When the ill need protection from the cure

October 17, 2008

In the quest to discover the root of illnesses, patients have to undergo an increasing number of scans and tests that may involve the use of ionising radiation to detect the source and scope of an ailment. However, this practice could also put patients at risk.

"There has been concern that new technologies are not providing the amount of patient protection that medical professionals had expected. This comes from continued radiation accidents in radiotherapy facilities, and continued reports of unnecessary radiation doses to patients in those diagnostic examinations," says the IAEA's Madan Rehani, a Radiation Safety Specialist.

So the IAEA will be conducting a session in Buenos Aires, Argentina to explore the impact of new imaging and radiation therapy technologies in medicine, from 18 - 19 October 2008.

For the first time medical experts, radiation protection experts and manufacturers of these machines will be discussing the issue to arrive at recommendations and guidelines, some of which shall apply to the industry.

It's estimated that each year there are about 4 billion X-ray examinations, 30 million nuclear medicine examinations and 5 million patients undergoing radiotherapy. But there's no accurate record of how much radiation a patient has been exposed to through the process of diagnosis and evaluation during a series of examinations.

"The IAEA has been giving substantial emphasis to the programme on radiation protection of patients," says Dr. Rehani. "We have a website which is unique in the world dedicated to the radiological protection of patients. The information is currently for health professionals and those who are participating in our projects from Member States. In future we want to have information for patients themselves."

The IAEA has been active in providing free training material online for health workers dealing with patient protection in different contexts, like diagnostic and interventional radiology, radiotherapy, nuclear medicine, cardiology and positron emission tomography/computed tomography (PET/CT) scanning.

According to a report by the UN Scientific Committee on the Effects of Atomic Radiation in 2000, patients are exposed to about 200 times more ionizing radiation than medical workers. In some countries, this figure can be nearly 500 times.

Seeking Solutions

Dr. Rehani says, "We also have projects in Member States finding out how much radiation patients are getting in different imaging procedures."

Medical practitioners in the 82 member states where studies are now being carried out, are then advised of how to reduce patient radiation doses without compromising diagnostic information or image quality.

In another 10 years, under the aims of the project, patients who wish to monitor themselves, could be able to check the amount of radiation they have been exposed to, not only through the course of their current examination, but over a lifetime.

Under Dr. Rehani's leadership, a team of professionals with significant expertise in radiation dose management and manufacturers will be developing methodology for a Smart Card project. The card would utilise a microchip carrying information about the radiation doses a patient receives. "We don't intend to make it obligatory. It will be a voluntary system. So it will take many years before it is widespread," says Dr. Rehani.

The team will have its first meeting early in 2009. Over the course of the next 3 years, they will focus on the minimum radiation quantities to be measured, guidelines, norms, disclaimers and security issues related to the use of the card. They will also liaise with companies that now produce chip cards that contain medical information, to see how radiation dosages can be measured and included on the current cards that are becoming available for medical records.

Although the Smart Card project is in its infancy, and the actual card will not be available for some time, this is a promising development for the future of patient information and radiation management.
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International Atomic Energy Agency

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