Unit 1

Introduction: Radiation is energy emitted and transferred through space or matter, and is often
called electromagnetic(e-m) radiation. In fact, electromagnetic energy is usually referred to as e-
m radiation or simply radiation. Radiation is a fact of life. We life in a word which radiation is
naturally present every-where. Light and heat from nuclear reactions in the sun are essential to
our existence. Radioactive materials occur naturally throughout the environment, and our bodies
contain radioactive materials such as carbon -40, potassium -40, polonium-210 quite naturally.
All life on earth has evolved in the presence of this radiation. Matter that intercepts radiation and
absorbs part or all of it, is said to be “exposed or irradiated”. When one spent a day at the bitch,
one is exposed to ultraviolet light and that exposure may result in sun burn. During a
radiographic examination the patient is exposed to X-ray or as some would say: the patient is
irradiated.

Types of Radiation

There are two classes of radiation according to the effects it produces on matter, namely:
Ionizing and non-ionizing radiation.

Ionizing Radiation: This is a special type of radiation that includes energetic x-rays and γ-rays
(in the class of electromagnetic radiation) and α, β, n, p (particulate radiations). It is any type of
radiation capable of removing orbital electron from an atom which it interacts. Its energy is
usually greater than 20eV, hence, are hazardous to health when they pass through human tissue.

Illustration

Non Ionizing Radiation: This is any radiation type that does not have enough energy to ionize
atoms of medium they interact with, hence, are of no serious health effect. Visible light, infrared,
microwaves, and radio waves, including GSM radiation belonging to the non-ionizing group and
hence, are not known to produce any health effects beyond the heat they may produce at very
high intensity.
  Sources of Ionizing Radiation

Ionizing radiation enters our lives in a variety of ways. It arises from natural processes such as
decay of uranium in the earth, and from artificial procedures like the use of X-rays in medicine.
So we can classify the source of ionizing as natural or artificial according to its origin. Natural
sources include cosmic rays, gamma rays from the earth, radon decay product in air, and various
radionuclides found in food and drink.

Artificial sources or Man-made include medical x-rays, fallout from the testing of nuclear
weapons in the atmosphere, discharges in the atmosphere, discharges of radioactive waste from
nuclear industry, industrial gamma rays, nuclear power plant, nuclear weapon testing and
miscellaneous items such as consumer products (watch dials, exit signs, smoke detectors,
television receivers, lantern mantles, and airport surveillance systems), contribute a few mrad to
our annual radiation dose.

Activity 1: Discuss history of discovery of X-ray, properties, effects and application of X-ray

 Benefit and Risks of Ionizing Radiation

The benefits and risks of any practice involving radiation need to be established, so that an
informed judgment can be made on their use, and any risk minimized. The discovery of ionizing
radiation and radioactive materials has led to dramatic advances in medical diagnosis

and treatment, and they are used for wide range of procedures in industry, agriculture, and
research. Nevertheless, they can be harmful to human beings, and people must be protected from
unnecessary or excessive exposures. So in circumstances that we can control, we need to make a
careful balance between the benefits and the risks of the procedures that expose people to
radiation.

Activity 2

Write on other benefits and risks of ionizing radiation.

Unit 2

Hazards associated with Ionizing radiation

From the very beginning, it was not realized that ionizing radiations have harmful effects that
could be avoided if save practices were implemented. Radiation injuries occurred fairly
frequently in early years. These injuries usually took the form of skin damage (sometimes
severe), loss of air and anemia. Physician and more often patients were afflicted primarily
because of long exposure time required for an acceptable radiograph and low energy of radiation
that was available at the time. Unfortunately, it was through the lives of those who experimented
with radiation as pioneers that the consequences of unprotected use of ionizing radiation were
known Clarence Dally, an assistant radiologist, suffered severe x-ray burns that required
amputation of both arms which eventually claimed his life in 1904 (in USA), making him the
first radiation fatality. By 1922, it was estimated that more than 100 radiologists had died from
occupationally induced cancer.

With the introduction of Coolidge tube and Snook transformer, the frequency of reports of
injuries to superficial tissues decreased. Years later, it was discovered that radiologists were
developing blood disorders such as aplastic anemia and leukemia at a much higher rate than
other physician. Because of these observations, protective devices were developed for use by
radiologists. X-ray workers were routinely observed for any effects of their occupational
exposure and were provided with personnel radiation monitoring devices. This attention to
radiation safety in radiology has resulted in the disappearance of reports of any type of radiation
effect on x-ray workers.

Today the emphasis on radiation control in diagnostic radiology has shifted back to protection of
the patient. Current studies suggest that even low doses of x-radiation employed in routine
diagnostic procedures may result in a small incidence of latent harmful effects. It is also well
established that the human fetus is highly sensitive to x-radiation early in pregnancy. This
sensitivity decreases as the age of the fetus increases. There is also concern that even low levels
of radiation exposure may produce harmful genetic results.
Unit 3

 Biological Effect of Radiation

The basic unit of life, the biological cell, contains more than 70% water and a variety of other
compounds. Ionization of water molecules results in the breakage of bonds in the water
molecules leading to dissociation of H2O to H2O+ and e- pair, and subsequently to production of
groups of other ions, free radicals (H and OH), aqueous electrons and compounds like H2O2. The
three important reactive species (eaq, OH, and H), with initial relative yields of about 45%, 45%
and 10%, respectively, attack the DNA molecules in the cell resulting in biological damage
which can lead to various health effects (or changes). In human body these changes may show as
radiation sickness e.g. cataracts or in lung cancer.

Activity 3

Draw the a well labelled cell, write the functions of each labelled part. Mention the effect of
ionizing radiation the cell.

The process leading to radiation sickness can be considered in four stages;

i. The Initial Physical Stage: this stage lasting only a few minute fraction of second, in
which energy is deposited in the cell causing ionization.
ii. The physio-chemical stage: this stage lasting about 6 seconds in which the ions interact
with other molecules resulting in a new product.
iii. The chemical stage: The stage lasting a few second in which the product reaction
interacts with the important organic molecule of the cell. They may attach themselves to
a molecule or cause links in long chain molecules to be broken.
iv. The biological stage: This stage varies from a minute to years depending on the amount
of radiation and symptom e.g. early death of a cell, prevention or delay of cell division
and permanent modification which is passed on to daughter cells.
Radiation effects are divided into two classes, namely; Somatic and Hereditary effects.
The cells are also classified into somatic and genetic cells.
Somatic cells are cells of individual tissue such as the lungs and liver. Their functions
provide life for an individual and these cells pass on their offspring operation instruction
 to act like they themselves acted. The effect on somatic cell results in radiation burn,
leukemia, erythema and their injuries occur to the individual that is exposed to ionization
radiation.
The genetic cells are cells that ensure species continuity e.g. (cells of reproductive
system) when creating a new species, the genetic instruction of two cells inter wear, add,
subtract and modify. If either the cell has been modified previously as a result of
ionization, it will not pass the genetic instruction as it is supposed to. The effect of
radiation on genetic cells result in cell death or cell mutation. These injuries occur to the
exposed persons and they interference of the resemblance characteristics and possible
deformity of the offspring.
The ultimate goal of radiobiological research is the accurate description of the radiation
effects on human to ensure radiation safety used in diagnosis and effectively.
The following are human responses to ionizing radiation:
 The Early Effects of Radiation on Human
 The Late Effects of Radiation on Human
 The effects of fetal irradiation
 The Early Effects of Radiation on Humans:
1. Acute Radiation Syndrome (ARS): This result from an acute radiation exposure
within a short time. These affects the bone marrow (hematologic syndrome), the
Gastric system (gastrointestinal syndrome) and neuromuscular damage with
possibility of injury and death (central nervous system syndrome), depending on the
dose.
2. Local Tissue Damage: The tissues that may be damage include: Skin, Gonads and
Extremities.
3. Hematologic depression
4. Cryptogenic damage: Disease of obscure or doubtful origin.
 The Late Effects of Radiation on Human includes:
1. Leukemia
2. Malignant disease such as bone cancer, lung cancer, thyroid cancer, breast cancer.
3. Local tissue damage such as skin, gonads, and eyes.
4. Lifespan shortening
 5. Genetic damage
6. Cytogenetic
7. Doubling dose
 The effects of fetal irradiation which includes:
1. Prenatal death
2. Neonatal death
3. Congenital malformation
4. Childhood malignancy
5. Diminished growth and development.

In general, the amount and duration of radiation exposure affects is the severity or type of health
effect. There are broad categories of health effects: stochastic and non-stochastic or deterministic
health effect of radiation

 Stochastic Health effect of exposure to radiation are associated with long term, low level
(chronic) exposure to radiation. (“Stochastic” refers to the likelihood that something will
happen). Increased levels of exposure make these health effects more likely to occur, but
do not influence the type or severity of the effect. Cancer is considered by most people
the primary health effect from radiation exposure. Simply put, cancer is the uncontrolled
growth of cells. Ordinarily, natural processes control the rate at which cells grow and
replace themselves. They also control the body’s processes for repairing or replacing
damage tissue. Damage occurring at cellular or molecular level can disrupt the control
processes, permitting the uncontrolled growth of cells(cancer). This is why ionizing
radiation’s ability to break chemical bonds in atoms and molecules make it such a potent
carcinogen.
Other stochastic effects also occur. Radiation can cause changes in DNA, the ‘blueprints’
that ensure cell repair and replacement produces a perfect copy of the original cell.
Changes in DNA are called mutations. Sometimes the body fails to repair these mutations
or even creates mutations during repair. The mutations can be teratogenic or genetic.
Teratogenic mutations are caused by exposure of the fetus in the uterus and affect only
the individual who was exposed. Genetic mutations are passed on to offspring.
 Non-stochastic or Deterministic Health Effects of Exposure to Ionizing Radiation:
 Non-Stochastic effects appear in cases of exposure to high levels of radiation, and become
more severe as the exposure increases. Short-term, high level exposure is referred to as acute
exposure. Many non-cancerous health effects of radiation are non-stochastic. Unlike cancer,
health effects from ‘acute’ exposure to radiation usually appear quickly. Acute health effects
include burns and radiation sickness. Radiation sickness is also called ‘radiation poisoning’.
It can cause premature aging or even death. If the dose is fatal, death usually occurs within
two months. The symptoms of radiation sickness include: nausea, weakness, hair loss, skin
burn or diminished organ function.

Medical patients receiving radiation treatments often experience acute effects, because they
are receiving relatively high ‘burst’ of radiation during treatment.

Amount of Radiation Safety

There is no firm basis for setting a “safe” level of exposure above background for stochastic
effects. Many sources emit radiation that is well below natural background levels. This
makes it extremely difficult to isolate its stochastic effects. In setting limits, EPA makes the
conservative (cautious) assumption that any increase in radiation exposure is accompanied by
an increased risk of stochastic effects.

Activity 4

Find out the amount (threshold) for various non-stochastic health effects

Unit 4

Protection from Radiation Hazards

Haven studied hazards associated with radiation, it is therefore necessary to know (understand)
ways of protection from radiation hazards.

Protection from radiation hazards is all the necessary steps taking to guard against the harmful
effects of radiation. In other words, radiation protection is defined as management measures to
protect the personnel, public and the environment from the risk generated by the use of ionizing
radiation. It is aimed at reducing the biological/health effects resulting secondary exposure to
ionizing radiation.

 Basic Radiation Protection Devices

Minimizing radiation exposure to technologist and patient is easy if the radiographic and
fluoroscopic devices designed for this purpose are recognized and understood. A brief
description of primary devices for radiation protection are;
i. Filter: Metal filters, usually aluminum, are inserted into the x-ray tube housing so
that the low energy x-ray emitted by the tube are absorbed before they can reach
the patient. These x-rays have little diagnostic value. This process is known as
filtration.
ii. Collimators: This take many different forms. Blade-type diaphragms, adjustable
light –localizing collimators, and cones are most frequently employed
collimating devices. Collimation restricts the useful x-ray beam to that part of the
body requiring examination and thereby spares adjacent tissue from unnecessary
exposure. Collimation also reduces scatter radiation and thus enhances image
contrast.
iii. Intensifying Screens: Today most x-ray films are exposed in cassette with
intensifying screens on the either side of the film. Examinations conducted with
intensifying screens reduce the exposure of the patient to x-rays by more than
95% compared with examinations conducted without intensifying screens.
iv. Protective apparel: Lead-impregnated leather or vinyl is used to make aprons
and gloves worn by radiologist and technologists during fluoroscopy and some
radiographic procedures.
v. Gonadal Shielding: The same lead-impregnated material used in aprons and
gloves is used to fabricate gonadal shields. Gonadal shields should be employed
with all persons of child bearing age when their gonads are in or near the useful
x-ray beam and when use of such shielding will not interfere with the diagnostic
value of the examination.
vi. Protective Barrier: The radiographic control console is always located behind a
protective barrier. Often the barrier is lead-lined and equipped with a leaded-
 glass window. Under normal circumstances personnel remain behind the barrier
during radiographic examination.

There are other procedures that should be followed. Abdominal films of expectant mothers
should never be taken during the first trimester unless absolutely necessary. Every effort should
be taken to ensure that an examination will not have to be repeated because of technical error.

 Ten basic radiation-control principles in diagnostic radiology

1. Understand and apply the cardinal principles of radiation control: time, distance and
shielding.
2. Do not allow familiarity to result in false security.
3. Never stand in the primary beam.
4. Always wear protective apparel when not behind a protective barrier.
5. Always were a personnel radiation monitoring device and position it outside the
protective lead apron on the collar.
6. Never hold a patient during a radiographic examination. Use mechanical restraining
devices when possible. Otherwise, have patients or friends hold the patient. No hospital
employee should be routinely used for this purpose.
7. The person holding the patient must always wear a lead apron and, if possible, lead
gloves.
8. Use gonadal shields on all persons within child bearing age when such use will not
interfere with the examination.
9. Examination of the pelvis and lower abdomen of women of reproductive capacity should
be limited to the 10-day interval following the onset of menstruation. During known
pregnancy, these examinations, when appropriate, should be postponed until the
conclusion of the pregnancy or at least until the conclusion of the pregnancy or at least
until later half.
10. Always collimate to the smallest field size appropriate for the examination.

Activity 5

Explain in details the three systems of radiation protection.

Unit 4
Radiation Protection Procedures

Introduction: The use of ionizing radiation must be handled carefully and be controlled.
Radiation protection procedures are aimed at minimizing the radiation exposure of radiologic
personnel and the radiation dose to patients during x-ray examination.

The health physicist subscribes to the ALARA philosophy to keep all radiation exposures as low
as reasonably achievable and radiologic technicians should follow these guides.

Radiation exposure of radiologic technicians and radiologists is measured with personnel

monitoring devices e.g. Film badge, thermoluminescene dosimeters and pocket ionization
chambers. The patient also is usually estimated by conducting simulated x-ray examinations with
human phantoms e.g. skin dose, mean marrow dose and genetically significant dose. If the
control of radiation protection is well adopted, occupational exposure and patient dose can be
kept acceptably low.

 Occupational exposure

This refers to radiation exposure of radiologic technicians and radiologists who are involved in
the use and handling of ionizing radiation (x-ray examination).

The radiation dose is measured in units of rad (gray) or milirad. Radiation exposure is measured
in roentgens (columb/kg) or miliroentgens. Exposure to radiologic technicians and radiologists,
the proper unit is the rem (sievert) or milirent. The rem is the unit of dose equivalent and is used
for radiation protection purposes.

Exposure dose and dose equivalent have precise different meanings and one often used
interchangeably in radiology because they have the same numerical values. Exposure (R) refers
to radiation intensity in air. Dose (rad) measures the radiation exposure which is used to identify
irradiation of patients. Dose equivalent (rem) identifies the biologic effectiveness of the radiation
energy absorbed and is applied to occupationally exposed persons.

Patient dose: This refers to exposure of patients during x-ray examination (medical x-ray
exposure).
The possible late effects of medical x-ray exposure are concern not because such exposures are
high but because of unnecessary radiation exposure.

If attention is given to good radiation control practices, the patient dose can be minimized to
achieve low radiation risk.

Measurement of patient dose: The patient dose can be measured in diagnostic x-ray through:

(a) Skin dose: Exposure to the skin is known as patient dose. It is also known as entrance
skin exposure (ESE).

Thermo luminescence dosimeters are used to skin dose. A small grouping or pack of three to
ten TLDs are easily taped to the patient’s skin in the center of the x-ray field.

The response of the TLD is proportional to dose, they can measure all levels experienced
radiation exposure. Size, sensitivity and accuracy of TLDs make them very satisfactory
patients radiation monitors.

(b) Mean marrow dose: This is an exposure to the bone marrow and it is the target organ
believed to be responsible for radiation induced leukemic. The mean marrow dose is the
average radiation dose to the entire active bone marrow.

Example: If during a particular examination 50% of the active bone marrow were in the
primary beam and received an average dose of 25m rad, the mean marrow dose would be
12.5m rad.

c. Genetically significant dose: This refers to medical x-ray exposure to the patient’s gonad
area. The measurements and estimates of gonad dose are important because of the suspected
genetic effects of radiation.

The gonad dose from diagnostic x-ray is low for each individual, it may have some significant in
terms of population effects.

 Radiation Dosimetry:

Radiation dosimetry is primarily of interest because radiation dose quantities serve as indices of
the risk of biologic damage to the patient. The biologic effects of radiation can be classified as
either deterministic or stochastic. Deterministic effects are believed to be caused by cell killing.
If a sufficient number of cells in an organ or tissue are killed, its function can be impaired.
Deterministic effects include teratogenic effects to the embryo or fetus, skin damage, and
cataracts. For a deterministic effect, a threshold dose can be defined below which the effect will
not occur. For doses greater than the threshold dose, the severity of the effect increases with the
dose. To assess the likelihood of a deterministic effect on an organ from an imaging procedure,
the dose to that organ is estimated. A stochastic effect is caused by damage to a cell that
produces genetically transformed but reproductively viable descendants. Cancer and hereditary
effects of radiation are considered to be stochastic. The probability of a stochastic effect, instead
of its severity, increases with dose. For stochastic effects, there may not be dose thresholds
below which the effects cannot occur. Radiation dose is sometimes a confusing issue because a
simple determination of dose does not tell the whole story, and this is especially true in medical
imaging. Radiation dose is defined as the absorbed energy per unit mass, but this says nothing
about the total mass of tissue exposed and the distribution of the absorbed energy. Would you
prefer to receive a dose of 10 mGy to the whole body or 20 mGy to a finger? The 10-mGy
whole-body dose represents about 1,000 times the ionizing energy absorbed for a l0-kg person
with a 35-g finger. As another example, a trauma victim has an abdominal computed tomography
(CT) scan and receives a radiation dose of 30 mGy to each slice. She then receives a pelvic CT
scan, but her radiation dose remains 30 mGy. Only the volume of exposed tissue varies. The
most direct way to overcome this conundrum, advocated by some, is to calculate the energy
imparted. ). The old term for energy imparted was integral dose. The energy imparted is simply
the amount of radiation energy absorbed in the body regardless of its distribution. Because dose
equals energy divided by mass.

Energy imparted (joules) = Dose (grays) X Mass (kilograms).

Calculations of energy imparted can be used to compare radiation doses between different
imaging procedures (e.g., a radiographic study versus CT examination). However, a
disadvantage is that energy imparted does not account for the different sensitivities of the
exposed tissues to biologic damage
In the field of health physics and radiation protection; Radiation Dosimetry is the
measurement, calculation and assessment of the ionizing radiation dose absorbed by an
object, usually the human body.

Five radiological quantities and their units are used to measure radiation. They should become a
familiar part of your vocabulary. Radiation is emitted by radioactive material. The quantity of
radioactive material is measured in Becquerel. Radiation quantity is specified in C/Kg, Gray, or
Sievert depending on the condition under which it is measured and the use of the measurement.

(Old unit)Roentgen (R) (C/kg): The roentgen is the unit of radiation exposure or intensity. It is
equal to the radiation intensity that will create 2.08 x 109 ion pairs/cm³. The official definition,
however, is in terms of electric charge per unit mass of air (1R = 2.58 X 10-4 C/kg). The charge
refers to the electrons liberated by ionization. The roentgen was first defined as a unit of
radiation quantity in 1928. Since then, the definition has been revised many times. Radiation
measuring instruments usually are calibrated in roentgens. The output of x-ray machines is
specified in roentgens or sometimes miliroentgens (mR). The roentgen applies only to x-rays and
gamma rays and their interactions with air.
(S.I unit) EXPOSURE (X): Quantity for ionizing electromagnetic radiation’s ability to
produce ionisation in air. Effect in tissue is proportional to the effect in air. Of three types
(medical, occupational and public).Old unit is Roentgen (R). SI unit is coulomb / kilogram (ckg-
1)

Absorbed Dose (Gy): The rad (old unit) is the unit of radiation absorbed dose. Biologic effects
usually are related to the radiation absorbed dose, and therefore the rad is the unit most often
used when describing the radiation quantity received by a patient or an experimental animal. The
rad is used for any type of ionizing radiation and any exposed matter, not just air. One rad is
equal to 100 ergs/g (10-2 Gy), where the erg (joule) is a unit of energy, and the gram (kilogram)

is a unit of mass.
(S.I unit) Absorbed dose (D): This is the energy absorbed per unit time. Old unit is (Rad). SI
unit is Gray.1GY=100rad=1j/kg

Rem (Sv): Personnel radiation-monitoring devices, such as film badges, are analyzed in terms of
rems (rad equivalent man). The rem is the unit of dose equivalent (DE) or occupational exposure.
It is used to express the quantity of radiation received by radiation workers. Some types of
radiation produce more damage than x-rays. The rem accounts for these differences in biologic
effectiveness. This is particularly important to persons working near nuclear reactors or particle
accelerators.
Equivalent dose (H): This is the absorbed dose multiplied by a radiation weighting factor that
expresses the biological effectiveness of a given type of radiation (gamma or x-ray) in a relevant
organ or tissue. H = D X Wr. Old unit is (Rem). SI unit is
(sievert).100 rem=1 sv. It is dose measure used for comparing the risk of stochastic effects.
Curie (Ci) (Bq): The curie is a unit of radioactivity. It is a unit of the quantity of radioactive
material and not the radiation emitted by the material. One curie is that quantity of material in
which 3.7 x 1010 atoms disintegrate every second (3.7 x 1010 Bq). The millicurie (mCi) and
microcurie (μCi) are common quantities of radioactive material.

Electronic volt (eV): The energy of an x-ray is measured in electron volts or, more often,
thousands of electron volts (keV). An electron that is accelerated by an electric potential of one
volt will acquire energy to one eV. A more fundamental unit of energy in the joule (J). One eV is
equivalent to 1.6 x 10-10 J. Most x-rays used in diagnostic radiology have energy up to 150 keV,
whereas those in radiotherapy are measured in MeV. Other radiologically important energies,
such as electron and nuclear binding energies and mass-energy equivalence, are also expressed in
eV.

Because diagnostic radiology is concerned primarily with x-rays, for our purposes we may
consider 1R equal to 1rad equal to 1rem (2.58 x 10-4 C/kg = 0.01 Gy = 0.01 Sv). With other types
of ionizing radiation this generalization is not true.

The special quantities of radiologic science and their associated special units

Customary unit SI unit

Quantity Name Symbol Name
Symbol

Exposure Roentgens R Coulomb per kilogram

C/kg
Absorbed dose rad rad gray
Gy
Dose equivalent rem rem seivert
Sv
Radioactivity curie Ci Becquerel
Bq
Multiply number of A by B ____to obtain number of
C_______
Divide number of C______ by B____ to obtain number of
A_______

A B C
R 2.58 x 10-4 C/kg
rad 0.01 Gy
rem 0.01 Sv
Ci 3.7 x 1010 Bq

MONITORING DEVICES

They are used to assess the amount of external radiation received by personnel at a given period
of time. There are three (3) main types of individual radiation recording devices called Personnel
Dosimeters used in diagnostic radiology and nuclear medicine;(a) Film badge (b) dosimeters
using storage phosphors ( e.g., thermoluminescent dosimeters, (TLDs), and (c) Pocket
dosimeters, each with its own specific advantages and disadvantages.
They are processed after exposure and will give the amount of radiation absorbed (in the same
manner as the body tissue) within that period. It is expected to be worn at the most exposed part
of the trunk while on duty and worn under the lead apron.

Ideally, one would like to have a single personnel dosimeter capable of meeting all of the
dosimetry needs in medical imaging. The ideal dosimeter would instantaneously respond,
distinguish between different types of radiation, and accurately measure the dose
equivalent from all forms of ionizing radiation with energies from several keV to MeV;
independent of the angle of incidence. In addition, the dosimeter would be small,
lightweight, rugged, easy to use, inexpensive, and unaffected by changes in environmental
conditions (e.g., heat, humidity, pressure) and nonionizing radiation sources.
Unfortunately, no such dosimeter exists; however, the majority of these characteristics can
be satisfied to some degree by selecting the dosimeter best suited for a particular
application.

1. Film Badges

The film badge is the most widely used dosimeter in diagnostic radiology and nuclear medicine.
It consists of a small sealed film packet (similar to dental x-ray film) placed inside a special
plastic holder that can be clipped to clothing. Just as with conventional x-ray film, radiation
striking the emulsion causes a darkening of the developed film. The amount of darkening is
measured with a densitometer and increases with the absorbed dose to the film emulsion. The
film emulsion contains grains of silver bromide resulting in a higher effective atomic number
than tissue; therefore, the dose to film is not equal to the dose to tissue. However, with the
selective use of several metal filters over the film (typically lead, copper, and aluminum), the
relative optical densities of the film underneath the metal filters can be used to identify the
general energy range of the radiation and allow for the conversion of the film dose to tissue dose.
Film badges typically have an area where the film is not covered by a metal filter or plastic and
thus is directly exposed to the radiation. This "open window" is used to detect medium and high
energy beta radiation that would otherwise be attenuated.

Most film badges can record doses from about 100 ~Gy to 15 Gy (10 mrad to 1,500 rad) for
photons and from 500 ~Gy to 10 Gy (50 mrad to 1,000 rad) for beta radiation. The film in the
badge is usually replaced monthly and sent to the commercial supplier for processing. An
exposure report is received from the vendor in approximately 2 weeks. The developed film is
usually kept by the vendor, providing a permanent record of radiation exposure. The dosimetry
report lists the "shallow" dose, corresponding to the skin dose, and the "deep" dose,
corresponding to penetrating radiations. Film badges are small, lightweight, inexpensive, and
easy to use. However, exposure to excessive moisture or heat will damage the film emulsion,
making dose estimates difficult or impossible. The film badge is typically worn on the part of the
body that is expected to receive the largest radiation exposure or is most sensitive to radiation
damage. Most radiologists, x-ray technologists, and nuclear medicine technologists wear the film
badge at waist or shirt-pocket level. During fluoroscopy, film badges are typically placed at
collar level in front of the lead apron to measure the dose to the thyroid and lens of the eye
because the majority of the body is shielded from exposure. Pregnant radiation workers typically
wear a second badge at waist level (behind the lead apron, if used) to assess the fetal dose

(2) Thermoluminescent and Optically Stimulated Luminescent Dosimeters Some dosimeters

contain storage phosphors, in which a fraction of the electrons, raised to excited states by
ionizing radiation, become trapped in excited states. When these trapped electrons are released,
either by heating or by exposure to light, they fall to lower energy states with the emission of
light. Thermoluminescent dosimeters (TLDs) are excellent personnel and environmental
dosimeters; however, they are somewhat more expensive and are not as widely used in
diagnostic radiology as film badges. The most commonly used TLD material for personnel
dosimetry is lithium fluoride (LiF). LiF TLDs have a wide dose response range of 10 ~ to 103 Sv
(l mrem to 105 rem) and are reusable. Another advantage of LiF TLDs is that the effective
atomic number is close to that of tissue; therefore, the dose to the dosimeter is close to the tissue
dose over a wide energy range. TLDs do not provide a permanent record, because heating the
chip to read the exposure removes the deposited energy. TLDs are routinely used in nuclear
medicine as extremity dosimeters; a finger ring containing a chip of LiF is worn on the hand
expected to receive the highest exposure during radiopharmaceutical preparation and
administration. TLDs are also the dosimeter of choice when longer dose assessment intervals
(e.g., quarterly) are required.

Dosimeters using optically stimulated luminance (OSL) have recently become commercially
available as an alternative to TLDs. The principle of OSL is similar to that of TLDs, except that
the light emission is stimulated by laser light instead of by heat. Crystalline aluminum oxide
activated with carbon (Alz03:C) is commonly used. Like TLDs, OSL dosimeters have a broad
dose response capability, and are capable of detecting doses as low as 10 ~Sv (1 mrem).
However, OSL dosimeters have certain advantages over TLDs in that they can be reread several
times and an image of the filter pattern can be produced to differentiate between static (i.e.,
instantaneous) and dynamic (i.e., normal) exposure.

(3) POCKECT DOSIMETERS

The major disadvantage to film and TLD dosimeters is that the accumulated exposure is not
immediately indicated. Pocket dosimeters measure radiation exposure, which can be read
instantaneously. The analog version of the pocket dosimeter (pocket ion chamber) utilizes a
quartz fiber suspended within an air-filled chamber on a wire frame, on which a positive
electrical charge is placed. The fiber is bent away from the frame because of coulombic repulsion
and is visible through an optical lens system upon which an exposure scale is superimposed.
When radiation strikes the detector, ion pairs are produced in the air that partially neutralize the
positive charge, thereby reducing coulombic repulsion and allowing the fiber to move closer to
the wire frame. This movement is seen as a down-range excursion of the hairline fiber on the
exposure scale. Pocket ion chambers can typically detect photons of energies greater than 20
keV. The most commonly used models measure exposures from 0 to 200 mR or 0 to 5 R. These
devices are small (the size of a pen) and easy to use; however, they may produce erroneous
readings if bumped or dropped and, although reusable, do not provide a permanent record of
exposure. Pocket dosimeters are utilized when high doses are expected, such as during cardiac
catheterization or manipulation of large quantities of radioactivity.

Table 1

Summary of Personnel Monitoring Methods

Method Measures Permanent

record Uses and
Comments
Film badge Beta; Yes Routinepersonnel
gamma monitoring; most
and x-ray common in
diagnostic
radiology and
nuclear
medicine.
TLD Beta;
gamma No Becoming more
and x-ray common but still
more expensive
than film; used
for phantom and
patient dosimetry

OSL Beta; No Advantage over

gamma TLD includes the
and x-ray ability to reread
the dosimeters
and distinguish
between dynamic
and static
exposures .
Pocket Gamma No Special
Dosimeter and x-ray monitoring (e.g.,
cardiac cath);
permits direct
(i.e., real-time)
reading of
exposure.
Problems with Dosimetry

Common problems associated with dosimetry include leaving dosimeters in a radiation field
when not worn; radio nuclide contamination of the dosimeter itself; lost and damaged
dosimeters; and not wearing the dosimeter when working with radiation sources. If the dosimeter
is positioned so that the body is between it and the radiation source, the attenuation will cause a
significant underestimation of the true exposure. Most personnel do not remain in constant
geometry with respect to the radiation sources they use. Consequently, the dosimeter
measurements are generally representative of the individual's average exposure. For example, if
the film badge is worn properly and the radiation field is multidirectional or the wearer's
orientation toward it is random, then the mean exposure over a period of time will tend to be a
good approximation (±10% to 20%) of the individual's true exposure.

RADIATION DETECTION EQUIPMENT IN RADIATION SAFETY

Radiation Survey ; Surveys provide a direct measure of area radiation levels and detect the
presence of radioactive material inadvertently spilled on person, surface or a piece of equipment.
Surveys are therefore an indication of the radiation hazard present either during or after an
experiment.

A variety of portable radiation detection instruments are used in diagnostic radiology and
nuclear medicine, the characteristics of which are optimized for specific applications. The
portable GM survey meter and portable ionization chamber satisfy the majority of the
requirements for radiation protection in nuclear medicine. X-ray machine evaluations
require specialized ion chambers capable of recording exposure, exposure rates, and
exposure durations. All portable radiation detection instruments should be calibrated at least
annually. GM survey instruments are used to detect the presence and provide a semiquantitative
estimate of the magnitude of radiation fields. Measurements from GM counters typically are in
units of counts per minute (cpm) rather than mR/hr, because the GM detector does not duplicate
the conditions under which exposure is defined. In addition, the relationship between count rate
and exposure rate with most GM probes is a complicated function of photon energy. However,
with specialized energy compensated probes, GM survey instruments can provide approximate
measurements of exposure rate (typically in mR/hr). The most common application of GM
counters is as radioactive contamination survey instruments in nuclear medicine. A survey meter
coupled to a thin window (~1.5 to 2 mg/cm2 ), large surface area GM probe (called a "pancake"
probe) is ideally suited for contamination surveys. Thin window probes can detect alpha
(>3MeY), beta (>45 keY), x-, and gamma (>6 keY) radiations. These detectors are extremely
sensitive to charged particulate radiations with sufficient energy to penetrate the window but are
relatively insensitive to x- and gamma radiations. These detectors will easily detect natural
background radiation (on the order of ~50 to 100 cpm at sea level). These instruments have long
dead times resulting in significant count losses at high count rates. For example, a typical dead
time of 100 Ilsec will result in a ~200/0 loss at 100,000 cpm. Older portable GM survey
instruments will saturate in high radiation fields and read zero, which, if unrecognized, could
result in significant overexposures. Portable GM survey instruments are best suited for low-level
contamination surveys and should not be used in high radiation fields or when accurate
measurements of exposure rate are required unless specialized energy compensated probes or
other techniques are used to account for these inherent limitations.

Portable air-filled ionization chambers are used when accurate measurements of radiation
exposure are required. These ionization chambers approximate the conditions under which
the roentgen is defined. They have a wide variety of applications including measurements
of x-ray machine outputs, assessment of radiation fields adjacent to brachytherapy or radio
nuclide therapy patients, and surveys of radioactive materials packages. Air-filled
ionization chamber measurements are influenced by changes in temperature, atmospheric
pressure, photon energy, and exposure rate. However, these limitations are not very
significant for conditions typically encountered in medical imaging. For example, a typical
portable ion chamber survey meter will experience only ~50/0 loss for exposure rates
approaching 10 R/hr; specialized detectors can