• Jonathan E Tucker and Michael D Wirt.
• Department of Radiology, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234-4504, USA.
• Mil Med. 2024 Feb 27; 189 (3-4): e638e644e638-e644.

IntroductionDiagnostic radiology in the deployed military environment (in-theater diagnostic radiology) was greatly improved in the early 1990s with the addition of CT systems installed in military-grade one-sided expandable ISO-shelters. These shelters were provided with limited radiation shielding by several flexible lead curtains covering only a small portion of the shelter walls, necessitating placement of deployed CT systems at substantial distances from the field medical facility to limit exposures to personnel from secondary radiation. The newest generation deployable CT system is housed in a two-sided ISO-shelter with radiation shielding applied to the shelter walls. To ensure compliance with military and national standards for protection against ionizing radiation, we developed a simple method to calculate safe distances based on workload, frequencies of the various CT exams performed, and occupancy of controlled and uncontrolled areas.Materials And MethodsCalculation of radiation air kerma rates outside a two-sided CT ISO-shelter was developed using guidance from the National Council on Radiation Protection and Measurements Report No. 147. The simplified formula included measured radiation transmission factors for the ISO-shelter wall and installed shielding, occupancy factors, fraction of all CT exams that covered the chest, abdomen, and/or pelvis, total number of CT exams per week, and shielding design goals for controlled and uncontrolled areas. The formula was modified subsequently to account for whole-body CT exams expected during armed conflict.ResultsCalculated safe distances revealed that the shielded two-sided CT ISO-shelter can be positioned much closer to the surgical shelters of the field medical unit than the previously unshielded one-sided CT ISO-shelter. Tables of safe distances for controlled and uncontrolled areas for the two medical support environments of disaster relief/peacekeeping and combat are provided. For example, for a controlled area at 100% occupancy when 300 CT exams per week are performed and 50% of those exams are of the chest, abdomen, and/or pelvis, the safe distance between the nearest surgical shelter and the shielded CT ISO-shelter is 2.1 m. By comparison, the safe distance for an unshielded CT ISO-shelter is 8.5 m under the same conditions. For lower occupancy factors and lower weekly workload, safe distances from the nearest surgical shelter are often negligible.ConclusionsThe shielding in the new deployable CT ISO-shelter substantially reduces the distance between it and the surgical shelters of the field medical unit necessary to ensure radiation safety. Safe distances depend on several factors including workload, types and frequencies of CT exams, occupancy factors, and classification of the area around the ISO-shelter, i.e., controlled and uncontrolled.© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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