L14 Pregnancy
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The document discusses radiation exposure during pregnancy from diagnostic and interventional radiology procedures. While thousands of pregnant women are exposed to radiation annually, for most patients the exposure is medically justified and the radiation risk is minimal. Higher doses from procedures like CT scans or radiotherapy administered during critical periods of pregnancy organ development can increase risks of fetal harm like malformations or mental impairment. The risks are dependent on the radiation dose and gestational period during exposure. Termination of pregnancy is generally not justified unless fetal doses exceed 100 mGy.
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1. It discusses the importance of quality customer service and managing patient expectations through clear communication and a professional demeanor.
2. The history of radiology and medicine are summarized, from ancient practices to modern advancements in technology and understanding of anatomy.
3. Key aspects of radiologic technology education are introduced, including developing skills in both medical imaging and caring for diverse patient needs.
Digital Imaging
In this fast growing techo-rich world, we need to have the basics go more stronger to equip ourselves efficiently.
Challenges in quality management of diagnostic medical imaging
Key challenges in quality management of diagnostic medical imaging departments include developing methods to collect and deliver knowledge about quality care to practitioners. Quality consists of technical outcome and service delivery. Key performance indicators used are customer satisfaction, patient access to appointments, and reporting time. Measuring and monitoring quality indicators is important to prove high quality imaging services. Maintaining good employee and departmental policies is also important for quality management.
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1) Radiation exposure during weeks 8-15 of pregnancy poses the highest risk of detrimental effects like mental retardation and congenital abnormalities for the unborn child. Doses higher than 1Sv can cause abnormalities or death, while much lower doses may cause mental retardation.
2) The pre-implantation and organogenesis stages (weeks 2-9) are the most radiosensitive periods, as radiation exposure can cause embryonic or fetal death. During organogenesis, abnormalities are also more likely.
3) During the fetal growth stage, risks include mental retardation, diminished IQ, and increased risk of cancer induction depending on the trimester of exposure. Threshold doses exist for deterministic effects while stochastic effects like cancer have no
Treatment of cancer during pregnancy
The document summarizes treatment options for cancer during pregnancy. Radiation exposure should be limited to less than 100 mGy to avoid risks to the fetus like growth restriction and malformations. Ultrasound is the preferred imaging method, while CT and PET scans should be avoided. Surgery can be done at any time, and chemotherapy is usually postponed until the second trimester to reduce fetal risks. Radiotherapy poses risks and its timing depends on fetal dose, gestational age, and tumor location. Carbon ion therapy may allow localized dose deposition while minimizing fetal exposure. Outcomes for pregnancy after cancer generally depend on cancer type.
Imaging During Pregnancy
1. The document outlines guidelines for diagnostic imaging during pregnancy, dividing fetal development into three phases: pre-implantation, major organogenesis, and fetal development.
2. It provides threshold doses of radiation for potential biological effects on the fetus such as abortion, organ malformation, growth retardation, and mental impairment. The risks are negligible below 5 rads.
3. Estimated radiation doses are provided for various diagnostic x-ray exams and CT scans, with abdominal CT posing the highest risk at over 1 rad and requiring only 1-2 scans to reach the 5 rad threshold.
4. Guidelines recommend that medically necessary x-rays below 5 rads are safe, and ultrasound and MRI which have
Imaging in prgnancy
The document discusses the balance between risks and benefits of medical imaging during pregnancy. It describes various imaging modalities like X-ray, CT, MRI, and nuclear medicine. While ionizing radiation carries risks like childhood cancer, the risks are very low from typical medical exposures. MRI is generally safe in pregnancy without radiation. The risks of any diagnostic imaging must be weighed against the potential benefits for both mother and baby.
Breast cancer & pregnancy 1
Cancer during pregnancy presents complex ethical and medical challenges. While rare, it requires balancing treatment of the mother's cancer against risks to the developing fetus. Surgery is generally safest after the first trimester. Radiation and many chemotherapies carry risks of fetal abnormalities, especially in the first trimester. Later in pregnancy, risks are growth restriction and preterm birth. Ovarian cancer is one of the most common cancers complicating pregnancy. It can often be surgically staged and treated while allowing continuation of pregnancy for early-stage and low-risk histologies. However, treatment should not be delayed at the expense of the mother's prognosis. More research is needed due to the rarity of these cases.
Pregnancy Outcome in Cancer Patients
Pregnancy does not negatively impact cancer prognosis. Cancer can be diagnosed or treated during pregnancy with careful management. A multidisciplinary team is needed to determine the safest diagnostic methods and treatment options while minimizing risk to the fetus. Ultrasound and MRI are generally considered safe imaging techniques in pregnancy. Chemotherapy may be given during pregnancy for some cancers but is typically avoided in the first trimester and near delivery. Fertility can decrease after cancer treatment but pregnancy after treatment usually has a normal outcome.
Guidelines for Diagnostic Imaging During Pregnancy and Lactation.pdf
Ultrasonography and magnetic resonance imaging (MRI) are not associated with risk during pregnancy and are the preferred imaging techniques. While radiation exposure from other techniques like radiography and computed tomography is typically lower than levels linked to fetal harm, they should not be withheld if needed. The use of gadolinium contrast with MRI should be limited to situations where benefits outweigh risks, and breastfeeding need not be interrupted after gadolinium administration.
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Uterine anomalies are congenital malformations that result from abnormal development of the Mullerian ducts during embryogenesis. The most common types are caused by incomplete fusion of the Mullerian ducts. Uterine anomalies are associated with higher rates of infertility, recurrent miscarriage, and other pregnancy complications. They are classified according to the American Fertility Society system.
Pediatric and young_adult_patients_and_oncofertility
This document discusses fertility preservation options for pediatric and young adult cancer patients. It finds that cancer treatments can impair development and cause infertility through damage to the ovaries, uterus, testes or hypothalamic-pituitary axis. Pelvic radiation over 2 Gy, alkylating chemotherapy, and hematopoietic stem cell transplantation carry higher risks. The standard options for fertility preservation are embryo and sperm cryopreservation, though oocyte and ovarian tissue cryopreservation are gaining acceptance. No options exist yet for prepubertal boys, though experimental testicular tissue cryopreservation is available at some centers. All at-risk patients should discuss potential infertility with oncologists before starting treatment.
Pregnancy and breast cancer
Pregnancy-associated breast cancer (PABC) refers to breast cancer diagnosed during pregnancy or within one year postpartum. Breast cancer is one of the most common malignancies affecting pregnancy, with incidence increasing as more women delay childbearing. Diagnosis and treatment of PABC presents many challenges due to protecting both the mother and fetus. Surgery is generally safe during any trimester, while chemotherapy should be avoided in the first trimester and radiation therapy given only after delivery. Treatment requires a multidisciplinary approach tailored to the individual considering disease extent, gestational age, and minimizing harm to the pregnancy and fetus.
Fertility And Pregnancy Outcome In Cancer Patients
Better life of Cancer patients during childhood and age reproductive period regarding fertility, fertility preservation and pregnancy outcome is the main concern.concentrating upon different safe diagnostic modalities, management and outcome.
Management of ovarian cancer in pregnant woman
Management of ovarian cancer during pregnancy involves an interdisciplinary approach balancing maternal and fetal safety. For early stage cancer, surgery aims to completely resect tumors without disturbing the pregnancy. Chemotherapy is preferred in the second or third trimester using single agent carboplatin. For germ cell tumors, maximal surgery is undertaken initially and adjuvant chemotherapy with BEP is recommended postpartum except for stage IA dysgerminomas and grade I immature teratomas.
Cancer in pregnancy march 2012 ghatage co
Cancer diagnosed during pregnancy presents complex management challenges due to risks to both the mother and fetus. Treatment options are limited and none are ideal. For early-stage cancers detected in the first trimester, termination may be recommended to allow standard treatment. For late-stage or aggressive cancers, delaying treatment could risk the mother's life but termination is not acceptable to all. Collaboration between medical specialists is needed to determine the safest individualized approach.
Art f reduction
Multifetal pregnancies, especially those of higher order multiples, pose significant risks to both mother and fetuses. These risks include maternal complications such as preeclampsia and gestational diabetes as well as fetal complications like premature birth, low birth weight, and developmental impairments. Multifetal pregnancy reduction (MFPR) aims to reduce these risks by terminating one or more fetuses, leaving the remaining fetuses with improved health outcomes. While controversial, MFPR is generally considered ethically acceptable for reducing high order multiples and may provide benefits for triplet pregnancies. The procedure involves using ultrasound guidance to transvaginally inject a needle into the selected fetus between 7-12 weeks gestation.
Gynaecology cancer awareness
This document discusses several types of gynecological cancers that commonly affect women, including cervical, uterine, and ovarian cancer. It provides information on risk factors, prevention methods like HPV vaccination and cancer screening, signs and symptoms, and treatment types. The three most common cancers are breast, colorectal, and cervical cancer. Cervical cancer can often be linked to HPV infection and lacks symptoms in early stages. Screening through Pap tests and HPV testing is effective for prevention and early detection.
Gynaecology cancer awareness
This document discusses several types of gynecological cancers that commonly affect women, including cervical, uterine, and ovarian cancers. For cervical cancer, it provides information on risk factors like HPV infection and sexual behaviors. It also discusses methods of prevention through vaccination and screening. For uterine and ovarian cancers, it outlines risk factors like obesity, hormone use, genetics, and reproductive history. Prevention methods include prophylactic surgery for high-risk individuals and lifestyle changes. Screening methods and common presenting symptoms are also summarized for each cancer type.
Gynaecology cancer awareness
This document discusses several types of gynecological cancers that commonly affect women, including cervical, uterine, and ovarian cancer. It provides information on risk factors, prevention methods like HPV vaccination and cancer screening, signs and symptoms, and treatment types. The three most common cancers are breast, colorectal, and cervical cancer. Cervical cancer can often be linked to HPV infection and lacks symptoms in early stages. Screening through Pap tests and HPV testing is effective for prevention and early detection.
Pregnancy associated breast cancer
Pregnancy-associated breast cancer has an incidence of about 1 in 3,000 pregnancies. Diagnosis can be difficult and delayed due to physiological changes during pregnancy. Breast ultrasound is the standard method for evaluating breast masses during pregnancy, while mammography plays a limited role. Treatment requires a multidisciplinary approach and depends on cancer stage and pregnancy trimester. Prognosis does not seem to differ from non-pregnant patients, and breastfeeding after treatment is generally encouraged when safe.
EASO2011 PanArab 4 Pentheroudakis
The document discusses cancer diagnosis and treatment during pregnancy. It provides recommendations for diagnostic imaging and staging tests during pregnancy to minimize radiation exposure to the fetus. Chemotherapy can be given in the 2nd and 3rd trimesters but is riskier in the 1st trimester due to risks of miscarriage and birth defects. Surgery is generally safe during pregnancy with highest risk of miscarriage for 1st trimester or abdominal operations. Prognosis for pregnant women with cancer is often similar to non-pregnant patients if diagnosed at the same stage.
Recurrent pregnancy loss
The document discusses recurrent pregnancy loss (RPL), defined as 3 or more consecutive pregnancy losses before 20 weeks of gestation. It outlines various etiological factors that can cause RPL, including anatomical, endocrine, immunological, genetic, thrombophilic, and environmental factors. For evaluation and treatment, it recommends investigating common, treatable causes first such as uterine anomalies, thyroid disorders, antiphospholipid syndrome, and thrombophilias. Treatments discussed include surgery, medications, lifestyle changes, and assisted reproductive technologies.
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L13.2 Occup Radioprot
The document discusses occupational exposure and radiation protection measures for workers in diagnostic and interventional radiology. It covers personal protective equipment, individual monitoring and dose assessment, investigation protocols for exceeding dose limits, health surveillance of workers, and record keeping requirements. Protective equipment like lead aprons and thyroid shields are required, and individual monitoring using dosimeters like TLD badges is used to assess exposure levels. Investigation is required if monthly effective doses exceed 0.5 mSv or doses over lead aprons exceed 5 mSv. Records of training, doses, and quality control tests must be maintained.
L13.1 Occup Regulatory
This document summarizes regulatory requirements for occupational radiation exposure in diagnostic and interventional radiology. It outlines responsibilities for licensees to limit and optimize doses, provide protective equipment and training, and maintain records. It also describes classification of controlled and supervised work areas, local rules for radiation safety, and requirements to restrict access and display warning symbols in controlled areas. Employers must make reasonable efforts to provide alternative work arrangements for employees who can no longer safely work with radiation.
L12 Shielding
This document discusses key considerations for designing radiation shielding in diagnostic radiology facilities. It outlines parameters to calculate shielding needs such as workload, occupancy, equipment used, and dose constraints. Common materials for shielding like lead, concrete, and gypsum are mentioned. The importance of continuity of shielding and reducing penetrations is emphasized. Record keeping of shielding design is recommended.
L08 Image Quality
The document discusses factors that affect image quality in diagnostic and interventional radiology. It describes key parameters of image quality including noise, resolution, and contrast. It outlines various factors that influence these parameters such as technique settings, patient factors, and characteristics of the imaging system and receptor. These factors can impair image quality by increasing unsharpness and reducing the detectability of anatomical structures.
L13.2 Occup Radioprot
The document discusses occupational exposure and radiation protection measures for workers in diagnostic and interventional radiology. It covers personal protective equipment, individual monitoring and dose assessment, investigation protocols for exceeding dose limits, health surveillance of workers, and record keeping requirements. Protective equipment like lead aprons and thyroid shields are required, and individual monitoring using dosimeters is used to assess exposure levels. Investigation is required if monthly effective doses exceed 0.5 mSv or doses over lead aprons exceed 5 mSv. Records of training, doses, and quality control tests must be maintained.
L13.1 Occup Regulatory
This document summarizes regulatory requirements for occupational radiation exposure in diagnostic and interventional radiology. It outlines responsibilities for licensees to limit and optimize doses, provide protective equipment and training, and maintain records. It describes dose limits and classification of controlled areas where specific protections are required. Local rules must be established, including procedures for personal dosimetry, minimizing exposure during unusual events, and ensuring work is adequately supervised.
L12 Shielding
This document discusses key considerations for designing radiation shielding in diagnostic radiology facilities. It outlines parameters to calculate shielding needs such as workload, occupancy, beam direction and tube leakage. Common shielding materials like lead, concrete and gypsum are described. The importance of continuity, integrity and quality control of the shielding installation is emphasized through inspection and record keeping.
L10 Patient Dose
This document discusses patient dose assessment in diagnostic and interventional radiology. It covers parameters that influence patient exposure like tube voltage and current. It also discusses different dosimetry methods like measuring entrance surface dose, dose area product, and computed tomography dose index. Finally, it addresses instrument calibration and how to accurately measure dose indicators through techniques like thermoluminescent dosimetry.
L09 Med Exp Bss
The document discusses the requirements of the International Basic Safety Standards (BSS) regarding medical exposure and the investigation of accidental exposures. It outlines the international organizations involved in regulating radiation protection, and the BSS requirements for justification, optimization of protection, and design of medical exposure equipment to minimize unintended exposure. The responsibilities of facilities and practitioners in ensuring proper medical procedures and oversight are also summarized.
L05 Interaction
The document discusses the interaction of radiation with matter. It covers topics including the atomic structure, quantities and units used in physics, production of bremsstrahlung and characteristic x-rays, photon interactions such as the photoelectric effect and Compton scattering, beam attenuation, and the principles of radiological image formation. The interaction of radiation depends on factors like the photon energy and atomic number of the absorbing material. Different interaction mechanisms dominate based on these factors and contribute to image contrast in medical imaging.
L03 Biological Effects
The document discusses the biological effects of ionizing radiation, including:
1) Radiation can cause both deterministic effects (effects above a threshold dose like cataracts) and stochastic effects (effects like cancer that have no threshold) through damage to cells.
2) Factors like dose rate, cell type, and oxygen levels affect radiosensitivity. Highly mitotic and undifferentiated cells are more sensitive.
3) Dose response curves show the relationship between dose and effect. Skin effects range from erythema to necrosis depending on dose.
4) Whole body irradiation can cause acute radiation syndrome depending on dose, with effects on bone marrow, GI tract and CNS. Fetal exposure
L04 Internat System
The document discusses the international system of radiation protection. It describes the key organizations that establish standards and recommendations, including the ICRP, IAEA, and UNSCEAR. The system is based on principles of justification, optimization and dose limitation. The ICRP provides recommendations, the IAEA establishes safety standards, and UNSCEAR studies radiation effects. Dose limits are established for occupational, medical and public exposures to restrict radiation doses.
Xray Production
The document discusses the key components of an X-ray production system, including the cathode, anode, generator, and tube rating charts. The cathode emits electrons via a heated filament towards the anode. X-rays are produced when electrons collide with the anode. Generators supply power to heat the cathode and accelerate electrons. Tube rating charts indicate safe operating limits based on heat loading to prevent damage. Automatic exposure control uses radiation detectors to optimize exposure time based on patient thickness.
Radiation protection Overview
This document provides an overview of key concepts in radiation protection for diagnostic radiology, including:
- Medical exposure involves exposing patients for diagnosis or treatment, following principles of justification and optimization.
- Justification involves assessing if a procedure does more good than harm at the individual, generic, and general levels.
- Optimization aims to keep patient doses as low as reasonably achievable given image quality needs.
- Guidance levels indicate typical dose levels and help identify unusually high exposures requiring review. They are not dose limits.
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L14 Pregnancy
- 1. RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY L14: Radiation exposure in pregnancy IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
- 5. Part 14: Radiation exposure in pregnancy Topic 1: Introduction to the problem IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
- 7. Example of justified use of CT in a pregnant female who was in a motor vehicle accident
- 8. Free blood Kidney ripped off aorta (no contrast in it) Splenic laceration 3-minute CT exam and taken to the operating room. She and the child survived.
- 10. Inadvertent exposure LMP Periods due Psychological issue or uncertainty 14 28 Exposure period Qn. How sensitive is early conceptus
- 14. Part 14: Radiation exposure in pregnancy Topic 2: Example of dose IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
- 18. Approximate fetal doses from conventional X Ray examinations ( data from the UK 1998 ) t h o ra ci c s p i n e < 0 . 0 1 < 0 . 0 1 M e an ( mGy ) M a x i mum ( mGy ) A b d o men 1 . 4 4 . 2 C h es t < 0 . 0 1 < 0 . 0 1 I n t r a v e no u s u r o g r a m o r l um b a r s p i n e 1 . 7 1 0 P e l vi s 1 . 1 4 S k u ll o r
- 19. Approximate fetal doses from fluoroscopic and computed tomography procedures (data from the U.K. 1998)
- 21. Part 14: Radiation exposure in pregnancy Topic 3: Fetal radiation risk IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
- 25. Heterotopic gray matter (arrows) near the ventricles in a mentally retarded individual occurring as a result of high dose in-utero radiation exposure
- 26. Frequency of microcephaly as a function of dose and gestational age occurring as a result of in-utero exposure in atomic bomb survivors (Miller 1976)
- 29. Probability of bearing healthy children as a function of radiation dose
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