Radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. Proceedings of an international conference

Medical applications of ionizing radiation (or 'radiation' for short) are accepted worldwide as essential tools for protecting and improving human health. However, they also represent by far the largest human-made source of radiation exposure. The United Nations Scientific Committee on the Effects of Atomic Radiation estimates that diagnostic medical applications of radiation account for about 95% of the exposure to radiation from human-made sources and about 12% of total exposure. Furthermore, there is certain to be a continuing increase in the prevalence of medical applications of radiation, including high dose procedures, as in the following cases: Radiological interventional procedures, which are increasingly being used to replace surgery, can lead to very high radiation doses, both to patients and to medical staff, in some cases exceeding thresholds for deterministic effects; The use of helical computed tomography (CT) has improved the diagnostic quality of CT examinations, and the procedures are faster and more flexible than with non-helical equipment. However, the increased number of procedures and the increased number of scans per procedure may lead to a significant increase in radiation exposure to patients. In diagnosis, the radiological protection objective is to keep doses as low as reasonably achievable while obtaining the necessary diagnostic information. According to the International Commission on Radiological Protection, doses from similar radiological investigations can differ by as much as two orders of magnitude. There is therefore considerable scope for dose reduction in diagnostic and interventional radiology and also in nuclear medicine. In therapy, the objective is to ensure that the target tissue is given the prescribed dose while minimizing the dose to surrounding healthy tissue. If the dose, dose distribution or dose fractionation is significantly different from that prescribed, serious consequences can arise, as in recent incidents involving the accidental exposure of radiotherapy patients. The application of well designed quality assurance programmes is necessary in order to ensure the protection of patients. In October 1999 the IAEA General Conference issued resolution GC(43)/RES/12 requesting the Secretariat of the IAEA to 'organize as soon as feasible, in close collaboration with the World Health Organization and within the IAEA's current budgetary resources, an international meeting on the radiological protection of patients for the purpose of an exchange of information and the development of recommendations, as appropriate, regarding the radiological protection of patients'. In response to that request, the IAEA organized the International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy, which was co-sponsored by the European Commission, the Pan American Health Organization and the World Health Organization, and which was hosted by the Government of Spain. The conference took place in Torremolinos (Malaga), Spain, from 26 to 30 March 2001. The conference was the first of its kind specifically focused on the radiological protection of patients. Apart from the opening and closing sessions, the conference programme comprised background sessions with papers by representatives of the co-sponsoring organizations and the professional societies, a briefing session with five papers to introduce the subject of the conference, 13 topical sessions and six round tables. The proceedings contain all the presentations and the summaries of all discussions, and also include the opening addresses and the conclusions and recommendations. The contributed papers are provided on a CD-ROM which accompanies these proceedings