Annals of the ICRPPub Date : 2020-12-01Epub Date: 2020-08-11DOI: 10.1177/0146645320929630
F Bochud, M C Cantone, K Applegate, M Coffey, J Damilakis, M Del Rosario Perez, F Fahey, M Jesudasan, C Kurihara-Saio, B Le Guen, J Malone, M Murphy, L Reid, F Zölzer
{"title":"Ethical aspects in the use of radiation in medicine: update from ICRP Task Group 109.","authors":"F Bochud, M C Cantone, K Applegate, M Coffey, J Damilakis, M Del Rosario Perez, F Fahey, M Jesudasan, C Kurihara-Saio, B Le Guen, J Malone, M Murphy, L Reid, F Zölzer","doi":"10.1177/0146645320929630","DOIUrl":"https://doi.org/10.1177/0146645320929630","url":null,"abstract":"<p><p>Whereas scientific evidence is the basis for recommendations and guidance on radiological protection, professional ethics is critically important and should always guide professional behaviour. The International Commission on Radiological Protection (ICRP) established Task Group 109 to advise medical professionals, patients, families, carers, the public, and authorities about the ethical aspects of radiological protection of patients in the diagnostic and therapeutic use of radiation in medicine. Occupational exposures and research-related exposures are not within the scope of this task group. Task Group 109 will produce a report that will be available to the different interested parties for consultation before publication. Presently, the report is at the stage of a working document that has benefitted from an international workshop organised on the topic by the World Health Organization. It presents the history of ethics in medicine in ICRP, and explains why this subject is important, and the benefits it can bring to the standard biomedical ethics. As risk is an essential part in decision-making and communication, a summary is included on what is known about the dose-effect relationship, with emphasis on the associated uncertainties. Once this theoretical framework has been presented, the report becomes resolutely more practical. First, it proposes an evaluation method to analyse specific situations from an ethical point of view. This method allows stakeholders to review a set of six ethical values and provides hints on how they could be balanced. Next, various situations (e.g. pregnancy, elderly, paediatric, end of life) are considered in two steps: first within a realistic, ethically challenging scenario on which the evaluation method is applied; and second within a more general context. Scenarios are presented and discussed with attention to specific patient circumstances, and on how and which reflections on ethical values can be of help in the decision-making process. Finally, two important related aspects are considered: how should we communicate with patients, family, and other stakeholders; and how should we incorporate ethics into the education and training of medical professionals?</p>","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320929630","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38250305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annals of the ICRPPub Date : 2020-12-01Epub Date: 2020-08-25DOI: 10.1177/0146645320927858
J Hislop-Jambrich
{"title":"What is the point of innovation in patient dose monitoring?","authors":"J Hislop-Jambrich","doi":"10.1177/0146645320927858","DOIUrl":"https://doi.org/10.1177/0146645320927858","url":null,"abstract":"<p><p><i>The Medical Futurist</i> says that radiology is one of the fastest growing and developing areas of medicine, and therefore this might be the speciality in which we can expect to see the largest steps in development. So why do they think that, and does it apply to dose monitoring? The move from retrospective dose evaluation to a proactive dose management approach represents a serious area of research. Indeed, artificial intelligence and machine learning are consistently being integrated into best-in-class dose management software solutions. The development of clinical analytics and dashboards are already supporting operators in their decision-making, and these optimisations - if taken beyond a single machine, a single department, or a single health network - have the potential to drive real and lasting change. The question is for whom exactly are these innovations being developed? How can the patient know that their scan has been performed to the absolute best that the technology can deliver? Do they know or even care how much their lifetime risk for developing cancer has changed post examination? Do they want a personalised size-specific dose estimate or perhaps an individual organ dose assessment to share on Instagram? Let's get real about the clinical utility and regulatory application of dose monitoring, and shine a light on the shared responsibility in applying the technology and the associated innovations.</p>","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320927858","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38400762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum.","authors":"","doi":"10.1177/0146645320966413","DOIUrl":"10.1177/0146645320966413","url":null,"abstract":"","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38761381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N Petoussi-Henss, D Satoh, A Endo, K F Eckerman, W E Bolch, J Hunt, J T M Jansen, C H Kim, C Lee, K Saito, H Schlattl, Y S Yeom, S J Yoo
{"title":"ICRP Publication 144: Dose Coefficients for External Exposures to Environmental Sources.","authors":"N Petoussi-Henss, D Satoh, A Endo, K F Eckerman, W E Bolch, J Hunt, J T M Jansen, C H Kim, C Lee, K Saito, H Schlattl, Y S Yeom, S J Yoo","doi":"10.1177/0146645320906277","DOIUrl":"https://doi.org/10.1177/0146645320906277","url":null,"abstract":"This publication presents radionuclide-specific organ and effective doserate coefficients for members of the public resulting from environmental external exposures to radionuclide emissions of both photons and electrons, calculated using computational phantoms representing the International Commission on Radiological Protection’s (ICRP) reference newborn, 1-year-old, 5-year-old, 10year-old, 15-year-old, and adult males and females. Environmental radiation fields of monoenergetic photon and electron sources were first computed using the Monte Carlo radiation transport code PHITS for source geometries representing environmental radionuclide exposures including planar sources on and within the ground at different depths (representing radionuclide ground contamination from fallout or naturally occurring terrestrial sources), volumetric sources in air (representing a radioactive cloud), and uniformly distributed sources in simulated contaminated water. For the above geometries, the exposed reference individual is considered to be completely within the radiation field. Organ equivalent dose-rate coefficients for monoenergetic photons and electrons were next computed employing the PHITS code, thus simulating photon and electron interactions within the tissues and organs of the exposed reference individual. For quality assurance purposes, further cross-check calculations were performed using GEANT4, EGSnrc, MCNPX, MCNP6, and the Visible Monte Carlo radiation transport codes. From the monoenergetic values, nuclide-specific effective and organ equivalent dose-rate coefficients were computed for 1252 radionuclides of 97 elements for the above environmental exposures using the nuclear decay data from ICRP Publication 107. The coefficients are given as dose-rates normalised to radionuclide concentrations in environmental media, such as radioactivity concentration (nSv h Bq m or nSv h Bq m), and can be renormalised to ambient dose equivalent (Sv Sv ) or air kerma free in air (SvGy ). The main text provides effective dose-rate coefficients for selected radionuclides; details including ageand sex-dependent organ dose-rate coefficients are provided as an electronic supplement to be downloaded from the ICRP and SAGE websites. The data show that, in general, the smaller the body mass of the","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320906277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Phantom Evolution.","authors":"John D Harrison","doi":"10.1177/0146645320919328","DOIUrl":"https://doi.org/10.1177/0146645320919328","url":null,"abstract":"The phantoms used by the International Commission on Radiological Protection (ICRP) are mathematical models of the anatomy of the human body, required for dosimetric calculations. The improvements made to these phantoms, particularly more recently, reflect considerable advances in scientific methodology and computing power, together with changing expectations that the best science will be used and will be communicated openly. The highly sophisticated models in this publication should ‘future-proof’ the Commission in readiness for anticipated requirements for new calculations.","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320919328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38634813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Effective Dose for Exposures in The Environment.","authors":"Kimiaki Saito","doi":"10.1177/0146645320916969","DOIUrl":"https://doi.org/10.1177/0146645320916969","url":null,"abstract":"It is often said that radiological protection is a practical science and I quite agree. There are many cases where decisions must be made even if the scientific knowledge is imperfect. In such cases, the decision should be made using the best scientific knowledge available at the time. Effective dose is a typical example of a useful concept for such decisions in radiological protection as a practical science. The biological effect of exposure to radiation below 100mSv is, as well known, not thoroughly elucidated; nevertheless, radiological protection needs to be implemented appropriately for the safe use of radiation which provides huge benefits to human lives via various applications such as nuclear energy and medical use. The concept of effective dose was invented more than 40 years ago by Professor Wolfgang Jacobi (Jacobi, 1975), and since its adoption by the International Commission on Radiological Protection (ICRP, 1991) has played an essential role in radiological protection as the basic protection quantity. I was lucky to get the chance to meet Professor Jacobi while attending his 60th birthday party which was held in 1988 at the Gesellschaft für Strahlenforschung (GSF) (now Helmholtz Zentrum München). At that time, Professor Jacobi was serving as the director of one of the research institutes of GSF. He was so kind to smile and talk to the stranger who joined the party by chance while studying at GSF for a single year. During the party, a scientific journal with articles dedicated to him and his work was presented to him as a gift. It was quite an inspiring moment, and I decided to continue working in the field of radiological protection. I remember, after returning to Japan, arguments with my colleagues on how effective dose is useful in radiological protection. I was in favour of using effective dose, but could not argue sufficiently about its merits at that time. The fact that effective dose has been used for more than 40 years has proved its usefulness. Dose coefficients for external exposures in the environment have been studied for a long time. The first comprehensive studies on this subject were those by Dillman (1974), and Poston and Snyder (1974). Since then, many researchers, myself included, have tackled this subject, mainly using computer simulations, and several articles have been published. Before effective dose was established, dose coefficients were calculated for the whole body and specific organs. After the invention of effective dose, dose coefficients were estimated mainly in terms of effective dose, and have been an essential input for dose evaluation in the environment.","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320916969","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. A. Kaabi, P. Allisy, Meshary Alnuaimi, K. Applegate, N. Ban, Catrin Bauréus Koch, Alistair Bell, T. Berris, É. Blanchardon, W. Bolch, S. Bouffler, M. Cantone, N. Caplin, K. Cho, R. Clarke, C. Clement, Kelsey Cloutier, D. Cool, C. Cousins, M. Cowie, K. Eckerman, A. Endo, Scott Foley, H. Fujita, Juan J. Burgos Gallego, E. G. Diaz, Julian Ginniver, D. Giuffrida, J. jónsdóttir, N. Hamada, G. Hammer, Naomi Harley, John D Harrison, Marcia Hartman, Dan Hibbing, T. Higuchi, T. Homma, Mark D. Hoover, M. Hosono, Chan Hyeong Kim, L. Jødal, D. Jokisch, M. Kai, Alexandra Kamp, K. Kang, I. Kawaguchi, P. Kazantsev, B. Kerr, L. Kratzwald, C. Larsson, D. Laurier, Lynn Lemaire, Chunsheng Li, J. Lochard, Stephen Long, R. Loose, M. A. López, Sigur ur Magnússon, Yahong Mao, J. Climent, Colin J. Martin, N. Martinez, P. Mattera, F. Mettler, Miguel Mota, Rock Neveau, A. Nisbet, J. O. Ramos, J. Pentreath, Nina Petoussi-Heinss, K. Potts, J. Preston, R. Puckett, M. Rehani, Julie Reyjal, M. Rosenstein, W. Rühm, M. Sasaki, Y. Sasa
{"title":"Chinese Institute for Radiation Protection European Commission UAE Federal Authority for Nuclear Regulation US Department of Energy US Environmental Protection Agency","authors":"F. A. Kaabi, P. Allisy, Meshary Alnuaimi, K. Applegate, N. Ban, Catrin Bauréus Koch, Alistair Bell, T. Berris, É. Blanchardon, W. Bolch, S. Bouffler, M. Cantone, N. Caplin, K. Cho, R. Clarke, C. Clement, Kelsey Cloutier, D. Cool, C. Cousins, M. Cowie, K. Eckerman, A. Endo, Scott Foley, H. Fujita, Juan J. Burgos Gallego, E. G. Diaz, Julian Ginniver, D. Giuffrida, J. jónsdóttir, N. Hamada, G. Hammer, Naomi Harley, John D Harrison, Marcia Hartman, Dan Hibbing, T. Higuchi, T. Homma, Mark D. Hoover, M. Hosono, Chan Hyeong Kim, L. Jødal, D. Jokisch, M. Kai, Alexandra Kamp, K. Kang, I. Kawaguchi, P. Kazantsev, B. Kerr, L. Kratzwald, C. Larsson, D. Laurier, Lynn Lemaire, Chunsheng Li, J. Lochard, Stephen Long, R. Loose, M. A. López, Sigur ur Magnússon, Yahong Mao, J. Climent, Colin J. Martin, N. Martinez, P. Mattera, F. Mettler, Miguel Mota, Rock Neveau, A. Nisbet, J. O. Ramos, J. Pentreath, Nina Petoussi-Heinss, K. Potts, J. Preston, R. Puckett, M. Rehani, Julie Reyjal, M. Rosenstein, W. Rühm, M. Sasaki, Y. Sasa","doi":"10.1177/0146645320953807","DOIUrl":"https://doi.org/10.1177/0146645320953807","url":null,"abstract":"Chinese Society for Radiation Protection Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety, Germany National Institute for Radiological Protection and Nuclear Safety, France Health Canada Canadian Nuclear Safety Commission American Academy of Health Physics Society for Radiological Protection, UK Radiation Effects Association, Japan International Radiation Protection Association American Association of Physicists in Medicine Dutch Society for Radiation Protection National Inspectorate for Nuclear Safety and Radiation Protection, Italy Canadian Radiation Protection Association Australian Radiation Protection and Nuclear Safety Agency Centre d’étude sur l’Evaluation de la Protection dans le domaine Nucléaire, France Federal Agency for Nuclear Control, Belgium Société Française de Radioprotection, France Medical Physics Association, Italy Society of Medical and Interventional Radiology, Italy Danish Society for Medical Physics Centers for Disease Control and Prevention, USA International Organisation for Medical Physics Society for Radiation Protection, Israel EURAMED Nordic Society for Radiation Protection Nordic Nuclear Safety Research South African Association of Physicists in Medicine and Biology National Centre for Radiation Protection, Delft University, Netherlands Spanish Radiation Protection Society East Tennessee Chapter of the Health Physics Society, USA Spanish Society of Medical Physics Institute of Physics and Engineering in Medicine, UK Icelandic Radiation Safety Authority ENUSA Industria Avanzandas, Spain Australasian Radiation Protection Association South Pacific Environmental Radioactivity Association RP Alba Limited","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645320953807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64982720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C H Kim, Y S Yeom, N Petoussi-Henss, M Zankl, W E Bolch, C Lee, C Choi, T T Nguyen, K Eckerman, H S Kim, M C Han, R Qiu, B S Chung, H Han, B Shin
{"title":"ICRP Publication 145: Adult Mesh-Type Reference Computational Phantoms.","authors":"C H Kim, Y S Yeom, N Petoussi-Henss, M Zankl, W E Bolch, C Lee, C Choi, T T Nguyen, K Eckerman, H S Kim, M C Han, R Qiu, B S Chung, H Han, B Shin","doi":"10.1177/0146645319893605","DOIUrl":"https://doi.org/10.1177/0146645319893605","url":null,"abstract":"Following the issuance of new radiological protection recommendations in ICRP Publication 103, the Commission released, in ICRP Publication 110, the adult male and female voxel-type reference computational phantoms to be used for calculation of the reference dose coefficients (DCs) for both external and internal exposures. While providing more anatomically realistic representations of internal anatomy than the older stylised phantoms, the voxel phantoms have their limitations, mainly due to voxel resolution, especially with respect to small tissue structures (e.g. lens of the eye) and very thin tissue layers (e.g. stem cell layers in the stomach wall mucosa and intestinal epithelium). This publication describes the construction of the adult mesh-type reference computational phantoms (MRCPs) that are the modelling counterparts of the Publication 110 voxel-type reference computational phantoms. The MRCPs include all source and target regions needed for estimating effective dose, even the micrometre-thick target regions in the respiratory and alimentary tract organs, skin, and urinary bladder, assimilating the supplementary stylised models. The MRCPs can be implemented directly into Monte Carlo particle transport codes for dose calculations (i.e. without voxelisation), fully maintaining the advantages of the mesh geometry. DCs of organ dose and effective dose and specific absorbed fractions (SAFs) calculated with the MRCPs for some external and internal exposures show that while some differences were observed for small tissue structures and for weakly-penetrating radiations the MRCPs provide the same or very similar values as the previously published reference DCs and SAFs, which were calculated with the Publication 110 reference phantoms and supplementary stylised models, for most tissues and penetrating radiations. Consequently, the DCs for effective dose (i.e. the fundamental protection quantity) were not found to be different. The DCs of ICRP Publication 116 and the SAFs of ICRP Publication 133 thus remain valid.","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0146645319893605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38730367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addendum 1 to ICRP <i>Publication 128</i>: Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances [Ann. ICRP 44(2S), 2015].","authors":"","doi":"10.1177/0146645320936035","DOIUrl":"10.1177/0146645320936035","url":null,"abstract":"","PeriodicalId":39551,"journal":{"name":"Annals of the ICRP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}