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Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.
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Objective To investigate the frequency of therapy-oriented oral radiation in Nanping, China and its distribution, and to provide a basis for the rational application of therapy-oriented oral radiation and the effective allocation of resources in Nanping. Methods A questionnaire was designed to investigate the frequency of therapy-oriented oral radiation in all oral radiation diagnosis and treatment institutions in Nanping. Results In 2021, there were 54 oral radiation diagnosis and treatment institutions and 79 oral radiation machines in Nanping. The total frequency of therapy-oriented oral radiation was 61593 visits and the radiation frequency was 19.54 visits per thousand patients. The average annual frequency of medical institutions at all levels was 721.87 to 3713.25 visits per institution; the male-to-female composition ratio of frequency of therapy-oriented oral radiation in December 2021 was 50.5%:49.5%. The proportion of radiation frequency of different devices was as follows: 38.7% (intraoral dental film), 46.5% (oral panorama), 10.3% (oral computed tomography [CT]), and 4.5% (cranial photography). The proportion of radiation frequency in patients of different ages was as follows: 17.1% (0−15 years), 48.2% (15−40 years), and 34.7% (over 40 years). The frequency of therapy-oriented oral radiation grew by 77.43%, 35.18%, and 8.16% every two years from 2015 to 2021, respectively. Conclusion The frequency level of therapy-oriented oral radiation in Nanping is at the level of Class II health care. The distribution of therapy-oriented oral radiation is highly unbalanced and is related to the level of economic development. Private healthcare institutions are growing rapidly, and public healthcare institutions of grade two and above occupy the main healthcare resources. The oral panorama accounts for the most, cranial photography accounts for the least, and oral CT is the fastest-growing portion. Therapy-oriented oral radiation is predominantly performed in the young and middle-aged populations, regardless of sex. Except for intraoral dental films, the general trend is upward.
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Objective To investigate the current status of radiation protection in non-medical radiation workplaces in Yantai, China, and to provide a scientific basis for occupational health management in non-medical radiation workplaces. Methods Non-medical radiation workplaces in Yantai were investigated using a questionnaire survey in 2022, including radiation source term, occupational health examination, personal dose monitoring, personal protective equipment, and radiation protection testing workplaces. Data were entered by a double-entry method and then analyzed. Results There were 56 non-medical radiation workplaces in Yantai, covering manufacturing, nonferrous metal ore mining, nuclear power plant, transportation, and technical services. There were 0 Class I radiation device, 150 Class II radiation devices, and 10 Class III radiation devices; there were 80 Class I radiation sources, 16 Class II radiation sources, 14 Class III radiation sources, 62 Class IV radiation sources, and 135 Class V radiation sources. There were 998 radiation workers, with an occupational health examination rate and personal dose monitoring rate of 98.3%. Among the 56 non-medical radiation workplaces, 47 (83.9%) were equipped with radiation protection monitoring instruments, 24 (51.1%) workplaces had verified the radiation protection monitoring instruments, with 2017 personal dose monitoring instruments and 2327 personal protective equipment in place, 42 (75%) workplaces carried out occupational health assessments, 44 (78.6%) workplaces carried out self-detection, and 53 (94.6%) workplaces carried out entrusting detections (monitoring pass rate: 100% [53/53]). The declaration rate of occupational hazard items was 87.5% (49/56). Conclusion There is still a gap between the current status and the requirements in the national regulations and standards regarding radiation protection in non-medical radiation workplaces. Therefore, the supervision and management of non-medical radiation workplaces should be further strengthened, especially the configuration and verification of radiation protection monitoring instruments.
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Ionizing radiation has been widely used for diagnosis and treatment of diseases. Nevertheless, radiation exposure may increase the risk of skin, cardiovascular system, hematological system, and metabolic disorders, and even the risk of cancers. Rational use of ionizing radiation improves prognosis and facilitates biomedical research, while misuse or overuse may result in serious consequences. Scientific and objective assessment of health hazards of medical radiation and establishment of effective protective interventions are of great importance to control the risk of radiation exposure. This article reviews the health hazards and protective measures of medical radiation.
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@#Practice in military medical radiation license management in the new era of military reform have surfaced problems in military radiation protection, involving radiation protection management regulation, occupational health monitoring for radiation workers, inspection of radiation equipment and site protection, implementation of the “Three Synchronizations System” for construction, renovation, and extension projects of radiation facilities, as well as quality control for radiation protection and diagnosis and treatment. Efforts should be focused on radiation protection training, self-management of medical radiation institutions, supervision and regulation from medical radiation license management institutions, and joint coordination of relevant departments. Under new regulations and standards, creatively conducting medical radiation license management and running the army in accordance with the law in the new era of military reform are of great significance for standardizing military radiation protection and ensuring the healthy development of military medical radiation services.
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Objective To investigate the application of radiological diagnosis and treatment equipment and distribution of medical radiation levels in medical institutions at various levels in Shijiazhuang, China in 2019, and to lay a sound foundation for further radiation protection and management. Methods A universally designed questionnaire was used to investigate and compile data on the level of the sampled hospitals, the number of radiation workers, equipment information, the number of outpatients and emergency patients, the number of inpatients, and the frequency of radiological diagnosis and treatment; the application frequency of each radiological diagnosis and treatment item was calculated based on the demographic data of Shijiazhuang. Results In Shijiazhuang, there were 390 medical institutions (excluding dental clinics) certified for radiological diagnosis and treatment, with a total of 4262 radiation workers and 1215 radiological diagnosis and treatment devices; 1.11 radiological diagnosis and treatment devices were available per 10 000 people, and 3.89 radiation workers were available per 10 000 people. The number of annual outpatients and emergency patients was 30 208 471, the number of inpatients was 1 981 295, and the total number of people or times receiving radiological diagnosis and treatment was 5 987 230. The application frequency of medical radiation was 546.70 persons/times per 1000 people, with the highest frequency for X-ray diagnosis (534.63 persons/times per 1000 people), followed by diagnosis and treatment with nuclear medicine (6.16 persons/times per 1000 people), and the lowest frequency for radiotherapy (1.17 persons/times per 1000 people). In terms of regional distribution, the highest frequency of medical radiation fell in Yuhua District (1602.97 persons/times per 1000 people), and the lowest frequency fell in Shenze County (203.21 persons/times per 1000 people). Conclusion The development of medical radiation is imbalanced in Shijiazhuang, with high-quality medical resources concentrated mainly in the main urban area, thus resulting in long-term overworking of hospital staff and equipment in some areas. The government and health administration departments should strengthen macro-control and the rational allocation of medical resources; medical institutions at various levels should rationally use radiological diagnosis and treatment equipment, strengthen judgments on the justness of radiation, and strengthen the training of radiation workers on protection knowledge and radiation protection optimization.
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Objective:To analyze the distribution of radiodiagnosis resources in China and provide data support for further optimizing the allocation of radiodiagnosis resources and improving the weaknesses in radiation protection.Methods:The survey was carried out in accordance with the unified plan and using questionnaires of the national medical radiation protection monitoring program issued from 2017 to 2019. The survey included all medical institutions performing radiodiagnosis in China. The survey indicators included distribution of medical institutions performing radiodiagnosis, number of equipment, number of radiation workers and other information, the allocation of radiation protection equipment and the frequency of radiodiagnosis. The survey was performed using questionnaire survey and reported through the national medical radiation protection monitoring information system. In terms of the organization code, the name of the organizations excludes those repeatedly reported. The original data was exported in the form of excel table from the database for the purpose of statistical analysis.Results:By the end of 2019, except Xinjiang Production and Construction Corps, Hong Kong, Macao and Taiwan regions and military systems, there were 68 924 diagnostic radiology medical institutions in China, 147 913 diagnostic radiology equipment, accounting for 91.7% of the total pieces of nationwide diagnostic radioprotective equipment. There are 367 201 radiologists in China, accounting for 76.1% of 406 830 radiologists in all medical institutions, with high allocation rate of radiation protection equipment. However, the allocation rate in first-class hospitals was the lowest among all levels of hospitals. The piece of protection equipment was increased with the grade of hospital. From perspective of of economic development level, the highest was found in the eastern region, with the lowest in the central and northeast region, both of which are about 90%.Conclusions:The current status of radiodiagnosis and protection was ascertained basically through this three-year round of survey, with a large number of survey data accumulated. This survey provides data support for the development of relevant protection policies and standards at national and provincial levels. Survey data indicated that there are still nearly 1 000 direct fluorescent screen fluoroscopy machines in use in China. Relevant policies and standards should be established to gradually phase out the equipment with serious radiation hazards.
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INTRODUCTION@#This study aimed to assess understanding of the potential risks associated with medical imaging among caregivers and adolescent patients in a paediatric emergency department (PED) in Singapore.@*METHODS@#A prospective convenience sample survey was performed involving adolescents and caregivers presenting to our PED from December 2015 to May 2016. The questionnaire examined demographic data, knowledge of imaging procedures and radiation risks, and expectations regarding information provided about medical radiation.@*RESULTS@#A total of 349 questionnaires were returned (caregivers 82.5%, adolescents 17.5%). A mean of 6.2 ± 2.4 (out of 11) questions were correctly answered. Those who had tertiary education fared better than those who did not (36.4% vs. 17.2% scoring above the mean, p = 0.001). Age, gender, history of previous imaging and imaging performed during the visit did not affect the score. Two-thirds of the participants did not associate medical radiation with any negative lifetime risk of cancers or know that different scans entailed differing amounts of radiation. Most were unaware that the radiation dose in medical imaging is adjusted to a child's size. Among patients who underwent imaging, 90.1% received explanations on the need for scans, and 26.5% were informed of the risks involved. Almost all participants wished to be informed of imaging indications and risks. More preferred to learn this from physicians (75.6%) or technicians (51.6%) rather than through educational pamphlets (34.4%) or Internet resources (22.9%).@*CONCLUSION@#Awareness regarding medical radiation needs to be improved in our patient population. A mismatch exists between caregiver expectations and the actual procedure of disclosure of the risk associated with radiation.
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OBJECTIVE: To explore the status of occupational stress and its influencing factors in medical radiation workers using two occupational stress measurement models. METHODS: A total of 632 medical radiation workers from Guangdong Province were selected as the study subjects using cluster sampling method. Chinese version of Job Content Questionnaire and Effort Reward Imbalance Questionnaire were used to assess occupational stress with job demand-control( JDC) and effort-reward imbalance( ERI) models. RESULTS: The rate of occupational stress in the study subjects was 43. 8%( 277/632) using the JDC model. The rate of occupational stress was 38. 6%( 244/632) using the ERI model. The multivariate logistic analysis results showed that the risk of JDC occupational stress was higher in workers with more than 8 hours work daily and more than 40 hours weekly( P < 0. 01). The risk of ERI occupational stress was higher in the workers with age of30. 0-40. 0,public medical institutions,daily work more than 8 hours and weekly work more than 40 hours( P < 0. 01).CONCLUSION: Under the two theoretical models,medical radiation workers have a certain degree of occupational stress. The age,medical institution type,daily and weekly work hours are the main factors affecting occupational stress.
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Objective To explore the distribution and application of diagnostic X-ray procedures in Shanghai through investigating the 49 sample medical institutions,to provide the theoretical basis of protective strategies for medical exposure.Methods According to the grade of medical institutions,stratified random samplings were used to select 49 medical institutions.The basic information of the surveyed medical institutions and person-times of various types of X-ray diagnostic procedures were gathered by radiology information system and manual recording.Results In the sampled medical institutions,393 sets of X-ray equipment were engaged in X-ray diagnostic radiology,and the total number of X-ray diagnostic imaging was 4 442 662.The gender ratio of male and female was 1 ∶0.99.The total frequency of diagnostic X-ray procedures was 1 228 examinations per thousand population,including 304 examinations per thousand population of CT scan,105 examinations per thousand population of dental radiography.Conclusions The frequency of diagnostic X-ray procedures in 2016 increased compared with the data surveyed during the period of the " 11th Five-year Plan",in which the frequency of CT procedures increased significantly.
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OBJECTIVE@#To understand the distribution of the average glandular dose (AGD) in mammography by investigating 1,828 exposure parameters of 8 mammography machines in three cities, by using random sampling.@*METHODS@#A survey of 8 mammography machines in three different cities, sampled using stratified random sampling methods, was performed, and 1,828 mammography exposure parameters were recorded. Incident air kerma (k) was measured by Quality-Assurance (QA) dosimeters, and AGD was calculated by series conversion coefficients based on a 3D detailed Monte Carlo breast model, published by Wang et al. RESULTS: The distribution of compressed breast thickness (CBT) fitted a normal distribution, while that of AGD fitted a skewed distribution. The mean value of CBT in a medio-lateral oblique (MLO) view was about 5.6% higher than that in the craniocaudal (CC) view, with significant statistical difference; mean value of AGD and CBT in the sample was 1.3 mGy and 4.6 cm, respectively. The AGD trended upward with increasing CBT, similar to the results of other researches.@*CONCLUSION@#The mean AGD and CBT levels in our study for mammography practice in China were 1.3 mGy and 4.6 cm, respectively. AGD is influenced by manufacturer-specific variation as machine response to CBT changes and target/filter combination. The present study can provide evidence for establishing a diagnostic reference level in China.
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Adulto , Femenino , Humanos , Persona de Mediana Edad , China , Mamografía , Dosis de RadiaciónRESUMEN
Objective To construct a national medical radiation protection monitoring information system (NMRPMIS) based on the national radiation health information platform, support the national medical radiation protection monitoring project data reporting, and comprehensively understand the current situation of medical radiation protection. Methods According to the national radiation protection monitoring plan, laws, regulations and standards, HTML, CSS and JavaScript were used in the front end, JAVA language was used in the back end, SQL server was used in the platform database and Tomcat was used as the middleware. A data reporting and analysis system was set in the system through B/ S structure, with statistical analysis of the 2017 annual monitoring data carried out. Results The business composition of the platform includes four levels: data acquisition ( through various business systems), data resource integration (integration of business system public data), application, and display. The national medical radiation protection monitoring system with flexible structure, centralized information and convenient operation was implemented. The national medical radiation protection information was reported in 2017. The basic situation of radiation protection in 33565 hospitals and the performance and protection information of 10624 pieces of radiation diagnosis and treatment equipment were reported in 2017. A total of 95 statistical information reports were completed, describing the current situation of medical radiation protection in China from four dimensions: time, administrative geographic information, hospital level, and equipment types. Conclusions Medical radiation protection monitoring system helped achieve the design goal and successfully complete the data reporting in 2017. It provides data support for understanding the current situation of medical radiation protection and the protection management policymaking in China.
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Objective@#To construct a national medical radiation protection monitoring information system (NMRPMIS) based on the national radiation health information platform, support the national medical radiation protection monitoring project data reporting, and comprehensively understand the current situation of medical radiation protection.@*Methods@#According to the national radiation protection monitoring plan, laws, regulations and standards, HTML, CSS and JavaScript were used in the front end, JAVA language was used in the back end, SQL server was used in the platform database and Tomcat was used as the middleware. A data reporting and analysis system was set in the system through B/S structure, with statistical analysis of the 2017 annual monitoring data carried out.@*Results@#The business composition of the platform includes four levels: data acquisition (through various business systems), data resource integration (integration of business system public data), application, and display. The national medical radiation protection monitoring system with flexible structure, centralized information and convenient operation was implemented. The national medical radiation protection information was reported in 2017. The basic situation of radiation protection in 33 565 hospitals and the performance and protection information of 10 624 pieces of radiation diagnosis and treatment equipment were reported in 2017. A total of 95 statistical information reports were completed, describing the current situation of medical radiation protection in China from four dimensions: time, administrative geographic information, hospital level, and equipment types.@*Conclusions@#Medical radiation protection monitoring system helped achieve the design goal and successfully complete the data reporting in 2017. It provides data support for understanding the current situation of medical radiation protection and the protection management policymaking in China.
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Objective To analyze 20 indicators for the evaluation of medical radiation protection monitoring in 31 provinces,municipalities or autonomous regions in 2017 and provide technical support and reference for further optimization of medical radiation protection monitoring projects.Methods According to " medical radiation protection monitoring assessment score sheet for medical and health institutions",a full range of analysis and evaluation was carried out of medical radiation protection monitoring and implementation at nationwide medical and health institutions by using fuzzy combined method of TOPSIS and rank sum ratio.Results TOPSIS method and rank sum ratio weighted fuzzy joint analysis showed that the top three indicators,in descending order,were management of provincial implementation plans,management of project leaders in various cities and management of funds whereas the lowest three indicators were completion of radiotherapy equipment commissioning,innovation and highlights and tcoverage of radiotherapy equipment.Conclusions The fuzzy combined application of TOPSIS method and rank sum ratio method can provide the comprehensive quantitative result for the implementation of medical radiation protection monitoring in 2017,objectively evaluate the implementation of various indicators,summarize the highlights and bottlenecks of work in 2017,and provide technical support and reference for further optimization of medical radiation protection monitoring.
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Objective@#To investigate the usage frequency of radiological diagnosis devices in ten hospitals in Tianjin, China, and to provide a basis for the survey of medical radiation frequency in Tianjin.@*Methods@#Ten hospitals from the ten districts in Tianjin were enrolled as subjects by a convenient sampling method. A survey was conducted to assess the general information and radiological diagnosis device information and usage frequency in those hospitals in 2016. The radiological examination frequency in Tianjin was estimated.@*Results@#A total of 610 458 patients received radiological examinations in the sampled hospitals in 2016. In those patients, 371 882 received X-ray examinations for imaging and 238 576 for computed tomography (CT) ; there were slightly more female patients than male patients, suggesting a relatively equal gender distribution; patients older than 40 years accounted for 65.53%, which was the highest among all the age groups. Different types of radiological diagnosis devices were mostly used in tertiary and secondary hospitals. In Tianjin, the estimated frequency of X-ray examination for imaging and CT scanning was 451 and 188 per thousand people, respectively, in 2016.@*Conclusion@#The frequency of radiological diagnosis is relatively high in the ten hospitals in Tianjin. The investigation of medical radiation in Tianjin needs to be improved.
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Objective To access the clinical effect of medical radiation protective ointment compared with trolamine cream to prevent acute radiation-induced skin injury in breast cancer patients undergoing radiotherapy after modified radical mastectomy. Methods Between February 2017 and February 2018,a total of 120 stage T1-4 N1-3 M0 eligible patients received intensity modulated radiation therapy were enrolled and matches into two groups:study group (60 cases) was administered medical radiation protective ointment from the first irradiation fraction,and control group (60 cases) received trolamine cream. When 3 grade reaction was observed,patients in control group start to administer medical radiation protective ointment until a month after radiation. Results The occurrence rate of acute breast dermal radiation reaction was 100％.Most patients in study group only underwent 1 grade radiation reaction (82％),while 2 and 3 grade radiation reaction (47％ and 13％) in control group were common ( P= 0. 000). Both pruritic degree and pain degree were higher in control group compared with study group (both P= 0. 000).In study group,the occurrence of 2 grade acute radiation-induced skin injury was obviously later than in control group with significant difference (P= 0. 000).Patients observed with 3 grade reaction relieved to certain reaction after administering medical radiation protective ointment. Conclusions Medical radiation protective ointment can effectively both alleviate and delay acute radiation-induced skin injury compared with trolamine cream. It also has therapeutic effect on 3 grade radiation reaction.
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ABSTRACT Introduction: The Bahamas became a member state of the International Atomic Energy Agency (IAEA) on January 7, 2014 (1). The purpose of this paper is to inform the reader on The Bahamas' ability to provide services that utilize radiation. Method: A study was conducted on various clinics across The Bahamas, New Providence in particular (primary sample area), Grand Bahama, Abaco and Exuma. Twenty per cent of the staff members of the respective locations were given questionnaires and the chief personnel were interviewed. Staff members were advised that their responses would remain anonymous and were welcomed to participate, thereafter. Microsoft Excel was used for data input and processing. Original surveys were checked against the dataset for potential errors. Results: Thirty-one clinics were approached to participate in the survey, of which 25 participated resulting in an 81% response rate. Fifty questionnaires were completed in total. Two clinics had multiple locations; therefore, 27 clinics (23 private, 4 public) participated in total. The included map illustrates the sample area of the survey, with New Providence being the primary sample area. The number of modalities, patients treated and frequency of quality assurance checks were also evaluated. Conclusion: Most of the examined clinics outsourced technicians and physicists to perform quality checks. This suggests that there is a need for qualified local technical support. Further studies are needed to understand the full extent of the country's needs regarding medical radiation and figuring out the steps necessary for approaching this subject.
RESUMEN Introducción: Las Bahamas se convirtieron en un Estado Miembro de la Agencia Internacional de Energía Atómica (AIEA) el 7 de enero de 2014 (1). El propósito de este trabajo es informar al lector sobre la capacidad de las Bahamas para prestar servicios que utilizan radiación. Método: Se realizó un estudio en varias clínicas a través de las Bahamas, Nueva Providencia en particular (área de muestra primaria), Gran Bahama, Abaco y Exuma. El veinte por ciento de los miembros del personal de las respectivas locaciones recibieron cuestionarios y el personal dirigente fueron entrevistados. A los miembros del personal se les informó que sus respuestas permanecerían anónimas, y se les dio la bienvenida por su participación. Para la entrada y el procesamiento de datos se usó Microsoft Excel. Las encuestas originales se chequearon contra el conjunto de datos para a fin de detectar posibles errores. Resultados: Treinta y una clínicas fueron abordadas para participar en la encuesta, de las cuales 25 participaron, para una tasa de respuesta de 81%. En total se completaron 50 cuestionarios. Dos clínicas tenían múltiples localidades. Por lo tanto, 27 clínicas (23 privadas, 4 públicas) participaron en total. El mapa incluido ilustra el área de la muestra de la encuesta, en la que Nueva Providencia es el área de la muestra primaria. El número de modalidades, los pacientes tratados, y la frecuencia de los controles de garantía de calidad, también fueron evaluados. Conclusión: La mayor parte de las clínicas examinadas subcontrataron técnicos y físicos para realizar chequeos de la calidad. Esto sugiere que hay necesidad de apoyo técnico local calificado. Se necesitan estudios adicionales para entender el alcance completo de las necesidades del país en relación con la radiación médica y los pasos necesarios para abordar este asunto.
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Humanos , Radioterapia/estadística & datos numéricos , Encuestas de Atención de la Salud , Necesidades y Demandas de Servicios de Salud , JamaicaRESUMEN
Nuclear medicine is a rapidly growing discipline that employs advanced novel hybrid techniques that provide unique anatomical and functional information, as well as targets for molecular therapy. Concomitantly, there has been an increase in the attention paid to medical radiation exposure. A radiological justification for the practice of nuclear medicine has been implemented mainly through referral guidelines based on research results such as prospective randomized clinical trials. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical mechanism to optimize medical radiation exposure in order to be commensurate with the medical purpose. The Korean Society of Nuclear Medicine has been implementing radiological optimization through a survey of the protocols on how each hospital determines the dose of administration of each radiopharmaceutical. In the case of nuclear medicine, radiation exposure of caregivers and comforters of patients discharged after administration of therapeutic radiopharmaceuticals can occur; therefore, optimization has been implemented through written instructions for patients, based on international recommendations. The development of patient-radiation-dose monitoring software, and a national registry and management system of patient-radiation-dose is needed to implement radiological optimization through diagnostic reference levels. This management system must work in agreement with the "Institute for Quality Management of Nuclear Medicine", and must take into account the medical reality of Korea, such as low medicine fee, in order to implement reasonable radiological justification and optimization.
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Humanos , Neoplasias/diagnóstico , Tomografía de Emisión de Positrones , Guías de Práctica Clínica como Asunto , Exposición a la Radiación/normas , Protección Radiológica , Radiofármacos/química , Valores de Referencia , República de Corea , Sociedades Científicas , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. METHODS: Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. RESULTS: Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography–computed tomography was the most critical factor in determining the level of effective dose. CONCLUSIONS: It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure.
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Electrones , Hospitales Universitarios , Corea (Geográfico) , Tamizaje Masivo , Exposición a la Radiación , SeúlRESUMEN
Japan has experienced serious nuclear disaster being a country hit by atomic bombs and as well as the occurrence of recent nuclear plant accidents. On the other hand, the Japanese population is exposed to higher dose of medical radiation compared to other developed countries, which is due to increasing number of diagnostic computed tomography (CT) examinations. The correlation between low-dose radiation exposure and cancer risks has been discussed nationwide since Fukushima nuclear plant accident has occurred, whereas cancer risks due to low-dose ionizing radiation from CT scans have been evident in recent large cohort studies. Though CT scan is a valuable diagnostic tool in medical practice because of its high resolution image with speed of scanning, it is crucial to evaluate whether the use of CT is appropriate weighing the benefits and possible risks. Hospitalist is required to have core competency to improve quality of medical care of the hospital and to coordinate with other departments or co-medical workers. In this regard, we discuss how hospitalist could play a role to justify the use of CT and minimize unnecessary radiological exposure, cooperating with radiologists or radiological technologists.