J Radiol
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Reducing radiation dose while maintaining adequate image quality on conventional and digital radiographs requires optimal use of the unit. Additional filtration avoids unnecessary tissue exposure and improves photon transmission. Automatic exposure control may reduce exposure and dose. ⋯ Radiographic films combined to rare-earth screens also afford a good photon-conversion efficiency. Large area flat panel amorphous silicon x-ray sensors may also reduce dose up to 50% compared to films. Finally, calculation of the Kerma-area product independent of the source distance constitutes an important indicator of radiation dose.
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The obligations of the radiologist for the radiation protection of patients include a review of the appropriateness of the examination and optimization of the protocol. Both internal and external quality assurance programs are mandatory. The specific tasks and their frequency are defined by the AFSSAPS. ⋯ The imaging technique must be optimized based on published guidelines or law for the most frequent examinations. All radiologists should be familiar with radiation protection. Incidents should be reported to the Nuclear Safety Authority.
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The purpose of this article is to provide radiologists with key elements of radiation protection for interventional radiology patients. The following points will be discussed: standards of the fluoroscopy units, dedicated dosimetry, risks (especially cutaneous) and means to reduce them, optimization of interventional radiology dose protocols, and national and international regulations. Appropriateness criteria in interventional radiology are national guidelines that should be implemented.
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The effects of exposure to ionizing radiation are determined by the absorbed dose D. The equivalent dose H takes into consideration the variation in probability of a stochastic effect (cancer, leukemia, genetic mutation) based on the quality of the exposure. The effective dose E takes into account the sensitivity of tissues (T) to stochastic effects from radiation exposure. Optimization of radiation exposure to patients in diagnostic radiology in based on diagnostic reference levels (DRL): entrance surface dose or dose-area product for conventional radiology; CT dose index and DLP for CT.