RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY

1. IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology RADIATION PROTECTION INDIAGNOSTIC ANDINTERVENTIONAL RADIOLOGY Part 12.2 : Shielding and X-ray room design Practical exercise - Inspection

2. Overview / Objectives • Subject matter : Inspection of diagnostic radiology department • Step by step procedure to be followed • Interpretation of results 12.2 : Shielding and X-ray room design

3. IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology Part 12.2 : Shielding and X-ray room design Practical exercise - Check list inspection of diagnostic radiology department

4. Radiology Department Features • Physical • Access, and access restriction • Separation of work and public areas • Radiation signs (trefoils, illuminated signs) • Shielding construction and materials • Protective equipment • Operational • QC program • Local rules • Staff qualifications and training 12.2 : Shielding and X-ray room design

5. Radiology Department Infrastructure • This must include : • electrical power • heating, ventilation and air conditioning (HVAC) • floor space and floor loading • links to other critical areas e.g., emergency 12.2 : Shielding and X-ray room design

6. Design Principles (1) • For a safe radiation environment, there are certain principles and considerations: • “separation” of different functional areas helps control access : • public areas (waiting, change etc.) • staff areas (offices, meeting rooms etc.) • work areas (radiation rooms, dark rooms, labs.) 12.2 : Shielding and X-ray room design

7. Patient Access Corridor • Note : • room numbers • access to change rooms • no access to staff areas 12.2 : Shielding and X-ray room design

8. Controlled Areas 12.2 : Shielding and X-ray room design

9. Design Principles (2) • Control of public access to work areas • work areas will normally be controlled areas, therefore public can only access when being examined or treated • Flow of staff to, from, and within work areas - separate from public areas 12.2 : Shielding and X-ray room design

10. Design Principles (3) • Consideration of spaces adjacent to radiation areas, including above and below • Storage space required (always need more than anticipated!!) • Lab, teaching, and meeting areas 12.2 : Shielding and X-ray room design

11. Design Principles (4) • Film processing and storage • location relative to radiation areas • chemical storage and disposal • ventilation (glutaraldehyde fumes) • silver recovery • bulk film storage 12.2 : Shielding and X-ray room design

12. Categories of Radiology Departments • WHO (1988) has three categories : • general radiography, general ultrasound, general fluoroscopy, conventional tomography • as Level 1, plus Doppler ultrasound, mammography, angiography (incl. DSA), CT • as Level 2, with more sophisticated techniques, plus MRI 12.2 : Shielding and X-ray room design

13. Radiology Room Features • X-ray tube(s) and table • Chest stand • Change room(s) • Operator’s console • Darkroom and film storage • Surrounding areas (use, occupancy) • Shielding 12.2 : Shielding and X-ray room design

14. Typical Room Design 12.2 : Shielding and X-ray room design

15. Department Design (1) • Larger departments, with ~ 4 or more rooms can be arranged to have separated traffic flows, but small departments can do this by having separate entry for staff and patients 12.2 : Shielding and X-ray room design

16. Department Design (2) • X-ray rooms : • must be large enough for the equipment (remember a chest stand) • must have sufficient space for patient transport (wheel chair, gurney or trolley, etc.) and for staff to transfer patient to x-ray examination table (if inpatient facility) • should have at least one patient change cubicle accessible from outside the room • must locate the operator’s console where the primary beam will NEVER be directed towards it, but where the patient can be easily observed 12.2 : Shielding and X-ray room design

17. Fluoroscopy Room Operator’s Area Note : Lead glass, clear view, good lighting 12.2 : Shielding and X-ray room design

18. Fluoroscopy Room 12.2 : Shielding and X-ray room design

19. Department Design (3) • must be able to accommodate large beds and trolleys, and any anaesthetic equipment likely to be used • must locate holes in floors for cables away from radiation beams, or be shielded • should have radiation warning signs on all doors • should have radiation warning lights outside for fluoroscopy, angiography and CT 12.2 : Shielding and X-ray room design

20. C-Arm Fluoroscopy UnitNote:Image intensifier X-ray tube under patient For lateral projection, image intensifier should be next to physician carrying out the procedure 12.2 : Shielding and X-ray room design

21. CT Room Entrance Note : illuminated warning sign sliding shielded doors radiation warning sign 12.2 : Shielding and X-ray room design

22. Protective Equipment • Lead vinyl materials, especially gowns • Lead vinyl is 0.3 - 0.5 mm + equivalent • Front is more important than rear • Can be partially open at rear (only high Pb) if staff member is not standing with back towards patient • Must be tested new and ~ every 12 months (using fluoroscopy) 12.2 : Shielding and X-ray room design

23. Radiology Work Area Note : rack for lead gowns, and easy access to all work rooms for staff 12.2 : Shielding and X-ray room design