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Medical uses of ionising radiations


Chapter 09

  1. Medical and dental radiodiagnosis installations
    1. Presentation of the equipment inventory
      1. Medical radiodiagnosis
      2. Interventional radiology
      3. Dental radiodiagnosis
    2. Technical rules for radiology and tomography installations
  2. Nuclear medicine
    1. Presentation of nuclear medicine activities
      1. In vivo diagnosis
      2. In vitro diagnosis
      3. Internal radiotherapy
      4. The shortage of technetium-99m
      5. The new nuclear medicine tracers
    2. Nuclear medicine unit organisation and operating rules
  3. Radiotherapy
    1. Presentation of radiotherapy techniques
      1. External radiotherapy
      2. Brachytherapy
      3. The new radiotherapy techniques
    2. Technical rules applicable to installations
      1. Technical rules applicable to external radiotherapy installations
      2. Technical rules applicable to brachytherapy installations
  4. Blood product irradiators
    1. Description
    2. Blood product irradiator statistics
    3. Technical rules applicable to installations
  5. Source suppliers
  6. The state of radiation protection in the medical sector
    1. Radiation protection of medical workers
      1. General indicators
      2. Dosimetry
      3. Significant radiation protection events liable to affect medical workers
    2. Radiation protection of patients
      1. Human resources (medical radiation physics, training)
      2. Patient exposure from medical imaging
      3. Radiotherapy treatment security
      4. Radiation protection of nuclear medicine patients
      5. Significant radiation protection events liable to affect patients
    3. The impact on the environment and the population
      1. Dosimetric impact on the population
      2. Significant events
  7. Outlook

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With a cure rate of about 80% of patients treated, radiotherapy is a fully justified method for cancer treatment. However, in the light of the organisational weaknesses detected during inspection of some radiotherapy centres, ASN will – with the assistance of its regional divisions – be maintaining its inspections at least until 2012 in all radiotherapy centres: particular vigilance will be given to the actual increase in medical radiation physics staffing levels, to compliance with the interim criteria published in July 2009 by the Minister for Health and to the gradual development of quality assurance, concerning which the first requirements will become binding as of the beginning of 2010.

At the beginning of 2010, at a meeting of the national committee in charge of monitoring the national radiotherapy action plan decided on by the Minister for Health, ASN will be presenting the conclusions of the international conference it organised in December 2009 on the radiation protection of radiotherapy patients. This will allow identification of any additional actions required. ASN will continue with its international consultations with IAEA, WHO and the European Commission, in order to identify new initiatives or areas of research to improve knowledge and increase the safety of radiotherapy care.

In the field of interventional radiology, in particular for the practices involving the highest levels of irradiation, ASN intends to send recommendations to the Minister for Health, based on the advice of the Advisory Committee for medical exposure, so that a national action plan can be defined to improve radiation protection of patients and professionals in this field.

In the field of tomography, and without waiting for the new IRSN and InVS dosimetry estimates of the average doses delivered to patients during radiological examinations, ASN will define the measures necessary to promote non-irradiating techniques (updating of the SFR medical imaging guide), steps to train technicians in optimisation, and implementation of procedures for evaluation of professional practices (clinical audit) in radiology. At a European level, as part of the work done by the Heads of European Radiation Control Authorities (HERCA), ASN will take part in the steps to be taken with the manufacturers of radiology and tomography appliances.

Finally, after publication of the radiotherapy inspection follow-up letters on www.asn.fr in July 2008 ASN will, as of the beginning of 2010, pursue its goal of publishing all the follow-up letters to the radiation protection inspections conducted in the medical sector.

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