The IAEA is encouraging medical professionals to optimize patient protection by shifting from manual to digital processes of monitoring ionizing radiation in imaging procedures, with its first publication on the topic. The new IAEA Safety Report on Patient Radiation Exposure Monitoring in Medical Imaging, developed in collaboration with the World Health Organization (WHO) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), offers guidance for countries to adopt digital means of recording, collecting and analysing data, which provide more accurate results more swiftly. Digital automated systems also enable radiological professionals to optimize individual radiation doses and minimize unnecessary radiological procedures.
What is Radiation?
"This report provides information on the type and amount of data that need to be collected for different imaging modalities - for example X rays or computed tomography (CT) scans - and on the different analytical uses of these data for medical facilities to ensure justified and optimized use of radiation in medical imaging," said Miroslav Pinak, Head of the IAEA Radiation and Monitoring Section.
Medical imaging procedures represent the largest artificial source of ionizing radiation to which people are exposed, with around 4.2 billion performed each year around the world, a number that continues to rise.
The new publication encourages countries to move away from manual processes and adopt digital means of data recording and collection, which provide more accurate and efficient results.
"The guidelines can be applied to manual means of collecting and analysing exposure data, as these are still the only option available in many places. However, the publication highlights the greater benefits of using automatic digital systems for the collection and analysis of exposure data," said Jenia Vassileva, a former IAEA radiation protection specialist, who was the focal point for this publication. "The report also recognizes the importance of standardizing data recording and collection, to ensure compatibility of data coming from different facilities and equipment."
Previously, the analysis of doses received by patients from radiological imaging procedures relied on estimated dose values based on small samples of standard-size patients, and data collection was performed manually. Automated exposure monitoring systems can record and collect larger and more accurate amounts of data from radiological procedures and facilitate their analysis. This digital process allows medical professionals to better account for factors that influence doses and image quality, such as the patient's weight, height and age, the imaged area of the body, and the equipment used. Such systems help radiology professionals to optimize doses to each individual patient- so that these are not unusually low or unusually high- and they also contribute to minimize unnecessary radiological procedures.
Patients who need recurrent imaging examinations over time can benefit from digital systems and electronic registries, which improve the tracking and sharing of exposure data for the whole sequence of images performed on the patient, minimizing unnecessary repeated procedures and optimizing future examinations.
"The publication is a step forward in improving access to data on patient doses. This will facilitate the global data collection on medical exposure coordinated by UNSCEAR and the assessment of trends and patterns of radiological examinations, thus helping identify gaps in radiation protection and supporting epidemiological studies on radiation effects," says Ferid Shannoun, Deputy Secretary at UNSCEAR.
Challenges of Digital Monitoring Systems
Challenges to the implementation of automated exposure monitoring programmes remain on various fronts, for instance on issues of privacy and ownership of patient data. Additionally, as Ola Holmberg, Head of the IAEA Radiation Protection of Patients Unit, said, "The proper use of the latest technologies for automated exposure monitoring and the utilization of advanced equipment requires well-trained medical professionals and qualified imaging medical physicists who can guarantee integrity in data recording, collection and analysis."
"The report offers the most comprehensive treatment of the subject to date. Given the ongoing developments of artificial intelligence and deep learning for medical applications, it opens a critical dimension regarding patient exposure data and their relevant role in improving effectiveness and safety of medical imaging," said Ehsan Samei, President of the American Association of Physicists in Medicine.
The new publication complements Safety Guide No. SSG-46 on Radiation Protection and Safety in Medical Uses of Ionizing Radiation and assists the implementation in medical imaging practice of the requirements of the International Basic Safety Standards. It also supports and complements IAEA actions to strengthen patient radiation protection under the umbrella of the Bonn Call for Action. It is available for free here.
