9 Reasons RDC's New Digital Radiation Dosimeter Is Right for Your Organization

We're excited to introduce our newest dosimetry solution, the NetDose Digital Dosimeter! In this article we'll explore why using this digital dosimeter could make the most sense based on the needs of your organization. 

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We hope that you find this article informative, and as always, we look forward to hearing your feedback! 

How Does a Digital Dosimeter Display Ionizing Radiation Exposure? 

There are five types of ionizing radiation: alpha radiation, beta radiation, neutron radiation, gamma radiation, and x-rays). You'll remember that ionizing radiation is a form of energy that acts by removing electrons from atoms and molecules of materials (i.e. living tissue, water, and air). 

If your organization has employees that work with or have the potential to be exposed to radiation or radioactive material, monitoring the levels of exposure they receive is vital. Generally, those in contact with radioactive substances during the regular course of their employment (or those who have the potential to be exposed to radiation), carry personal radiation dosimeters. These are also sometimes referred to as personal radiation detectors. 

A digital dosimeter is a semi-passive radiation dosimeter that is used to estimate ionizing radiation dose of the individual wearing it. Personal dose equivalent is a measure of the biological damage to living tissue as a result of exposure to radiation. Digital dosimeters provide a real-time direct display of information about the measured dose for the individual wearing the device. 

Radiation Dose Reporting with Digital Dosimeters 

Organizations that have switched to digital dosimeters have placed a significant amount of value on the convenience of being able to upload dose results whenever it's convenient for them, instead of being tied to a set schedule dictated by an external team. This increased autonomy makes dose reporting with a digital dosimeter more convenient than alternative dosimetry solutions. 

The Specs: RDC's NetDose Digital Dosimeter 

RDC's new NetDose dosimeter utilizes silicon photomultiplier (SiPM) technology for real-time dose determination with a minimal reportable dose of 1 mrem (0.01 mSv). 

The NetDose dosimeter is used to monitor occupational exposure to an individual working with radioactive materials emitting gamma rays and/or X-rays. 

This dosimeter ensures the dose received remains within the allowable dose limit and provides organizations with real-time insights and peace of mind in confirming safety in the work environment. 

Energies Measured

Photons (both gamma and x-ray radiation). Photon: 17 keV &#; 6.7 MeV. 

Reporting Periods

On-demand with routine read weekly - no need for the usual routine of shipping badges. This dosimeter takes incremental dose readings every hour and stores results in memory, which is transmitted on demand or automatically weekly. This gives organizations more autonomy and control over radiation dose report times. 

Badge Reassignments

The NetDose Digital Dosimeter can be easily reassigned to other workers, and the dosimeter can keep track of who had the exposure at what time. 

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1) Cost Savings

The elimination of shipping requirements allows an organization to save a considerable amount of money annually. Shipping costs are most pronounced for clinics with a small number of badges who return them for processing monthly or quarterly. 

2) Convenience

The ability to upload dose results when it is convenient - rather than being tied to a schedule - leads to increased autonomy within an organization's radiation safety program.  

3) Avoiding Lost Badge Shipments 

Organizations that have experienced a history of lost badge shipments can avoid these fees moving forward. This also reduces the gaps in dose reporting that such circumstances cause. 

4) Easy Badge Reassignments 

The ease of assigning and reassigning badges online makes personnel changes less stressful and more cost-effective. 

5) On-Demand Dose Readings 

On-demand readings and dose reporting are crucial for organizations whose employees have the potential to experience elevated levels of radiation or work in a dangerous radiation zone. 

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6) Photon Measurement and Incremental Dose Readings

NetDose measures photons (both gamma and x-ray radiation) and takes incremental dose readings every hour to provide on-demand reporting. 

7) Quality and Peace of Mind 

NetDose provides an organization with the peace of mind that their occupational radiation workers are protected. 

8) Service Standards and Accreditation

NetDose is an NVLAP-accredited (Lab Code -0) semi-passive radiation dosimeter with a Lower Limit of Detection (LLD) of 1 mrem (0.01 mSv). This means this dosimeter reports doses down to very low levels.  

The NetDose dosimeter can be configured to record doses at various intervals, providing a comprehensive overview of cumulative radiation exposure. Additionally, the device monitoring the dose rate per hour (incremental exposure) throughout the week offers a more detailed analysis. This allows users to identify outliers in exposure rates and make informed adjustments to radiation protection techniques. By analyzing data for spikes in dose rates and modifying factors like time, distance, or shielding safety can be enhanced. Specific tasks or activities can be done with more granular data than a month, week, or day. 

9) Advanced Technology and Devices 

In general, professionals are more interested in changing the way they do business with respect to personal dosimeters. With a desire for less traditional passive radiation monitoring for an advanced alternative.

Let RDC Help Choose the Right Solution for Your Organization  

Radiation Detection Company has 75 years of experience providing quality dosimetry service to over 31,000 companies worldwide. Have a question that we didn't address in this article? Reach out to our Support team, and one of our specialists will be more than happy to help.  To learn more about NetDose Digital Dosimetry, visit here.

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Introduction

Radiation safety is a concern for patients, physicians, and staff in many departments, including radiology, interventional cardiology, and surgery. Radiation emitted during fluoroscopic procedures is responsible for the greatest radiation dose for medical staff. Radiation from diagnostic imaging modalities, such as computed tomography, mammography, and nuclear imaging, are minor contributors to the cumulative dose exposures of healthcare personnel. However, any radiation exposure poses a potential risk to both patients and healthcare workers alike.[1]

Radiation protection aims to reduce unnecessary radiation exposure with a goal to minimize the harmful effects of ionizing radiation.[2] In the medical field, ionizing radiation has become an inescapable tool used for the diagnosis and treatment of a variety of medical conditions. As its use has evolved, so have the cumulative doses of lifetime radiation that both patients and medical providers receive. Most radiation exposure in medical settings arises from fluoroscopic imaging, which uses x-rays to obtain dynamic and cinematic functional imaging. Formal radiation protection training helps reduce radiation exposure to medical staff and patients.[3] However, enforcing radiation safety guidelines can be an arduous process, and many interventionalists do not receive formal training in either residency or fellowship on radiation dose reduction. In particular, clinicians or medical staff that use fluoroscopic imaging outside of dedicated radiology or interventional departments have low adherence to radiation safety guidelines. Fluoroscopy is used in many specialties, including orthopedics, urology, interventional radiology, interventional cardiology, vascular surgery, and gastroenterology. As radiation exposure becomes more prevalent, a thorough understanding of radiation exposure risks and dose reduction techniques will be of utmost importance.

There are three basic principles of radiation protection: justification, optimization, and dose limitation. Justification involves an appreciation for the benefits and risks of using radiation for procedures or treatments. Physicians, surgeons, and radiologic personnel all play a key role in educating patients on the potential adverse effects of radiation exposure. The benefits of exposure should be well known and accepted by the medical community. Often, procedures that expose patients to relatively higher doses of radiation&#;for example, interventional vascular procedures&#;are medically necessary, and thus the benefits outweigh the risks. The As Low as Reasonably Achievable (ALARA) principle, defined by the code of federal regulations, was created to ensure that all measures to reduce radiation exposure have been taken while acknowledging that radiation is an integral part of diagnosing and treating patients. Any amount of radiation exposure will increase the risk of stochastic effects, namely the chances of developing malignancy following radiation exposure. These effects are thought to occur as a linear model in which there is no specific threshold to predict whether or not malignancy will develop reliably. For these reasons, the radiologic community teaches protection practices under the ALARA principle.

Function

A basic understanding of the science behind the damaging effects of radiation is crucial in evaluating the different strategies to protect medical professionals and patients. X-rays are composed of high-energy photons within the electromagnetic spectrum. X-rays are notable in comparison to lower energy photons since they are powerful enough to break molecular bonds and ionize atoms.[4] This ionization produces free radicals, chemically active compounds that can indirectly damage DNA.[5] Medical staff and patients can be exposed to x-ray radiation either as scattered x-rays or by direct exposure to the x-ray beam. Scattered x-rays give up part of their energy during the scattering process, and thus energy deposited in tissues from scattered x-rays is lower than directly from the x-ray source. Radiation doses can be expressed in three different ways. The absorbed dose is the radiation deposited in an object and is measured in milligrays (mGy). The equivalent dose is calculated, taking into account the organ-specific radiation exposure, as well as the organ's sensitivity to radiation, and is expressed in millisieverts (mSv). The effective dose is the sum over the entire body of the individual organ equivalent doses and is expressed in millisieverts (mSv). An understanding of these definitions is critical to interpreting dose recommendations. The ICRP's dose recommendations are shown in fig 1.[3] For reference, 20 mSv/year roughly equates to 2 to 3 abdominal and pelvic computed tomography (CT) scans or 7 TO 9 years of background radiation. Exposure surpassing this threshold averaged over five years has been associated with a 1 in lifetime risk of fatal cancer.[6][7][5]

Issues of Concern

Radiation exposure can produce biological effects as either a dose-dependent effect or a dose-dependent probability.[8] Dose-dependent effects are referred to as deterministic effects and occur when a specific exposure threshold has been exceeded. A dose-dependent probability is referred to as a stochastic effect and represents an outcome that occurs with a certain probability but without a defined threshold at which these effects are triggered.[9] Examples of deterministic effects that have been documented in the fields of interventional radiology, cardiology, and radiation treatment include radiation-induced thyroiditis, dermatitis, and hair loss.[10] Stochastic effects are discovered many years after radiation exposure and include the development of cancer.[3] It is important to note that deterministic effects are determined by the cumulative amount of radiation exposure an organ or tissue experiences over time (the lifetime equivalent dose). In comparison, there is a chance that a specific x-ray causes DNA damage that later develops into cancer, a stochastic effect. As the number of x-rays a patient is exposed to increases, the chance of a stochastic effect increases; however, the lifetime equivalent radiation dose does not play a role in stochastic effects. Researching the effects of long-term low-dose exposure to ionizing radiation is difficult because literature is based on epidemiologic data from large radiation exposures at doses that are much higher than is used in the medical setting. Current literature suggests that medical radiation may result in a modest increase in the risk of cataracts, cancer, and possibly hereditary diseases.[6] 

Clinical Significance

The duration of radiation exposure, distance from the radiation source, and physical shielding are the key facets in reducing exposure. The exposure duration can be minimized in several ways. When exposing a patient to radiation, the technician or physician should preplan the required images to avoid unnecessary and redundant exposure. Magnification significantly increases the exposure to the patient; therefore, magnification should be used judiciously.[11] Continuous or live fluoroscopy may be helpful to understand anatomy during procedures better, but standard fluoroscopy machines capture roughly 35 images per second. Decreased exposure can be achieved instead by using pulsed fluoroscopy, which obtains about five images per second without sacrificing imaging quality. Lastly, exposure duration should be limited whenever possible. 

Increasing the distance between the x-ray beam and the part that is being imaged is another way to minimize exposure. The image intensifier or x-ray plate should be as close to the patient as possible, with the x-ray tube positioned as far away as possible while maintaining adequate image resolution. A similar approach can be used to minimize exposure to medical professionals. Scattered radiation&#;the type of radiation that surgeons, interventionalists, and operating room staff commonly encounter during procedures requiring fluoroscopy&#;follows an inverse square law. Scattering exposure levels decrease proportionally with the inverse of the distance squared from the x-ray source. Staff can lower their exposure levels by a factor of four by doubling their distance from the source. Through this simple concept, occupational radiation exposure can be dramatically reduced.

Physical radiation shielding can be accomplished with different forms of personal protective equipment (PPE). Some fluoroscopy suites contain ceiling-suspended lead acrylic shields, which can reduce doses to the head and neck by a factor of 10. Portable rolling shields, which do not require installation, can protect staff in operating rooms and interventional settings. These mobile shields have been shown to decrease the effective radiation dose to staff by more than 90% when used correctly.[12] In cases where it is not feasible to shield oneself behind a physical barrier, all personnel should wear leaded aprons for protection. Leaded aprons, which are required in most states, commonly come in thicknesses of 0.25 mm, 0.35 mm, and 0.5 mm. Aprons that wrap circumferentially around the body are preferred to front aprons, given their increased surface area coverage. In general, transmission through leaded aprons is typically between 0.5% and 5%. Leaded aprons should always be companied by a thyroid shield. Personal protective equipment also protects our patients. Patients should wear protective gowns in areas not being imaged, whether in plain radiographs, fluoroscopy, or CT scans. Leaded eyeglasses and should be at least 0.25 mm lead equivalents to provide adequate protection for the lens of the eye. Leaded glasses are commonly cited as the least worn piece of PPE in multiple studies, with compliance rates ranging from 2.5% to 5%.[13] Studies have shown a relationship between occupational radiation doses and cataract development before 50 in a large cohort of radiation technologists, specifically the posterior lens.[14] Interestingly, the opacification of the posterior lens, in comparison to the other locations, is relatively specific to radiation exposure. Regular use of leaded eyeglasses can reduce radiation exposure to the lens by 90%. The low compliance rate for wearing leaded eyeglasses demonstrates an area for improvement. Beyond the appropriate use of leaded aprons, proper storage and testing of the equipment are critical to ensuring its effectiveness. Lead garments should be checked every six months to assure their integrity, and leaded aprons should be hung rather than folded to prevent cracking.

Dosimeters are devices that measure cumulative radiation exposure. These devices should be worn by all hospital staff who encounter planned ionizing radiation. Unfortunately, in a significant number of healthcare settings, there is a paucity of monitoring and, thus, a lack of reliable data. Sanchez et al. reported that as much as 50% of physicians do not wear or incorrectly wear dosimeters.[15] Dosimeters should be worn both outside and inside the leaded apron for comparison of doses, and the readings should be analyzed by the facility&#;s radiation safety department. Raising awareness of the importance of dosimetry should be a priority for the occupational safety or radiation safety departments in health systems. Staff who comply with dosimeter regulations can receive feedback about where and when they are receiving radiation doses, which can help audit behaviors and promote increased safety awareness.

Other Issues

Since when I-131 was used for the treatment of thyrotoxicosis, the use of nuclear medicine for imaging and therapeutic procedures has increased at an exponential rate.[16] Nuclear medicine uses radioactive material to help diagnose and treat conditions such as cancer or cardiac disease. PET scans are an example of diagnostic imaging that involves injecting a small dosage of radiopharmaceutical material to image and measure the function of an organ. Medical administration of radiopharmaceuticals or external beam radiation therapy is used under the prescription of an authorized physician. Internal radiation therapy, or brachytherapy, is a form of nuclear medicine treatment where radiation is released from inside the body for treatment of cancer, such as non-Hodgkin lymphoma.[16] Brachytherapy comes with its side effects, which differ from ionizing radiation from medical imaging. The most common adverse reactions are thrombocytopenia, neutropenia, fatigue, nausea, vomiting, diarrhea.

Radiation exposure from various nuclear power plants has allowed us to develop basic principles of radiation protection to ensure the safety of employees and how to handle unplanned exposures. If an employee encounters a scenario where radioactive material has been spilled, it must be dealt with according to specific regulations. For example, radioactive materials should not be flushed down normal sanitation drains. They should be allowed to decay in an adequately shielded facility when they have half-lives less than 90 days.[17] Radioactive waste tags should be labeled and disposed of to radioactive waste departments. The secure storage of the waste should be maintained at all times.

Enhancing Healthcare Team Outcomes

As medical imaging evolves, so does the medical community&#;s understanding of how to protect people from ionizing radiation. The first step to optimizing safe radiation practice is educating hospital staff on radiation best practices. Each institution&#;s radiation safety department is responsible for educating and enforcing protective strategies. Protocol development and education strategies have been effective in multiple specialties. Simple interventions can play a major role in radiation dose optimization. For example, after a 20-minute video was used to educate physicians on radiation best practices, it was found to reduce median fluoroscopy time by 30% to 50%.[18] Justification, optimization, and adherence to dose limits can significantly decrease exposure when followed. Following the ALARA principle, health care workers should confirm that the benefits of the exposure outweigh the risks and strive to decrease radiation exposure as far below the dose limits as practical.

Figure

Figure 1: ICRP Dose recommendations Created by Nicholas Frane, DO

Disclosure: Nicholas Frane declares no relevant financial relationships with ineligible companies.

Disclosure: Adam Bitterman declares no relevant financial relationships with ineligible companies.

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