This document discusses guidelines for imaging pregnant women to minimize radiation risk to the fetus. It provides that for most extra-abdominal exams, the fetal radiation dose is less than 0.1 mSv and risks are only increased above 150 mSv. Exams of the abdomen/pelvis can deliver up to 25 mGy but rarely exceed risks. Proper screening and documentation of pregnancy status is important. Guidelines recommend explicit questioning and documentation of last menstrual period and fetal risks/benefits should be considered before higher dose exams. Increased awareness through signage is suggested.
Presentation contains info on Radiation Protection in Pregnancy - radiodiagnosis, MRI, nuclear medicine and radiotherapy. Including notes on foetal dose, shielding techniques in radiotherapy and precaution for pregnant radiographers/medical physicists.
This document discusses quality control and quality assurance for x-ray machines. It outlines various tests that should be conducted, including central beam alignment, focal spot size, tube voltage, and timer checks. These tests help ensure the machine is functioning properly and producing high quality images. Acceptable tolerances and testing frequencies are provided. The roles of the quality assurance committee, including the medical physicist, radiologist, biomedical engineer, and technicians are described.
This free eBook was written to help Radiologic Technologists improve their image quality and understand some of the latest tools and techniques available with Computed and Digital Radiography equipment.
Guidelines for Diagnostic Imaging During PregnancySun Yai-Cheng
The document provides guidelines for diagnostic imaging during pregnancy from the American College of Obstetricians and Gynecologists. It states that exposure to less than 5 rads of radiation from a single x-ray procedure is not associated with increased risks of fetal anomalies or loss. Ultrasonography and MRI are the preferred imaging methods during pregnancy as they have no known adverse fetal effects. Contrast agents may be used if the diagnostic benefit outweighs the potential risk to the fetus.
Safety of Diagnostic Imaging Procedures During PregnancyAshraf ElAdawy
1. The document discusses the risks and realities of diagnostic radiography during pregnancy, noting that while maternal illness may require imaging, radiation exposure poses potential risks to the fetus that must be balanced against medical benefits.
2. Risks to the fetus from radiation exposure include cell death, teratogenic effects like growth issues and malformations, carcinogenesis, and genetic mutations. The risks are highest during early pregnancy and decline in the second and third trimesters.
3. No adverse effects are statistically proven from diagnostic radiation levels below 5 rads, and no single diagnostic procedure exceeds this cumulative dose limit during pregnancy.
Beam hardening artifact occurs when an X-ray beam passes through multiple materials of varying densities within a scan volume. This causes the beam to become harder as lower energy photons are preferentially absorbed, leading to streaks or shading in the reconstructed CT image. Photon starvation is another cause of streak artifacts, occurring when there is insufficient photon flux passing through areas of higher attenuation, such as across the shoulders. Adaptive filtering and modulating tube current based on attenuation can help reduce these artifacts. Ring artifacts from defective detector elements in older CT scanners appear as rings in the reconstructed images.
Presentation contains info on Radiation Protection in Pregnancy - radiodiagnosis, MRI, nuclear medicine and radiotherapy. Including notes on foetal dose, shielding techniques in radiotherapy and precaution for pregnant radiographers/medical physicists.
This document discusses quality control and quality assurance for x-ray machines. It outlines various tests that should be conducted, including central beam alignment, focal spot size, tube voltage, and timer checks. These tests help ensure the machine is functioning properly and producing high quality images. Acceptable tolerances and testing frequencies are provided. The roles of the quality assurance committee, including the medical physicist, radiologist, biomedical engineer, and technicians are described.
This free eBook was written to help Radiologic Technologists improve their image quality and understand some of the latest tools and techniques available with Computed and Digital Radiography equipment.
Guidelines for Diagnostic Imaging During PregnancySun Yai-Cheng
The document provides guidelines for diagnostic imaging during pregnancy from the American College of Obstetricians and Gynecologists. It states that exposure to less than 5 rads of radiation from a single x-ray procedure is not associated with increased risks of fetal anomalies or loss. Ultrasonography and MRI are the preferred imaging methods during pregnancy as they have no known adverse fetal effects. Contrast agents may be used if the diagnostic benefit outweighs the potential risk to the fetus.
Safety of Diagnostic Imaging Procedures During PregnancyAshraf ElAdawy
1. The document discusses the risks and realities of diagnostic radiography during pregnancy, noting that while maternal illness may require imaging, radiation exposure poses potential risks to the fetus that must be balanced against medical benefits.
2. Risks to the fetus from radiation exposure include cell death, teratogenic effects like growth issues and malformations, carcinogenesis, and genetic mutations. The risks are highest during early pregnancy and decline in the second and third trimesters.
3. No adverse effects are statistically proven from diagnostic radiation levels below 5 rads, and no single diagnostic procedure exceeds this cumulative dose limit during pregnancy.
Beam hardening artifact occurs when an X-ray beam passes through multiple materials of varying densities within a scan volume. This causes the beam to become harder as lower energy photons are preferentially absorbed, leading to streaks or shading in the reconstructed CT image. Photon starvation is another cause of streak artifacts, occurring when there is insufficient photon flux passing through areas of higher attenuation, such as across the shoulders. Adaptive filtering and modulating tube current based on attenuation can help reduce these artifacts. Ring artifacts from defective detector elements in older CT scanners appear as rings in the reconstructed images.
Macroradiography is a radiographic technique used to magnify images relative to the object being imaged. It works by increasing the object-to-film distance, which magnifies the image size. Key factors that affect image quality include geometric unsharpness, which increases with magnification, and limitations of the x-ray tube's fine focal spot, which restricts output. Macroradiography is useful for examining small bony structures and pulmonary patterns at higher magnification.
This document discusses Computed Radiography (CR) and Digital Radiography (DR), which are two methods for obtaining digital x-rays. CR uses existing x-ray machines and captures images digitally using imaging plates, which store x-ray data that is later extracted digitally. DR uses direct or indirect flat panel detectors in digital x-ray machines to directly or indirectly convert x-rays into electronic signals. Both methods allow for digital image processing and eliminate the need for darkroom film processing.
Mammography is the cornerstone imaging modality for breast cancer screening and diagnosis. It involves two standard views - craniocaudal and mediolateral oblique. Additional spot views may be needed based on findings. Image quality is optimized through use of specific equipment like molybdenum targets, grids, and compression to reduce thickness. Mammography finds masses and suspicious calcifications and uses the BI-RADS assessment system to characterize findings and guide need for biopsy. Regular screening can detect cancers early and improve outcomes.
K space is the domain where MRI data is stored during acquisition. It represents the spatial frequency content of the image, with each point containing information about the whole image. K space is filled line by line using gradients to encode phase and frequency, with the center lines containing contrast and the outer lines containing resolution. A Fourier transform converts the data into the actual image domain. Understanding k space is important for MRI physics and image reconstruction.
The document discusses factors that impact radiographic image quality, including film factors, geometric factors, and subject factors. Key aspects of image quality are spatial resolution, contrast resolution, noise, and artifacts. Spatial resolution refers to the ability to distinguish small structures, while contrast resolution is the ability to distinguish similar densities. Noise comes from film graininess and quantum mottle. The film's characteristic curve shows the relationship between exposure and optical density. Proper processing, including time, temperature and chemicals, is important for achieving good radiographic quality.
This document provides information about mammography, including its indications, types of examinations, basics, instrumentation, and procedures. Mammography uses low-energy x-rays to detect breast pathologies. It can be used for screening asymptomatic women, investigating breast lumps, or following up after breast surgery. Diagnostic mammograms use two or three views of each breast, while screening mammograms use a two-view protocol. Modern instrumentation includes flat panel detectors, grids, compression paddles, and automatic exposure control. Procedures involve craniocaudal and mediolateral oblique views. Reporting follows the BI-RADS system for risk assessment.
This document provides guidance for pediatric radiography technicians. It discusses preparing children for exams, building trust, using immobilization devices, evaluating developmental abnormalities, minimizing radiation exposure, and reporting suspected child abuse. Successful exams require preparing the room in advance, explaining the process to the child and parents, and using communication skills and immobilization as needed based on the child's age and cooperation level. Common pediatric conditions seen radiographically are also outlined.
This document discusses rules for minimizing radiation exposure during pregnancy, including the 10-day rule, 14-day rule, and 28-day rule. The 10-day rule, established in 1970 by ICRP, states that radiological exams of the lower abdomen and pelvis should be confined to the 10-day period following a woman's last menstrual period due to increased risk to the fetus in the first trimester. The 14-day rule restricts non-urgent pelvic x-rays to the first 14 days of the menstrual cycle. The 28-day rule, from 1984, says radiological exams can occur throughout the cycle until a period is missed, at which point the possibility of pregnancy should be considered. The document
This document discusses the advancement of mammographic equipment. It begins by introducing the components and purpose of mammography equipment. Key components discussed in detail include the x-ray tube, compressor, anti-scatter grid, cassette holder, and digital detectors. The document then covers recent advancements, such as digital mammography technologies like computed radiography, full-field digital mammography, and digital breast tomosynthesis, which uses 3D imaging to improve cancer detection rates.
The document discusses the history and development of artificial intelligence over the past 70 years. It outlines some of the key milestones in AI research from the early work in the 1950s to modern advances in deep learning. While progress has been made, fully general artificial intelligence that can match or exceed human levels of intelligence remains an ongoing challenge that researchers continue working to achieve.
CT is one of the highest contributor for medical radiation exposure to patients. Some common CT dose descriptors and dose optimizations methods are briefly described in this presentation.
Computed tomography (CT) utilizes X-rays and computer processing to produce cross-sectional images of the body. In CT, X-rays pass through the body and are measured by a detector array, with the data used to reconstruct tomographic slices. The key components of a CT scanner include an X-ray tube, detector array, data acquisition system, computer system, and display system. CT has advantages over plain films by eliminating superimposition of structures and increasing contrast, allowing clinicians to better distinguish between tissues.
This document discusses quality control procedures for CT scanners, including checking image quality metrics like resolution, noise, and CT number accuracy using phantoms. Regular quality control is recommended to establish baselines, identify potential problems early, and reduce downtime. Various tests are described to check parameters like resolution, noise, CT numbers, distance measurement accuracy, slice thickness, table movement, and laser alignment using specialized phantoms and protocols.
This document discusses various components of an MRI system including magnets, RF coils, gradient coils, and safety considerations. It describes the different types of magnets used in MRI like permanent, resistive, and superconducting magnets. It explains the purpose and types of RF coils and gradient coils used to generate the magnetic field gradients needed for spatial encoding in MRI. Safety aspects such as screening for metallic objects, specific absorption rate limits, and absolute contraindications for MRI are also summarized.
The document discusses several radiographic techniques. It explains that high kilovoltage technique uses kVp above 90 kVp to improve visualization of different tissue densities on a single chest x-ray. Soft tissue radiography requires a low kVp, like in mammography, to maximize contrast between low density soft tissues through increased differential absorption. Macroradiography magnifies the image size relative to the object through a greater source-to-film distance compared to source-to-object distance.
This document defines and provides examples of common CT artifacts, including their causes and potential solutions. It discusses ring artifact caused by a miscalibrated detector element; noise (photon starvation) caused by low photon counts; metal artifacts from multiple factors like beam hardening; and beam hardening artifact from polychromatic X-rays. Motion artifacts from patient movement are also addressed. Solutions include recalibrating detectors, increasing mA or kV, and using techniques like faster pitch or cardiac gating.
Computed Tomography Dose Index, Includes various CTDI parameters and the way of calculating effective dose from various Computed Tomography procedures along with their conversion factor.
NCRP National Council On Radiation ProtectionChandan Prasad
The National Council on Radiation Protection and Measurement (NCRP) is a US regulatory board established in 1929 to provide independent scientific analysis and recommendations on radiation protection for humans and the environment. It works with other organizations through two committees and seven program areas to establish guidance on radiation safety in areas like medicine, the environment, and security. The NCRP also cooperates with the International Commission on Radiological Protection to determine radiation dose limits based on analysis of risk.
1) Mammography is an x-ray exam used to detect breast changes, with modern machines using low doses of radiation.
2) The document discusses mammography techniques, including standard craniocaudal and mediolateral oblique views as well as additional views.
3) Contraindications and recommendations for screening are provided based on risk factors and age. The document provides an overview of mammography procedures and guidelines.
Fertility And Pregnancy Outcome In Cancer PatientsMamdouh Sabry
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.
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.
Macroradiography is a radiographic technique used to magnify images relative to the object being imaged. It works by increasing the object-to-film distance, which magnifies the image size. Key factors that affect image quality include geometric unsharpness, which increases with magnification, and limitations of the x-ray tube's fine focal spot, which restricts output. Macroradiography is useful for examining small bony structures and pulmonary patterns at higher magnification.
This document discusses Computed Radiography (CR) and Digital Radiography (DR), which are two methods for obtaining digital x-rays. CR uses existing x-ray machines and captures images digitally using imaging plates, which store x-ray data that is later extracted digitally. DR uses direct or indirect flat panel detectors in digital x-ray machines to directly or indirectly convert x-rays into electronic signals. Both methods allow for digital image processing and eliminate the need for darkroom film processing.
Mammography is the cornerstone imaging modality for breast cancer screening and diagnosis. It involves two standard views - craniocaudal and mediolateral oblique. Additional spot views may be needed based on findings. Image quality is optimized through use of specific equipment like molybdenum targets, grids, and compression to reduce thickness. Mammography finds masses and suspicious calcifications and uses the BI-RADS assessment system to characterize findings and guide need for biopsy. Regular screening can detect cancers early and improve outcomes.
K space is the domain where MRI data is stored during acquisition. It represents the spatial frequency content of the image, with each point containing information about the whole image. K space is filled line by line using gradients to encode phase and frequency, with the center lines containing contrast and the outer lines containing resolution. A Fourier transform converts the data into the actual image domain. Understanding k space is important for MRI physics and image reconstruction.
The document discusses factors that impact radiographic image quality, including film factors, geometric factors, and subject factors. Key aspects of image quality are spatial resolution, contrast resolution, noise, and artifacts. Spatial resolution refers to the ability to distinguish small structures, while contrast resolution is the ability to distinguish similar densities. Noise comes from film graininess and quantum mottle. The film's characteristic curve shows the relationship between exposure and optical density. Proper processing, including time, temperature and chemicals, is important for achieving good radiographic quality.
This document provides information about mammography, including its indications, types of examinations, basics, instrumentation, and procedures. Mammography uses low-energy x-rays to detect breast pathologies. It can be used for screening asymptomatic women, investigating breast lumps, or following up after breast surgery. Diagnostic mammograms use two or three views of each breast, while screening mammograms use a two-view protocol. Modern instrumentation includes flat panel detectors, grids, compression paddles, and automatic exposure control. Procedures involve craniocaudal and mediolateral oblique views. Reporting follows the BI-RADS system for risk assessment.
This document provides guidance for pediatric radiography technicians. It discusses preparing children for exams, building trust, using immobilization devices, evaluating developmental abnormalities, minimizing radiation exposure, and reporting suspected child abuse. Successful exams require preparing the room in advance, explaining the process to the child and parents, and using communication skills and immobilization as needed based on the child's age and cooperation level. Common pediatric conditions seen radiographically are also outlined.
This document discusses rules for minimizing radiation exposure during pregnancy, including the 10-day rule, 14-day rule, and 28-day rule. The 10-day rule, established in 1970 by ICRP, states that radiological exams of the lower abdomen and pelvis should be confined to the 10-day period following a woman's last menstrual period due to increased risk to the fetus in the first trimester. The 14-day rule restricts non-urgent pelvic x-rays to the first 14 days of the menstrual cycle. The 28-day rule, from 1984, says radiological exams can occur throughout the cycle until a period is missed, at which point the possibility of pregnancy should be considered. The document
This document discusses the advancement of mammographic equipment. It begins by introducing the components and purpose of mammography equipment. Key components discussed in detail include the x-ray tube, compressor, anti-scatter grid, cassette holder, and digital detectors. The document then covers recent advancements, such as digital mammography technologies like computed radiography, full-field digital mammography, and digital breast tomosynthesis, which uses 3D imaging to improve cancer detection rates.
The document discusses the history and development of artificial intelligence over the past 70 years. It outlines some of the key milestones in AI research from the early work in the 1950s to modern advances in deep learning. While progress has been made, fully general artificial intelligence that can match or exceed human levels of intelligence remains an ongoing challenge that researchers continue working to achieve.
CT is one of the highest contributor for medical radiation exposure to patients. Some common CT dose descriptors and dose optimizations methods are briefly described in this presentation.
Computed tomography (CT) utilizes X-rays and computer processing to produce cross-sectional images of the body. In CT, X-rays pass through the body and are measured by a detector array, with the data used to reconstruct tomographic slices. The key components of a CT scanner include an X-ray tube, detector array, data acquisition system, computer system, and display system. CT has advantages over plain films by eliminating superimposition of structures and increasing contrast, allowing clinicians to better distinguish between tissues.
This document discusses quality control procedures for CT scanners, including checking image quality metrics like resolution, noise, and CT number accuracy using phantoms. Regular quality control is recommended to establish baselines, identify potential problems early, and reduce downtime. Various tests are described to check parameters like resolution, noise, CT numbers, distance measurement accuracy, slice thickness, table movement, and laser alignment using specialized phantoms and protocols.
This document discusses various components of an MRI system including magnets, RF coils, gradient coils, and safety considerations. It describes the different types of magnets used in MRI like permanent, resistive, and superconducting magnets. It explains the purpose and types of RF coils and gradient coils used to generate the magnetic field gradients needed for spatial encoding in MRI. Safety aspects such as screening for metallic objects, specific absorption rate limits, and absolute contraindications for MRI are also summarized.
The document discusses several radiographic techniques. It explains that high kilovoltage technique uses kVp above 90 kVp to improve visualization of different tissue densities on a single chest x-ray. Soft tissue radiography requires a low kVp, like in mammography, to maximize contrast between low density soft tissues through increased differential absorption. Macroradiography magnifies the image size relative to the object through a greater source-to-film distance compared to source-to-object distance.
This document defines and provides examples of common CT artifacts, including their causes and potential solutions. It discusses ring artifact caused by a miscalibrated detector element; noise (photon starvation) caused by low photon counts; metal artifacts from multiple factors like beam hardening; and beam hardening artifact from polychromatic X-rays. Motion artifacts from patient movement are also addressed. Solutions include recalibrating detectors, increasing mA or kV, and using techniques like faster pitch or cardiac gating.
Computed Tomography Dose Index, Includes various CTDI parameters and the way of calculating effective dose from various Computed Tomography procedures along with their conversion factor.
NCRP National Council On Radiation ProtectionChandan Prasad
The National Council on Radiation Protection and Measurement (NCRP) is a US regulatory board established in 1929 to provide independent scientific analysis and recommendations on radiation protection for humans and the environment. It works with other organizations through two committees and seven program areas to establish guidance on radiation safety in areas like medicine, the environment, and security. The NCRP also cooperates with the International Commission on Radiological Protection to determine radiation dose limits based on analysis of risk.
1) Mammography is an x-ray exam used to detect breast changes, with modern machines using low doses of radiation.
2) The document discusses mammography techniques, including standard craniocaudal and mediolateral oblique views as well as additional views.
3) Contraindications and recommendations for screening are provided based on risk factors and age. The document provides an overview of mammography procedures and guidelines.
Fertility And Pregnancy Outcome In Cancer PatientsMamdouh Sabry
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.
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 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.
The document provides guidelines for performing a routine mid-trimester fetal ultrasound scan between 18-22 weeks gestation. It outlines the purpose, who should perform the scan, and what should be evaluated which includes fetal anatomy, growth, and well-being. Key recommendations include using standardized measurements and imaging protocols, producing a report for the referring provider, and minimizing fetal exposure during the scan. The guidelines aim to optimize outcomes for both mother and fetus through an accurate and safe examination.
This document discusses best practices for patient care in radiology departments. It emphasizes that patients should be treated with safety, quality care, comfort and minimal radiation exposure. It also stresses the importance of clear communication between radiology staff and patients to avoid errors. The document provides recommendations for optimizing various aspects of the patient experience, including minimizing wait times, increasing communication, and making the environment more welcoming. It suggests radiologists take a more active role in interacting with patients. Finally, it discusses various protocols to ensure patient privacy, safety and informed consent are maintained during examinations.
New microsoft office power point presentationMahwish Afzal
This document discusses comparing the efficacy of visual inspection with acetic acid (VIA) and pap smear as methods for cervical cancer screening in low resource settings. Cervical cancer is very common in Pakistan but there is no effective or affordable screening program. The objectives are to compare the sensitivity, specificity, and predictive values of VIA and pap smear, and to determine the prevalence of cervical abnormalities. VIA may be better for low resource areas as it is low cost, provides immediate results, and does not require follow up visits. The study aims to enroll women ages 25-60 to undergo both VIA and pap smear to evaluate which method is more effective for cervical cancer screening in Pakistan.
The document discusses the Ionising Radiation (Medical Exposure) Regulations 2000 (IR(ME)R) in the UK. There are three key principles of IR(ME)R: justification, optimization, and limitation. Justification requires that the benefits of an imaging exam outweigh the risks for individual patients. Optimization aims to keep radiation doses as low as reasonably possible through good technique and quality assurance. Limitation sets legal dose limits for workers, trainees, and the public. The regulations establish duty holders like employers, referrers, practitioners, and operators who are responsible for following the principles and protecting patients.
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.
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 therapeutic radiology can harm the fetus, with risks being greatest during organ development in the first trimester. Procedures should only be performed if the medical benefit outweighs the radiation risk to the fetus.
The Role of laparoscopy in the era of ARTDrRokeyaBegum
The advancement of new perspectives in assisted reproductive technology (ART) through the use of modern infertility evaluation technique Stillclinician needs to reassess how infertility should be best treated.
Recently the focus of treatment for infertility has shifted from systematic correction of each identified factor.
Fertility societies and organizations recommend suspending new fertility treatments during the COVID-19 pandemic to avoid complications, mitigate risks, and support reallocation of healthcare resources, but continuing fertility preservation for cancer patients if no symptoms present. Guidelines advise "freeze-all" approaches for current patients and maintaining support for patients while protecting staff safety through telemedicine, social distancing, and strict sanitization protocols in IVF laboratories. The uncertainties of the pandemic are causing patient anxiety, so clinics aim to communicate regularly and prioritize care once restrictions lift.
Focused reproductive endocrinology and infertility (2019) guidelineVõ Tá Sơn
Focused reproductive endocrinology and infertility (2019) image library, guideline,
Hình ảnh học siêu âm trong nội tiết sinh sản và vô sinh,
AIUM 2019,
Bs Võ Tá Sơn,
Explain the non safe or harm aspects of CT scan on the patient,, particularly after multiple CT scans done for one patient. mentioned essentially the risk of cancer in later life, which reach 1/2000.
Also, mentioned the organs, age group, and gender which affected more by CT radiation
Finally , stressing on eliminating CT scan as possible
Briefing Note: Cervical Cancer Screening in the Gwassi Division, Suba Distric...sarahsteklov
A briefing note on cervical cancer screening practices in the Gwassi Division, Suba District, Nyanza Province, Kenya. Includes WHO guidelines, a pilot study in a neighboring region and interview and survey data from the community.
This document discusses perinatal hydronephrosis (ANH), which refers to dilation of the renal pelvis detected on prenatal ultrasound in 1-3% of pregnancies. ANH is most commonly used to define this condition but measurements and definitions vary. Ultrasound remains the main imaging modality used, while MRI can provide additional detail. Factors like gestational age, bladder filling, and grading systems impact ANH assessment and prediction of postnatal outcomes. Counseling involves discussing differential diagnoses, natural histories, and management plans. Fetal intervention is rarely needed but may be considered to improve pulmonary and renal development in cases of late oligohydramnios or poor fetal urine markers.
Invited lecture by Dr Sujoy dasgupta in the Annual Conference of the "Academy of Clinical Embryologists" (ACE) held in October 2021 in "Hybrid mode" (Kolkata and Webinar)
This document provides guidance for obtaining informed consent from women undergoing diagnostic laparoscopy. It discusses the risks and benefits of the procedure, including both serious but rare risks like damage to internal organs, as well as more common but mild risks like bruising or shoulder pain. It recommends discussing any additional procedures that may become necessary during surgery. The goal of diagnostic laparoscopy is to identify the cause of a woman's symptoms, though it may not always provide a clear diagnosis.
This document discusses caesarean section (CS), including its risks, benefits, indications, and surgical technique. It covers topics such as the rising CS rate globally and factors influencing it, contraindications for CS, categories of urgency, optimal timing for elective CS, and techniques to minimize risks like infection and blood loss. Surgical steps are outlined in detail, from skin incision to uterine closure. Overall, the document provides a comprehensive overview of CS for medical professionals.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
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Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
2. Introduction
• The imaging of pregnant women presents a unique challenge to
radiologists because of the concern about the radiation risk to the
conceptus (ie, embryo or fetus).
• Thousands of pregnant women are exposed to ionising radiation
each year
• Lack of knowledge is responsible for great anxiety and probably
unnecessary termination of pregnancies
• For most patients, radiation exposure is medically appropriate and
the radiation risk to the fetus is minimal.
Lack of knowledge is responsible for great anxiety and
probably unnecessary termination of pregnancies
For most patients, radiation exposure is medically appropriate and the
radiation risk to the fetus is minimal
3. Example: justified use of CT
Pregnant female, was in motor vehicle accident
Fetal
skull
ribs
Blood
outside
uterus
Fetal dose 20 mGy
4. AAH POLICY- EMERGENCY
INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION ——————————————————————————————————————
• During emergency, if informed consent cannot be
obtained or no relative is available to sign on behalf of the
patient, the physician shall clearly document in electronic
radiology requisition, the reason for the examination and
sign the consent. The radiologist will document the
reason for the examination and steps taken to minimize
risks to the embryo/fetus in the radiology report.
5. INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION ——————————————————————————————————————
3 minute CT exam and taken to the
operating room. She and the child survived
Free blood
Kidney torn
off aorta (no contrast in it) Splenic laceration
6. Fetal radiation risk
There are radiation-related risks throughout
pregnancy that are related to the stage of pregnancy
and absorbed dose
Radiation risks are most significant during
organogenesis and in the early fetal period, somewhat
less in the 2nd trimester, and least in the 3rd trimester
Less Least
Most
risk
7. INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION ——————————————————————————————————————
Radiation-induced malformations
Malformations have a threshold of 100-200 mGy or
higher and are typically associated with central nervous
system problems
Fetal doses of 100 mGy are not reached even with 3
pelvic CT scans or 20 conventional diagnostic x-ray
examinations
These levels can be reached with fluoroscopically
guided interventional procedures of the pelvis and with
radiotherapy
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Central nervous system effects
During 8-25 weeks post-conception the CNS is
particularly sensitive to radiation
Fetal doses in excess of 100 mGy can result in some
reduction of IQ (intelligence quotient)
Fetal doses in the range of 1000 mGy can result in
severe mental retardation and microcephaly,
particularly during 8-15 weeks and to a lesser extent
at 16-25 weeks
9.
10. Radiation Risk
Radiation exposure that is extra-abdominal will not
contribute significant radiation dose to the developing
embryo/fetus.
For most extra-abdominal exams, including CT, the
radiation dose to the embryo/fetus is less than 0.1 mSv (10
mrem).
11. Radiation Risk
Radiation exposure that is extra-abdominal will not
contribute significant radiation dose to the developing
embryo/fetus.
For most extra-abdominal exams, including CT, the
radiation dose to the embryo/fetus is less than 0.1 mSv (10
mrem).
“The risk of malformation is increased only at
levels above 150 mSv (15 rem).”
12. Radiation Risk
If the radiation dose is received between the second
and eighth post-conception weeks, therapeutic
abortion based solely on radiation exposure is not
advised for doses less than 150 mSv (15 rem).
13. Approximate fetal doses from
conventional x-ray examinations
Data from the UK, 1998
Dose
Examination
Mean (mGy) Maximum (mGy)
Abdomen 1.4 4.2
Chest <0.01 <0.01
Intravenous uro-
gram; lumbar spine
1.7 10
Pelvis 1.1 4
Skull;
thoracic spine
<0.01 <0.01
14. Approximate fetal doses from fluoroscopic and
computed tomography procedures
Data from the UK, 1998
Dose
Examination
Mean (mGy) Maximum (mGy)
Barium meal (UGI) 1.1 5.8
Barium enema 6.8 24
Head CT <0.005 <0.005
Chest CT 0.06 1.0
Abdomen CT 8.0 49
Pelvis CT 25 80
15. Clinical Imaging Institute
Audit: Pregnancy Questioning
.Objectives: To exclude the possibility of pregnancy in
female of childbearing age who are undergoing
radiography.
Audit Plan: Continuous
Place of study: Clinical Imaging Institute/Al Ain Hospital.
Duration of study: 4 months.
Sample size: 100 patients were evaluated in this study.
16. Data collection method
• Our local process is as follows:
• Female patients of childbearing age, who will undergo
x-ray procedures are screened for possibility of
pregnancy.
• They sign the consent form which is given to the
department secretary who then records the medical
record numbers in a logbook before it is sent to HIM
department to be filed in patients file.
• These forms are sent to HIM department on a weekly
basis.
17.
18. Method
• Patients who had X-rays were identified through
the logbook kept with secretary and Cerner
online worklist .
• Data was compiled in table format and
descriptive analysis was performed.
• Study was focused on female patients age 12-
50.
• Consent was documented.
23. Data Analysis and result:
• Percentages:
• 82% cases= CT
• 18% cases= Xray
• 38% cases where abdomen/pelvis area
examined.
• 62% cases ,away from the adomen/pelvis
area.
24. Discussion
• Study shows that CT section is more compliant with
documenting consent for their female patients as
compared to x-ray.
• Radiographer’s say that they enquire verbally and
document on Cerner.
• How safe is this practice?
• Consent form should include the signature of the staff
who has taken the consent as well. Forms to be filled
showing LMP date.
25. Guidelines:
• Based on the current knowledge, the following
guidelines should be adhered to;
• Routine examinations-28 day rule.
• For non-urgent examinations involving high doses to
uterus in patients who are at risk of pregnancy but not
yet overdue, - “10 day rule”
• Radiation exposure of the lower abdomen and pelvis of
women of childbearing potential should be kept to a
minimum. During pregnancy, radiation to these regions
should only occur if the radiological examination
cannot be postponed because of the urgent nature of
the investigation
26. Specific guidelines:
• Taken from Radiological Protection Institute of Ireland.
• The referring clinician has a responsibility to ensure
that the examination is justified and shall provide the
radiologist with all relevant information as part of the
examination request.
• For high dose examinations, involving greater than 10
mGy to the fetus, the 10 day rule should be applied4.
• For urgent examinations that are justified irrespective
of pregnancy status,a clinical waiver section within the
request, should be completed by the referring clinician.
27. Specific guidelines
• When a female patient of reproductive capacity presents for any
radiological procedure involving ionizing radiation, the following
process should be applied:
• The patient should be explicitly asked by the radiologist, the
radiographer or the radiology nurse, whether she is or might be
pregnant and her answer should be recorded in writing. The
record should be kept according to local protocol. The date of
the first day of the last menstrual period (LMP) of the patient
should be recorded.
• A brief but simple explanation should follow, such as: “I have to
ask because radiation in pregnancy may increase the risk of
childhood cancer above the natural baseline level”
• The examination may proceed if the patient states that she is
not pregnant and has signed a consent form.
28. Specific guidelines
• When a patient answers that she: is pregnant, or might be
pregnant or cannot exclude the possibility of pregnancy and the
menstrual period is overdue the referring clinician should be
asked to review the justification for the examination, bearing in
mind the possible presence of a fetus.
• When there is definite pregnancy, or potential for an unknown
• pregnancy, the review of justification should consider the
following:
• n Is there a suitable alternate approach to imaging using non-
ionising radiation, e.g. ultrasound or magnetic resonance?
29. Specific guidelines
• Is the examination critical to immediate and essential patient
management, or could management proceed if the examination
is deferred until pregnancy can be completed or definitely
excluded?
• Is the likely fetal radiation dose and risk of the examination
greaterthan the benefit of the examination and/or greater than
the risk incurred by not doing the examination?
• The use of contraception does not rule out pregnancy. Whilst
contraceptive use mitigates against the likelihood of pregnancy,
the efficacy of the method used is a matter for professional
judgment and where there is doubt, these guidelines should be
followed.
30. Specific guidelines
• When an examination is justified during pregnancy or
when pregnancy cannot be ruled out, all accepted
methods of optimising the examination and reducing
the dose delivered should be applied.
• Additional guidance:
• A clearly displayed multi-lingual notice briefly
explaining the importance of declaring a pregnancy
before an X-ray examination is recommended.
• For non-English speaking patients, the hospital
interpretation services should be used.
31. Suggestions:
• Do we have enough signage? Increase the
number and distribution of posters and patient
information leaflets to create awareness about
pregnancy and radiation.
Ability to scan the consent forms into PACS would
greatly facilitate such an audit.
34. Conclusion
• Radiographic, fluoroscopic, and CT examinations in
areas of the body other than the abdomen and pelvis
deliver minimal radiation doses to the fetus.
• Radiographic, fluoroscopic, and CT examinations of
the abdomen and pelvis and from nuclear medicine
studies rarely exceed 25 mGy.
• While this information may reassure pregnant women
and their physicians about the risks from necessary or
unintended radiation exposures, conservative clinical
management is the best way of minimizing radiation
risk in utero.
35. References
• 1. International Commission on Radiological Protection. Statement from
the 1983 Washington meeting of ICRP. Annals of International Commission
on Radiological Protection 1984:14
• 2. National Radiological Protection Board. Exposure to ionizing radiation of
pregnant women: advice on the diagnostic exposure of women who are, or
who may be pregnant. ASP8.NRPB, 1985.
• 3. College of Radiographers and Royal College of Radiologists. Guidelines
for implementation of ASP8.NRPB, 1986.
• 4. National Radiation Protection Board. Board statement on diagnostic
medical exposure to ionising radiation during pregnancy and estimates of
late radiation risks to the UK population. Documents of the NRPB 1993;
4(4):1-14.
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Web sites for additional information
on radiation sources and effects
European Commission (radiological protection pages):
europa.eu.int/comm/environment/radprot
International Atomic Energy Agency:
www.iaea.org
International Commission on Radiological Protection:
www.icrp.org
United Nations Scientific Committee on the Effects of
Atomic Radiation:
www.unscear.org
World Health Organization:
www.who.int