and intensity-modulated radiotherapy
IAEA TECDOC Series No. 1588
Planning a clinical PET center
IAEA Human Health Series No. 11
This publication is intended to assist healthcare administrators and clinicians in their efforts to plan and establish a new clinical PET facility.
Appropriate use of FDG-PET for the management of cancer patients
IAEA Human Health Series No. 9
This publication addresses the important issue of appropriateness of the application of PET/ CT procedures in different clinical scenarios of many cancers. It is a useful resource for specialists in nuclear medicine and oncology and aims to make reliable information widely available to those member states where PET programs are still in their planning phase or where the use of PET scanning is limited.
Production of long-lived parent radionuclides for generators: 68Ge, 82Sr, 90Sr and 188W
IAEA Radioisotopes and Radiopharmaceuticals Series No. 3
This book provides information on the production and processing of four important long-lived parent radionuclides, 68Ge, 82Sr, 90Sr and 188W, used for the preparation of generators for nuclear medicine applications such as positron emission tomography and therapy. It includes descriptions of the production routes for, and process chemistry of, the selected parent radionuclides, including relevant separation approaches.