A Holistic Approach to Assessment of Population Exposure to Radiation: Challenges and Initiatives of a Regulatory Authority.

A regulatory authority for radiation safety should continuously evaluate and improve the national safety framework, in line with current requirements and standards. In this context, the Greek Atomic Energy Commission initiated a series of concerted actions. The radiation dose to the population due to public and medical exposures was assessed. The assessment of dose due to public exposure was based on measurements of radon concentrations in dwellings, radionuclide concentrations in environmental samples, and air dose rates; the assessment of dose due to medical exposure was based on dose measurements for typical examinations or procedures and data on their frequency. The mean effective dose to a member of the population was found to be 4.5 mSv (1.8 mSv and 2.7 mSv from medical and public exposures, respectively). Regarding occupational exposure, aircrew dose assessment, eye lens monitoring, and the national dose registry were significantly improved. With respect to artificial tanning (sun beds), the ultraviolet radiation produced was assessed and the practices followed were observed. Results demonstrated exceedance of the 0.3 W m erythema effective irradiance limit set in European Union standards by 63.5% of the sun beds measured, along with general noncompliance with standards. An overarching activity was the upgrade of the Greek Atomic Energy Commission information system in order to collect and disseminate radiation data electronically, launch a networking strategy for interaction with stakeholders, and facilitate the process of regulatory control. In response to the above findings, regulatory actions have been initiated.

Diagnostic reference levels and patient doses in computed tomography examinations in Greece.

The purpose of this study is to present a national survey that was performed in Greece for the establishment of national Dose Reference Levels (DRLs) for seven common adult Computed Tomography (CT) examinations. Volumetric computed tomography dose index and dose-length product values were collected from the post-data page of 65 'modern' systems that incorporate tube current modulation. Moreover, phantom dose measurements on 26 'older' systems were performed. Finally, the effective dose to the patient from a typical acquisition during these examinations was estimated. The suggested national DRLs are generally comparable with respective published values from similar European studies, with the exception of sinuses CT, which presents significantly higher values. This fact, along with the large variation of the systems' dose values that were observed even for scanners of the same type, indicates a need for further patient protection optimisation without compromising the clinical outcome.

Comparison of full field digital (FFD) and computed radiography (CR) mammography systems in Greece.

The purpose of this study is to evaluate and compare the performance of 52 full field digital (FFD) and computed radiography (CR) mammography systems checked by the Greek Atomic Energy Commission with respect to dose and image quality. Entrance surface air kerma (ESAK) was measured and average glandular dose (AGD) was calculated according to the European protocol on dosimetry in mammography. The exposures were performed using the clinical protocol of each laboratory. The image quality was assessed by the total score of resolved phantom structures incorporated in an American College of Radiology accreditation phantom. The mean ESAK values for FFD and CR systems were 4.59 ± 1.93 and 5.0 ± 1.78 mGy, respectively, whereas the AGD yielded a mean value of 1.06 ± 0.36 mGy for the FFD and 1.04 ± 0.35 mGy for the CR systems. Considering image quality, FFD systems indicated a mean total score of 13.04 ± 0.89, whereas CR systems a mean total score of 11.54 ± 1.06.

Image quality evaluation and patient dose assessment of medical fluoroscopic X-ray systems: a national study.

This study presents the results from a survey conducted by the Greek Atomic Energy Commission (GAEC), during the period 1998-2003, in 530 public and private owned fluoroscopic X-ray systems in Greece. Certain operational parameters for conventional and remote control systems were assessed, according to a quality control protocol developed by GAEC on the basis of the current literature. Public (91.5%) and private (81.5%) owned fluoroscopic units exhibit high-contrast resolution values over 1 lp mm(-1). Moreover, 88.5 and 87.1% of the fluoroscopic units installed in the public and private sector, respectively, present Maximum Patient Entrance Kerma Rate values lower than 100 mGy min(-1). Additionally, 68.3% of the units assessed were found to perform within the acceptance limits. Finally, the third quartile of the Entrance Surface Dose Rate distribution was estimated according to the Dose Reference Level definition and found equal to 35 mGy min(-1).

Performance of medical radiographic X-ray systems in Greece for the time period 1998-2004.

This study presents the results of the on-site inspections performed by the Greek Atomic Energy Commission (GAEC) on conventional X-ray systems, both in public and private medical radiology departments. A part of the inspection concerns the assessment of important radiographic parameters obtained according to a specified quality control protocol and the comparison of the measured parameter values with the corresponding acceptance limits. A total number of 1011 radiographic systems were inspected by the GAEC during the period 1998-2004, with 63.4% of them being privately owned. Analysis of 8 different operational parameters is carried out providing information on the overall performance, as well as on each parameter of the inspected X-ray systems. Tube voltage reproducibility values show the highest percentage of acceptability (98.9%, 99.5% for private and public owned radiographic systems respectively), while linearity of radiation output for private systems (72.5%) and time accuracy for public ones (72.7%) show the worst results. The comparison of the results for the private sector to those of a similar study carried out during the period 1995-1997 indicates a substantial improvement in X-ray systems performance. Higher level of improvement shows exposure time accuracy (12.2% percentile increase) and linearity of radiation output (12.5% percentile increase). Nevertheless, the situation can be further optimized if maintenance and quality control of the radiographic systems are carried out on a more regular basis.