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INDEX
397
Dosimeters
extremity, 74–75, 74f
personnel, 73–76
characteristics of, 76
optically stimulated luminescence
dosimeter as, 76–80, 76f
placement of, 73–74, 73f
purpose of, 73
radiation exposures of, 75–76, 75t
requirement for, 73
thermoluminescent dosimeter
as, 74
types of, 76–81
skin dose measurement using, 238
Double-strand break, in DNA, 119–
120, 120f
Doubling dose concept, 170, 170b
Dual-energy x-ray absorptiometry
(DEXA), 247–248, 248f
Duality, wave-particle, 17b, 113
E
Early tissue reactions, 58, 59b, 137–152
genetic effects, 138
as radiation-induced response
concern in radiation
protection, 183
somatic effects, 138–149, 138f, 139f,
140f, 141f
acute radiation syndrome, 140–143
cytogenetic effects, 148–149, 149f
early tissue reactions, 139–143
hematologic effects, 147–148, 148f
LD 10/30, LD 50/60, and LD
100/60, 144, 144t
LD 50/30, 143–144, 143f
lethal dose, 143–144
local tissue damage, 144
repair and recovery, 144
reproductive system effects, 147,
147f
skin effects, 145f
Edison, Thomas A., 56
Education, dose limits for, 189
EfD. see Effective dose
Effective atomic number (Z
eff
), 44
Effective communication, 229–230
importance of patient instructions,
229, 229f
for procedures causing pain or
discomfort, 229, 230f
Effective communication (Continued) Embryologic effects (Continued)
repeat radiographic exposures result
from poor communication,
229–230
verbal messages and body language
of, 229
Effective dose (EfD), 4, 10–11, 10t, 20,
175. see also Collective effective
dose
average annual occupational
exposure values, 75t
creation of, 60
limits for, 183–184, 295
nonoccupational, 295
occupational, annual, 295
typical values of radiologic
procedures, 10t
Effective dose (EfD) limiting system,
175
basis of, 175, 175f
tissue weighting factor and, 185,
185b
underlying concept of radiation
protection, 185
Effective half-life (T eff ), 326
Elastic scattering. see Coherent
scattering
Electrical voltage, of x-ray beam, 36
Electrolytes, in cell, 97, 97b
Electromagnetic radiation, 17–18
Electromagnetic spectrum, 17–18,
18f, 18t
Electromagnetic wave, 17b
Electron capture, 321–322
Electrons. see also Beta particles
Auger, 43
electromagnetic radiation and, 19
inner-shell, 42–43, 42f
outer-shell, 48, 48f
pair production of, 49–51, 50f
Embryo-fetus
dose determination for, 242–243,
243f, 244t, 245b, 246b, 246f
effects of low-level ionizing
radiation on, 168
ionizing radiation effects on nervous
tissue of, 131–132
risk and, 185
Embryologic effects, 158, 167–168
of Chernobyl nuclear power plant
accident, 168
embryonic cell radiosensitivity
during first trimester, 167–168
during second and third
trimesters, 168
of low-level ionizing radiation, 168
stages of gestation in humans and,
167, 167f
UNSCEAR, 168
Emergencies. see Radiation
emergencies
Employers, responsibilities of,
radiation safety and, 8b
Endoplasmic reticulum, 100
Energy
of electromagnetic waves, 17b, 18t
mass-energy equivalent, 50b
of photons, in x-ray beam, 36
Energy discrimination, of optically
stimulated luminescence (OSL)
dosimeter, 76–77, 76f
Energy transfer determinants, 112–116
linear energy transfer, 112–115,
113b, 113f, 114f
oxygen enhancement ratio, 115–116,
116b
relative biologic effectiveness, 115,
115b
Enhanced natural sources, 22
Entrance dose, 64
Entrance skin exposure (ESE), 216
of diagnostic imaging procedure,
238
genetically significant dose, 238
gonadal dose, 238
for medical radiation, 29–30, 30t
Environmental Protection Agency
(EPA), 178t, 179, 337
radon and, 22–23
Enzymes, 90
EPA. see Environmental Protection
Agency
Epidemiologic studies
for determining risk of cancer,
158–159
from Japanese atomic bomb
survivors, 161–164
Epidemiology, 154
Epilation, 146
Epithelial tissue, 131
EqD. see Equivalent dose
398
INDEX
Equivalent dose (EqD), 20, 21t, 22t,
63b, 65–66, 175
biologic damage potential and,
20–21
to embryo-fetus, determination of,
243, 245b, 246b, 246f
ionizing radiation and, 22t
larger allowance for radiation
workers, 295
for radiation workers, 295
radioisotope calculation, 327
Erythema, 21t, 139, 139f, 146
Erythrocytes, 129–130, 148, 148f
ESE. see Entrance skin exposure
Examination table, radiographic, 196
Exit photons, 48
Exposure (X), 4. see also Radiation
exposure
Exposure audit, 8
Exposure factors, technical, in pulsed
fluoroscopy, 196
Exposure linearity, 181b, 204
Exposure reproducibility, 203–204
Extraterrestrial radiation. see Cosmic
radiation
Extremity dosimeter, 74–75
Extremity monitoring, in high-level
control interventional procedures,
309
Eye
cataractogenesis in, 166–167, 166f
specific area shielding for, 232
Eyeglasses, protective, 304, 304f
F
18
F. see Fluorine-18
Fallout
from atomic bomb test, 164
from nuclear weapons testing, 25,
26f
Fats. see Lipids
FDA. see Food and Drug
Administration
FDG. see Fluorodeoxyglucose
Female patients
American College of Radiology
position on abdominal
radiologic examinations of, 240
gonadal dose of diagnostic imaging
procedures for, 238
gonadal shielding dose reduction
from, 247
Fetal dose
determination of, 242–243, 243f,
244t, 245b, 246b, 246f
for medical radiation, 29–30, 30t
Fetal effects, review of, by UNSCEAR,
168
Fetus. see Embryo-fetus
FGP. see Fluoroscopically guided
positioning
Film. see Screen-film
Filtered back projection, 256
Filters, compensating, 202–203, 203f
Filtration, 199–202
of diagnostic x-ray beam, 296
for general diagnostic radiology,
201–202
purpose of, 199–201, 201f
total filtration requirement, 201,
201b, 202b, 202f
types of, 201
Flat field digital mammography
(FFDM), 288
Fluorescence, x-rays and, 2
Fluorescent radiation, 43
Fluorescent yield, 43
Fluorine-18 (18F), 50–51, 324–325
Fluorodeoxyglucose (FDG), 325
Fluoroscopic equipment, radiation
safety features of, 217–220
digital, 217–219
digital subtraction angiography,
219–220
fluoroscopic procedures and, 212,
212f
high-level control interventional
procedures, 220–222, 221b,
222t, 223b
mobile C-arm fluoroscopy
equipment, 217, 217f
pulsed fluoroscopy, 215
roadmapping, 219–220
Fluoroscopic exposure control switch,
217
Fluoroscopic field size, limiting of,
215
Fluoroscopic imaging systems,
nondigital, 212–217
Fluoroscopically guided positioning
(FGP), 239–240
Fluoroscopy
C-arm. see C-arm fluoroscopy
digital. see Digital fluoroscopy
Fluoroscopy (Continued)
high-level control. see High-level
control fluoroscopy
image intensification. see Image
intensification fluoroscopy
imaging personnel dose
management during, 305–306
Bucky slot shielding device for,
306, 306f
dose-reduction techniques in,
305
personnel protection in, 305, 305f
protective curtain for, 306
remote control fluoroscopic
systems for, 306
rotational scheduling of personnel
for, 306
pulsed. see Pulsed fluoroscopy
radiation exposure due to, 29t
radiogenic skin injuries due to, 221
skin damage caused by, 146, 150
source-skin distance in, 206
Food and Drug Administration (FDA),
177, 178t
manmade (artificial) radiation and,
17
public health advisory, about high-
level control interventional
procedures, 221–222, 221b
White Paper, 181–182
Fraternal twins, 108
Free radicals, 113, 117
indirect action through, 116–117, 117f
organic molecule formation of, 119
water radiolysis producing, 117–119,
118f
Frequency, of electromagnetic waves,
17–18
Fukushima Daiichi nuclear plant crisis,
28–29
Full field digital detector, 279
Full field digital mammogram
(FFDM), 280–281
G
G1 phase, 104
G2 phase, 104
Gamma rays, 18t, 113, 113b
Gas-filled radiation survey. see
Radiation survey instruments
Gastrointestinal syndrome, 141–142,
143t
INDEX
399
Geiger-Müller (GM) survey
meter, 83
components of, 83
disadvantages of, 83
sensitivity and use of, 83, 83f
General diagnostic radiology, filtration
for, 201–202
Genes, 95–96, 96f
Genetic cells, molecular effects of
irradiation on, 116
Genetic code, 94
Genetic effects, 27, 138, 168–170
agents of, 169
dominant or recessive point
mutations, 169
doubling dose concept and, 170,
170b
ionizing radiation and, 169–170
irradiation mutations, 168–169
mutant genes incapacities, 169
natural mutations, 169
Genetic mutations, 147
Genetically significant dose (GSD),
238, 295
Genome, 96–97
Germ cells, 96
ionizing radiation effects on, 132
local tissue damage, 144
meiosis, 106, 108f
radiation effects on, 147, 147f
Gloves, requirements for, 304, 304f
Glow curve, 75
Glycoproteins, 100
GM survey meter. see Geiger-Müller
(GM) survey meter
Golgi apparatus, 100
Gonadal dose, 30t, 238, 247
Gonadal shielding, 231–232, 232f, 247
devices for
use of, 232f
dose reduction from, 232
Granulocytes, 148, 148f
Gray, Louis Harold, 61
Gray (Gy), 4, 61
EqD calculations, 61
equivalence of damage from
different radiation
sources, 65
subunits of, 64–65
Grenz rays, 146
Grids. see Radiographic grids
GSD. see Genetically significant dose
H
Hair loss, 146
Half-value layer (HVL), 201–202, 203t,
325
Helical CT. see Spiral CT
Helium nuclei. see Alpha particles
Hematologic depression, 21t, 129, 147–
148
Hematologic effects, in early tissue
reactions, 147–148, 148f
Hematopoietic syndrome, 141
Hematopoietic system, 148, 148f. see
also Blood cells
Hereditary effects. see Genetic effects
Heritable damage, risk models for,
155–156, 156f
High-kVp radiography
air gap technique use in, 235
use of, to reduce dose to patient,
233, 234f
High-level control fluoroscopy
(HLCF), 220
High-level control interventional
procedures, 220–222
justification for, 220
personnel dose management during,
308–309
dose-reduction technique for,
308–309
extremity monitoring for, 309
radiation exposure reduction for,
309
radiation safety techniques for, 308
public health advisory about
overexposure and exposure rate
limits in, 221–222, 221b
radiation-induced skin injuries, 222t
use of fluoroscopic equipment by
nonradiologist physicians,
221–222, 223b
High-linear energy transfer radiation,
114–115, 114f
Hiroshima atomic bombing, 163–164
Historical evolution, of radiation
quantities and units, 55–61
discovery of x-rays, 55–56, 55f, 56f
early definition of, 57–59, 59b
first injury reports, 56–57, 57f, 58f
investigations for reducing exposure, 57
quantities and units in use today,
60–61
skin erythema dose, 57
HLCF. see High-level control
fluoroscopy
Homes, radon in, 22, 23f
Hormesis, radiation, 189–190
Hormones, 91
Housing cables, x-ray tube, 304–305
Human genome, 96–97
Human-made (artificial) radiation,
24–30
air travel, 25
atmospheric fallout from nuclear
weapons testing, 25
consumer products, 24–25
medical radiation, 29–30
nuclear fuel, for generation of
power, 25
nuclear power plant accidents,
25–29
HVL. see Half-value layer
Hydrogen free radicals, 118, 118f
Hydrogen peroxide, 118
Hydroperoxyl radical, 118
Hydroxyl free radicals, 117–118
I
123
I. see Iodine-123
125
I. see Iodine-125
131
I. see Iodine-131
IAEA. see International Atomic Energy
Agency
ICRP. see International Commission
on Radiological Protection
ICRU. see International Commission
on Radiation Units and
Measurements
Identical twins, 108
Image-formation, photons, 37–38, 38f
Image Gently Campaign, 11, 247
Image intensification fluoroscopy, 213f
benefits of, 212, 214b
brightness of fluoroscopic image in,
198–199
digital detectors in, 212
image intensifier tubes in, 213–215,
214f
Image matrix, 207–208
Image receptor (IR), 37
Image reconstruction (IR), 281–283,
282f
Image Wisely Campaign, 11–12, 247
Imaging department protocol, for
pregnant personnel protection, 298
400
INDEX
Imaging procedures
blood cell effects during, 130
educating patients about, 8, 9f
risk and potential benefit of, 8
justification and responsibility for,
5–6, 5f
diagnostic efficacy in, 5–6, 6b, 6f
radiation exposure due to, 22t
Imaging processing, quality control
program for, 234–235
Immobilization, of patient, 230–231, 255f
Incoherent scattering. see Compton
scattering
Indirect action, of ionizing radiation,
116, 117f, 119
Indirect transmission, of x-ray
photons, 37
Inelastic scattering. see Compton
Scattering
Inorganic compounds, of cell, 97–98,
98f
Instant death, 126
Internal contamination, 115, 338
Internal radiation, 24
International Commission on
Radiation Units and
Measurements (ICRU), roentgen
definition by, 57–58
International Commission on
Radiological Protection (ICRP),
57–58, 175–176
EfD creation by, 60
International System of Units (SI), 4
International X-Ray and Radium
Protection Commission, 57–58
Interphase, 104, 105f
Interslice scatter, 254
Interstrand covalent cross-link, 121, 121f
Interventional fluoroscopy, 74
Intestines, epithelial tissue lining of,
organic damage on, 139–140, 140f
Intrastrand covalent cross-link, 121
Inverse square law, 327
imaging personnel radiation dose
and, 300–301, 300f, 301b, 301f
in x-ray suite protection design
calculation, 311
Investigation levels, in ALARA concept,
181
Involuntary motion, immobilization
for, 231
Iodine, 27
123 (123
IodineIodineIodine-
I53), 323
125 (125
I53), 321–322, 321f
131 (131
I53), 164–165, 322
half-life of, 165
Ionization
in human cells, consequences of, 2b
process of, 19
of water molecules, 117
Ionization chamber-type survey meter
(cutie pie), 82–83, 82f
advantages and disadvantages
of, 82–83
sensitivity ranges and uses of, 82
Ionization chambers, 4
Ionizing radiation, 2, 112
adverse biologic effects of, need for
safeguarding against, 4–5
dose limits for exposure to, 173–193
dose of, 20
effective dose (EfD), 20
equivalent dose (EqD), 20, 21t
effectiveness of, as cancer-causing
agent, 163
electromagnetic, 19
justification and responsibility
for imaging procedures with,
5–6, 5f
diagnostic efficacy, 5–6, 6b, 6f
low-level, effects of, on embryofetus,
168
particulate, 19–20
as possible cause of genetic
(hereditary) effects, 169–170
x-rays and, 2
Ions, 2
IR. see Image receptor
Irradiation effects, 116–125
on chromosomes, 121–122
classification of interaction, 116–
117, 117f
direct action, 117
on DNA, 119–121
indirect action, 119, 119f
radiolysis of water, 117–119
on somatic and genetic cells, 116
target theory and, 122–125, 126f
Isotopes, 20, 320
Iteration, 256
Iterative reconstruction, for reduction
of patient dose in CT, 256
J
Japan, atomic bombing in, acute
radiation syndrome after, 143
Japanese atomic bomb survivors, 161–
164, 162f, 163f
Joule, 64
K
Karyotype, 148, 149f
Kilovolts (kV)
in computed radiography, 209
of x-ray beam, 36
Kinetic energy, 17–18
L
Last image hold feature, 218–219
Late tissue reactions, 153–172
epidemiology and, 154
as radiation-induced response
concern in radiation
protection, 183
Latent period, of acute radiation
syndrome, 142
Law of Bergonié and Tribondeau,
129
LD. see Lethal dose
Lead apron
for imaging personnel dose
reduction, 296–297, 297f, 297t,
299f
Lead gloves, 305, 305f
Leakage radiation
secondary protective barrier against,
302–303
x-ray suite protection design for,
310f, 311
Lesion, point, 117–118
LET. see Linear energy transfer
Lethal dose (LD), 143–144
10/30, LD 50/60, and LD 100/60,
144, 144t
50/30, 130t, 143–144, 143f
Leukemia, 154
Chernobyl nuclear power plant
accident causing, 165
in Japanese atomic bomb survivors,
162–163, 163f
radiation dose and, 163–164
radiation-induced, 163–164
risk models for predicting, 156
Leukocytes. see White blood cells
INDEX
401
Life span shortening, 165–166
animal studies on, 165
human studies on, 165–166
American radiologic technologists
and, 165–166
American radiologists and, 165
Lifetime effective dose, 186, 295
Light-localizing variable-aperture
rectangular collimators, 197–199
coincidence between radiographic
beam and localizing light beam
of, 199
construction of, 197–198, 197f,
198f
luminance of, 198–199
positive beam limitation and, 199,
200f, 201f
skin sparing and, 198
Linear accelerator, for oncology
treatment, 19–20
Linear energy transfer (LET), 112–115,
113b, 113f, 114f
Linear nonthreshold curve, 154–155,
155f
Linear-quadratic dose-response
relationship, 115–116
Linear-quadratic nonthreshold curve,
155–156, 156f
Linear threshold curve, 156–157, 156f
Linearity, 181b, 204
Lipids, in cell, 92, 92b
Local tissue damage, 144
on reproductive system, 147, 147f
on skin, 145f
Low-linear energy transfer radiation,
128, 128f
Luminance, 198–199
Lung cancer, 23
Lymphocytes, 91, 130, 148, 148f
Lysosomes, 101
M
M phase, 104
Mag mode, 308
Magnification, of image intensifier
tubes, 213–215, 214f
Male patients
gonadal dose of diagnostic imaging
procedures for, 238
gonadal shielding dose reduction
from, 232
Mammography
breast compression, 214f, 276–278
coherent scattering in, 38–41
filtration for, 277–278, 278f
patient dose in, 276–277, 277f
reduction of, 277
screening, 277
Manifest illness, of acute radiation
syndrome, 142
Mapping, genetic, 96–97
mAs. see Milliampere-seconds
Mass density, photoelectric absorption
and, 44, 45f
Mass-energy equivalent, 50b
Maternity apparel, for pregnant
personnel protection, 299
Matter, interaction of x-radiation with,
34–53
attenuation in, 37–38
coherent scattering in, 38–41, 41f, 42b
Compton scattering in, 48–49
pair production in, 49–51
photodisintegration in, 51
photoelectric absorption in, 41–48
probability of, 38, 40t, 41t
significance of absorption in
biologic tissue, 35–36, 35f
types of, 38
x-ray beam production and energy
in, 36
Maximum permissible dose (MPD), 59
Mean marrow dose. see Bone marrow
dose
Mechanical vibrations, 17b
Medical imaging. see Imaging
procedures
Medical management, for radiation
bioeffects, 337–338, 338t
Medical usage, of radioisotopes,
320–329
nuclear medicine, 323–324
positron emission tomography and
computed tomography,
324–325, 325f
radiation protection and PET-CT
scanner, 325–329, 328f
radiation therapy, 320–322, 321f
radioactive materials, handling and
disposal of, 322–323
Medicine, as manmade source of
radiation exposure, 29–30, 29t, 30t
Meiosis, 106–108, 107f, 108f
Messenger RNA (mRNA), 94–95, 95f
Metaphase, 105–106, 105f, 148–149
Milliamperage, required, for image
intensification fluoroscopy,
212–213
Milliampere-seconds (mAs), 231
low exposure, to reduce dose to
patient, 233, 234f
Milligray (mGy), 4
Milligray per minute, 61
Milliroentgens (mR), 4
Millisievert (mSv), 4, 20
Mineral salts, in cell, 98
Mitochondria, 100–101
Mitosis, 104–106, 105f, 106f
anaphase, 105f, 106
interphase, 105f, 106–107
metaphase, 105–106, 105f, 148–149
prophase, 105
telophase, 105f, 106
Mitotic death, as cellular effect of
irradiation, 127
Mitotic delay, as cellular effect of
irradiation, 127
Mitotic spindle, 102
Mobile C-arm fluoroscopy equipment,
radiation safety features of, 217,
217f
Mobile x-ray examinations, personnel
dose management during,
306–307
Mobile radiographic units, 196–199
minimal source-skin distance for,
206f
Modified scattering. see Compton
scattering
Modified upper gastrointestinal
examination, 246b
Molybdenum filter, 277–278, 278f
Monitoring. see Radiation monitoring
Monosaccharides, 91–92, 91b
Monozygotic twins, 108
Motion. see Patient motion
Motion reduction methods, 246
MPD. see Maximum permissible dose
mRNA. see Messenger RNA
mSv. see Millisievert
Multidetector computed tomography
scanning (MDCT), 260–262, 260f
advantages, 261b, 300–301
402
INDEX
Multidetector computed tomography
scanning (Continued)
collimation, slice width, and slice
number, 260–261
slice thickness and reconstruction
interval, 261–262, 262f, 263t
Multifield image intensification tubes,
213–214
Multiple births, 108
Muscle tissue, ionizing radiation effects
on, 131
Mutagens, 169
Mutations
description at molecular level, 121,
121f
dominant or recessive point, 169
irradiation mutations, 168–169
local tissue damage causing, 147
mutant genes incapacities, 169
natural, 169
N
Nagasaki atomic bombing, 155–156
NAS/NRC-BEIR. see National Academy
of Sciences/National Research
Council Committee on the
Biological Effects of Ionizing
Radiation
National Academy of Sciences/National
Research Council Committee on
the Biological Effects of Ionizing
Radiation (NAS/NRC-BEIR), 175
National Council on Radiation
Protection and Measurements
(NCRP), 175, 176t
current recommendations (Report
No. 116), 186–189, 187f
annual occupational effective dose
in, 295
annual occupational effective dose
limit and, 186
cumulative effective dose
(CumEfD) limit, 186
for education and training
purposes, 189
EfD limits for radiation workers
and population as a whole,
190
negligible individual dose, 189
for nonoccupationally exposed
individuals, 186–188
for pregnant radiation workers,
189
National Council on Radiation
Protection and Measurements
(Continued)
for tissue, 189
early definition of radiation
quantities and units by, 59
reports of, 29–30, 29t, 186–189
shielding guidelines (Reports No.
147), 315, 315t
Nationwide Evaluation of X-ray Trends
(NEXT) program, 12
Natural radiation, 21–24
cosmic, 23–24
internal, 24
terrestrial, 22–23
Natural disasters, consequence of,
nuclear power plant accidents as,
28–29
Natural radiation, 21–24
Natural mutations, 169
Nausea and vomiting, radiation doses
causing, 141
Neck shield, 304, 304f
Negative contrast medium, 47–48
Negatron, pair production of, 49–50, 50f
Negligible individual dose (NID), 189
Nervous tissue, ionizing radiation
effects on, 131–132, 131f
Neuron organogenesis, ionizing
radiation effects on, 132
Neutrino, 324
Neutrons, 17, 19
Neutrophils, ionizing radiation effects
on, 130–131
New Safe Confinement structure, at
Chernobyl, 28, 28f
NEXT program. see Nationwide
Evaluation of X-ray Trends
(NEXT) program
NID. see Negligible individual dose
Nit, 198–199
Nitrogen-13 (13N), 50–51
Nitrogenous organic bases, 93–94, 93f
Nonagreement states, 178
Nonessential radiologic examinations,
237, 237b
Nonionizing radiation, 18–19, 18f
Nonoccupational dose, limits for, 190,
295
Nonthreshold curve
linear, 154–155, 155f
linear-quadratic, 155–156, 156f
Nonthreshold relationship, 154–155
NRC. see Nuclear Regulatory
Commission
Nuclear medicine
radiation in, 29–30, 29t
radioisotopes in, 323
Nuclear power plant accidents, 25–28.
see also Chernobyl nuclear power
plant accident
as consequence of natural disasters,
28–29
Fukushima Daiichi nuclear plant
crisis, 28–29
Three Mile Island Unit 2 (TMI-2),
25–26
Nuclear reactor core, Three Mile Island
Unit 2 and, 28–29
Nuclear Regulatory Commission
(NRC), 177–178, 178t
Nuclear weapons testing, fallout from,
25
Nucleic acids, 92–97. see also
Deoxyribonucleic acid;
Ribonucleic acid
Nucleolus, 103
Nucleoplasm, 102–103
Nucleotides, 92–97
Nucleus, 94–95
O
Object-to-image receptor distance
(OID), 235
Occupancy factor, in x-ray suite
protection design calculation, 312,
312t
Occupational dose, 7. see also
Personnel dose
limits for, 176t, 190, 191t, 295
Occupational hazard, scattered
radiation as, 296
Occupational radiation exposure, 49b.
see also Personnel dose
ALARA concept for, 296
first reports of, 56–57
in modern era of radiation
protection, 59–60
values for typical year, 75t
Occupational risk, 184–185
Occupational Safety and Health
Administration (OSHA), 178t,
179
Off-focus radiation, 195–196
OID. see Object-to-image receptor
distance
INDEX
403
Oncology treatment, linear accelerator
for, 19–20
Optically stimulated luminescence
(OSL) dosimeter, 76–80, 76f
advantages of, 77
control monitor for, 77
disadvantages of, 77
energy discrimination of, 76–77
personnel monitoring report of,
77–80
sensitivity of, 77
Optimization, 181
Optimization for radiation protection
(ORP), 6–7
Organelles. see Cytoplasmic organelles
Organic compounds, of cell, 90–97,
90b
carbohydrates, 91–92, 91b
lipids, 92, 92b
nucleic acids, 92–97
proteins, 90–91, 91f
Organic damage, from radiation, 21
Organic free radical formation, 119
Organogenesis, 167
neuron, 131–132, 131f
ORP. see Optimization for radiation
protection
Orthovoltage radiation therapy, skin
damage caused by, 146
OSHA. see Occupational Safety and
Health Administration
OSL dosimeter. see Optically
stimulated luminescence (OSL)
dosimeter
Osmosis, 98
Ova, 132–133, 147
Ovaries, radiation effects on, 147
Overexposure, of patient, 211–212
Overhead protective barrier, 303,
303f
Overshielding, in x-ray suite, 310
Oxidation, 101
Oxygen effect, 115
Oxygen enhancement ratio, 115–116,
116b
Oxygen fixation hypothesis, 115–116
P
Pain, effective communication for
procedures causing, 229, 230f
Pair production, 49–51
annihilation radiation, in positron
emission tomography, 50–51
importance of, 41b
probability of, 41t
process of, 49–50
in x-radiation with soft tissue,
interaction of, 40t
Particulate radiation, 19–20
Patient care, team approach to, 3
Patient centering, for reduction of
patient dose in CT, 256–257
Patient dose
during diagnostic x-ray procedures,
227–251
air gap technique for, 235, 236f
computed tomography and, 247
concern about risk of exposure,
237–240, 237b
dual-energy x-ray absorptiometry
(DEXA), 247–248, 248f
effective communication for,
229–230, 229f, 230f
fluoroscopically guided
positioning of, 239–240
gaining cooperation, 246–247
gonadal shielding and, 231–232
Image Gently Campaign and, 247
Image Wisely Campaign and, 247
immobilization, 230–231, 231f
irradiation during unknown
pregnancy, 240–241, 241f,
242b
pediatric considerations, 244–247
pregnancy, 240–244, 243f, 244t,
245b, 246b, 246f
protective shielding, 231–232,
232f
radiographic image processing,
233–235
repeat images, 235–236, 237b
specifying amount of radiation
received, 237–239
technical exposure factors,
232–233, 233b, 234f
unnecessary radiologic
procedures, 237b
grid ratio and, 205
in image intensification fluoroscopy,
213f
imaging procedure management of
CT, 254–257, 255b, 255f
mammography, 254f, 261
shielding for, 254
pulsed fluoroscopy effects on, 215
Patient dose (Continued)Pair production (Continued)
radiographic grid effects on,
205–206, 205f
Patient education, 8–12
Alliance for Radiation Safety in
Pediatric Imaging and, 10–11
background equivalent radiation
time and, 8–9
on imaging procedures, 8, 9f
increased radiation sensitivity of
children and, 9–10
NEXT program and, 12
protocols for dose alerts and, 12
reference values and, 12
on risk of imaging procedure versus
potential benefit, 8
Patient motion, 246
types of, 230–231, 231f
Patient protection, 8–12
Peak kilovoltage (kVp), 35
high radiography, 235
Pediatric imaging
Alliance for Radiation Safety in
Pediatric Imaging, 247
Image Gently Campaign, 247
x-ray considerations, 244–247
Permanent inherent filtration, 36
Person-sievert, 68, 68b
Personnel dose, management during
diagnostic x-ray procedures,
293–318, 294b
ALARA concept in, 295, 296f
annual limit for occupationally
exposed personnel, 294–295
basic principles of radiation
protection and, 300–304
C-arm fluoroscopy, 307–308
dose-reduction methods and
techniques for, 295–298,
297t
fluoroscopic procedures, 305–306
high-level control interventional
procedures, 308–309
mobile x-ray examinations,
306–307
patient restraint and, 298
for pregnant personnel protection,
298–299
radiation caution signs, 315–316
x-ray suite protection design for,
309–315
x-ray tube housing cables in,
304–305
404
INDEX
Personnel dosimeters, 73–76
characteristics of, 76
optically stimulated luminescence
dosimeter as, 76–80, 76f
placement of, 73–74, 73f
purpose of, 73
radiation exposures of, 75–76, 75t
requirement for, 73
thermoluminescent dosimeter as, 74
types of, 76–81
Personnel dosimetry, 73
Personnel monitoring, 73–76. see also
Dosimeters
report, 73
requirement for, 73
PET. see Positron emission tomography
PET/CT scanner, 325–329, 328f
Phosphor, in computed radiography,
213–214
Photodisintegration, 51
Photoelectric absorption, 41–48
body structures and
mass density and effective atomic
number, 44
thickness, 44
contrast media and, 47–48
importance of, 41b
probability of, 41t
occurrence of, 43–44
process of, 42–43
radiographic contrast and, 46–47
in x-radiation with soft tissue,
interaction of, 40t
Photoelectrons, 42–43
Photomicrograph, 148, 149f
Photomultiplier tube, 204
Photons
coherent scattering of, 38–41, 41f,
42b
Compton scattering of, 48–49
direct and indirect transmission of,
37
energy of, in diagnostic x-ray beam,
36
pair production of, 40t
photodisintegration of, 51
primary, exit, and attenuated, 37–38,
38f
probability of, interaction with
matter, 41b, 41t
Phototiming, 204–206
Physician, diagnostic efficacy and, 3
Picture element, 207–208
Pitch ratio, 254
Pixel, 207–208
Platelets. see Thrombocytes
Pluripotential stem cell, 148, 148f
Plutonium, 19
Point lesion, 117–118, 120f
Point mutations, 169
Polonium, radiation exposure due to,
22
Polysaccharides, 91–92, 91b
Polyzygotic siblings, 108
Positive beam limitation, 181b, 199
Positive contrast media, 47–48, 47f
Positron, 49–50, 324
Positron emission tomography (PET)
annihilation radiation in, 50–51
radioisotopes in, 324–325, 325f
Potassium, radiation exposure due to, 24
Potassium iodide, 164–165, 338
Pregnancy
Chernobyl nuclear power plant
accident and, 168
first trimester of, embryonic cell
radiosensitivity during, 167–168
patient dose management
during American College of
Radiology position on
abdominal radiologic
examinations of female
patients, 240
dose determination for embryo-
fetus, 241–242, 243f, 244t
irradiation during known
pregnancy, 243–244
irradiation during unknown
pregnancy, 240–241, 241f,
242b
pregnancy possibility
determination, 240
protection of pregnant patients,
240–244
personnel dose management during,
298–299
second trimester of, embryonic cell
radiosensitivity during, 168
third trimester of, embryonic cell
radiosensitivity during, 168
Primary photons, 37–38
Primary protective barrier, 216, 301–
302, 302f
calculation of, 313–314, 314f
Primary radiation, 36
x-ray suite protection design for,
310, 310f
Priscilla Test, 26f
Prodromal stage, of acute radiation
syndrome, 141, 141f, 142
Programmed cell death. see Apoptosis
Prophase, 105
Proportional counter, 82
Protective apparel, 296–298, 297f,
297t
Protective apron, personnel dosimeter
with, 73–74
Protective curtain, during fluoroscopic
procedures, 305f, 306
Protective garments, during mobile
x-ray examinations, 306
Protective shielding
of imaging personnel, 301–303
of patient, 231–232, 232f
Protective tube housing, diagnostic-
type, 195–196, 196f
Protein synthesis, 90–91
Proteins, in cells, 90–91, 91f
Protons, 19–20
Protoplasm, 89–90, 90b, 90f
Pulsed fluoroscopy, 215
filtration in, 216
limiting fluoroscopic field size, 215
radiation delivery factors, 215–216
timing device, 216
Pulsed progressive systems, in digital
fluoroscopy, 217–218
Purines, 92–93, 93f
Pyrimidines, 92–93, 93f
Q
Quality control program, 234–235
Quality factor (Q), 65
Quantities and units, 54–71
absorbed dose, 64–65
air kerma, 64
ColEfD. see Collective effective
dose
coulombs per kilogram (C/kg), 64
EfD. see Effective dose
equivalence of damage from
different sources, 65
exposure, 61–64
Gy. see Gray
rad, 59–60
rem, 59
INDEX
405
Quantities and units (Continued)
SI units of measure and, 61–68
Sv. see Sievert
TEDE. see Total effective dose
equivalent
units summary, 68t, 69t
Quantum mottle, 232–233
R
Radiant energy, control of, 3
Radiation, 16–33. see also Ionizing
radiation
biologic damage potential of, 20–21
defined, 2
dose, 20
EfD and BERT values for, 10t
electromagnetic, 17–18
electromagnetic spectrum, 17–18,
17b
ionizing and nonionizing, 18–19
manmade. see Human-made
(artificial) radiation
particulate, 19–20
quantities and units. see Quantities
and units
sources of, 21–30
types of, 17–30
use of, in healing arts, 2
Radiation absorbed dose, 59–60
Radiation-absorbent barriers, 309–310,
310b
Radiation biology, 111–136
cell radiosensitivity in. see Cell,
radiosensitivity of
cellular effects of irradiation in. see
Cellular effects, of irradiation
energy transfer determinants in. see
Energy transfer determinants
ionizing radiation mechanism of
damage, 112
mammalian cell survival curves in,
127–128, 128f
Radiation caution signs, 315–316,
316f
Radiation Control for Health and
Safety Act of 1968, 180–181
Radiation dose, 288–289, 289b. see also
Dose
Radiation dose-response relationship.
see Dose-response relationship
Radiation emergencies, 336–338
Radiation emergency plans, 336
Radiation exposure. see also Dose;
Dose limits
background equivalent radiation
time (BERT) and, 9, 10t
need for safeguarding against,
4–5
occupational. see Occupational
radiation exposure
reduction of, methods for,
investigations of, 57
vulnerability of children to,
244–245
Radiation hormesis, 189–190
Radiation-induced cancer. see Cancer,
radiation-induced
Radiation-induced malignancy, 175
Radiation lethality, 142, 143t
Radiation monitoring, 275–292. see
also Area monitoring; Personnel
monitoring
of area, survey instruments for,
81–83
of personnel, 73
of x-ray exposure, 83–84
Radiation oncology treatment, linear
accelerator for, 19–20
Radiation protection, 1–15
ALARA principle for, 6–8
cardinal rules of, 7
concept of, 3–5
defined, 2
diagnostic efficacy and, 5–6
goals of, 3
modern era of, 59–60
patient protection and patient
education for, 8–12
about imaging procedures, 8
Alliance for Radiation Safety in
Pediatric Imaging and,
10–11
background equivalent radiation
time and, 8–9
increased radiation sensitivity of
children and, 9–10
NEXT program and, 12
protocols for dose alerts and, 12
reference values and, 12
risk of imaging procedure versus
potential benefit, 8
radiation-induced responses of
concern in, 182–183, 182b
radioisotopes and, 325–329, 328f
Radiation protection standards
organizations, 175–177, 176t
International Commission on
Radiological Protection,
175–176
National Academy of Sciences/
National Research Council
Committee on the Biological
Effects of Ionizing Radiation
(NAS/NRC-BEIR), 177
National Council on Radiation
Protection and Measurements,
176, 177b
United Nations Scientific
Committee on the Effects of
Atomic Radiation (UNSCEAR),
176–177
Radiation safety committee (RSC),
179–180
Radiation safety measures, 298–299
Radiation safety officer (RSO),
179–180
authority of, 180, 180b
required training and experience for,
180, 180b
responsibilities of, 179–180
Radiation safety program, 8b
Radiation survey instruments, 81–83
gas-filled, 82–83
requirements for, 82
types of, 81–82
Radiation therapy
blood cell effect during treatment,
131
orthovoltage, skin damage caused
by, 146
radioisotopes used in, 320–322
Radiation weighting factor (WR), 65,
115
Radiation workers
change in employment by, 80
dose limits for, 190, 191t
early medical, carcinogenesis and,
161
larger equivalent dose allowance for,
322
life span shortening and, 165–166
radiation safety and, 3–5
responsibility for maintaining
ALARA and, 8b
Radiationless effect, 43
Radio waves, 17b
406
INDEX
Radioactive contamination, 27
Radioactive decay, 19
Radioactive dispersal device. see
Radiation emergencies
Radiodermatitis, 56–57, 145
Radiographic contrast, photoelectric
absorption on, 46–47
Radiographic equipment
diagnostic x-ray, code of standards
for, 180–181, 181b
radiation safety features of, 195–204
compensating filters, 202–203,
203f
control panel, or console, 196
diagnostic-type protective tube
housing, 195–196, 196f
exposure linearity, 204
exposure reproducibility, 203–204
filtration, 199–202
radiographic grids, 205–206, 205f
source-to-image receptor distance
indicator, 196
x-ray beam limitation devices,
196–199, 197f, 198f, 200f
Radiographic examination table, 196
Radiographic fog, 48
Radiographic grids, 205–206, 205f
Radiographic image receptor, 38f
Radiographic imaging
pediatric considerations during,
244–247
postprocessing of, quality control
program for, 233–235
Radioimmunotherapy (RIT), 329–336
agents, 332–333, 332t
antibody, 331
imaging and treatment, 335–336
immune system, 329–331, 329b, 330b
immunoglobulin-G, 331–332
monoclonal antibodies, 331, 331f
procedures, 333
radioantibodies, 332
safety considerations, 333–335
Radioisotopes, 319–342
medical usage of, 320–329
nuclear medicine, 323–324
PET-CT scanner, 325–329, 328f
positron emission tomography
and computed tomography,
324–325
radiation protection, 325–329
radiation therapy, 320–322, 321f
Radioisotopes (Continued)
radioactive materials, handling
and disposal of, 322–323
Radiologic technologists. see Radiation
workers
Radiologists. see Radiation workers
Radionuclides, 22
Radiosfcsensitivity
apoptosis and, 127
of cells. see Cell, radiosensitivity of
embryonic cell
during first trimester, 167–168
during second and third
trimesters, 168
Radium, natural radiation from, 22–23
Radium watch-dial painters,
carcinogenesis and, 160
Radon, 22–23
Recessive point mutations, 169
Recoil electron, 48–49
Record, of radiation exposures, 75–76
Recovery, after radiation damage, 144
Red blood cells. see Erythrocytes
Reference values, 12
Regulatory agencies, US, 177–179,
178t
agreement states, 178
Environmental Protection Agency
(EPA), 179
Food and Drug Administration
(FDA), 179
Nuclear Regulatory Commission
(NRC), 177–178
Occupational Safety and Health
Administration (OSHA), 179
Relative biologic effectiveness, 115,
115b
Relative risk models, for cancer, 158,
159f
Rem, 59
Remote control fluoroscopic systems,
306
Repair, after radiation damage, 144
Repair enzymes, 90–91
Repeat exposures, radiographic, result
from poor communication,
229–230
Repeat images
consequences of, 235
repeat analysis program, benefit of,
236, 237b
repeat rates, 235–236
Repeat rates, in digital radiography,
210–212, 211f
Replication, 106–107
Reproducibility, 181b, 203–204
Reproductive cells, 96, 132–133
Reproductive death, as cellular effect of
irradiation, 127
Reproductive system, radiation effects
on, 147, 147f
Restitution, 122, 123f
Rhodium filter, 277–278, 278f
Ribonucleic acid (RNA), 92–94
messenger, 94–95, 95f
ribosomal, 95
structure of, 94–97, 95f
transfer, 95
Ribosomal RNA (rRNA), 95
Ribosomes, 94–97, 95f
Risk, 5–6
concern about, 237–240
dose limits and
embryo-fetus vulnerability, 185
occupational, 183–184
occupational, 184–185
Risk estimates, for cancer, 158–165
absolute risk and relative risk
models for, 158, 159f
epidemiologic studies for, 158–159
models for extrapolation of cancer
risk from high-dose to
low-dose data, 159–160, 159f
Risk models
for predicting cancer risk, 155–156,
156f
predicting high-dose cellular
response, 156–157, 156f
for predicting leukemia and breast
cancer, 156
selection of, rationale for, 157
RNA. see Ribonucleic acid
Roentgen, Wilhelm Conrad, 55–56, 55f
Roentgen (R), 4, 57–58
Roentgens per minute, 61
Rollins, William Herbert, 145
Rotational scheduling, of personnel,
306
Routine radiographic procedures,
placement of personnel
dosimeters during, 73–74, 73f
rRNA. see Ribosomal RNA
RSC. see Radiation safety committee
RSO. see Radiation safety officer