Managing Risks

Leaf Decoration Leaf Decoration

General Precautions

There are many methods our radiographic procedures ensure radiation safety for the patients.

  • Use of Lead
    • We provide both lead aprons and lead collars when appropriate during radiographic exams.
    • The lead, around 0.5mm thick, is capable of reducing scatter radiation by about 90% (Cheon et al., 2018).
    • Radiographic procedures themselves are rather low doses of radiation (range), so effects are already unlikely (Hall & Giaccia, 2019).
  • Distance
    • Inverse-square law (Lakhwani et al., 2018)
      • The intensity of the X-ray beam is proportional to the reciprocal of the distance squared.
      • The further away someone is from the radiation source, the lower the intensity of radiation they receive.
    • Radiation technologists try their best to optimize distance so there is sufficient exposure for good image quality while minimizing dose to patients.
  • Fractionation
    • Primarily used in radiation therapy rather than radiography.
    • Fractionating dose delivery allows for cells to recover while the area of interest still receives a sufficient dose for treatment (Hall & Giaccia, 2019).
    • This limits the effects on surrounding tissues, while effectively targeting the treatment area.
  • ALARA Principle
    • This is the “As Low As Reasonably Achievable” principle, where hospitals and radiation workers work to limit exposure to patients as much as possible without compromising image quality.
    • A study conducted by Safrullah et al. (2017) concluded that around 99% of hospitals that completed their survey recognized the ALARA principle.
    • 84% affirmed the beneficial use of lead protection (Safrullah et al., 2017).
Lead Apron Use Inverse Square Law

Image Source: The Essential Physics of Medical Imaging, Fourth Edition (Bushberg)

Symptom-Specific Precautions

Probiotics to Mitigate RT-Induced Diarrhea (Stubbe & Valero, 2013)

  • Specifically 1 sachet VSL#3
  • A study of treatment vs. placebo candidates showed promising results of true effect in reducing diarrhea post-RT treatment.
  • Treatment candidates had fewer bowel movements.
VSL#3 Probiotic

Exercise to Mitigate Fatigue (Stubbe & Valero, 2013)

  • Regular exercise has been proven to reduce fatigue post-irradiation (RT).
  • This applies to patients with cancers at multiple stages.
  • Healthcare providers should be the ones creating the exercise plans.
Exercise Illustration

Calendula to Reduce Skin Toxicity (Stubbe & Valero, 2013)

  • Depending on the dose, skin toxicity ranges from inflammation and reddening to ulcerations and fibrosis (Hall & Giaccia, 2019).
  • This is a topical steroid with statistical significance indicating a reduction in the occurrence of high toxicity of the skin.
Calendula Cream

Systemic Steroids for Pneumonitis & Others

  • Pneumonitis can arise due to multiple causal factors, so it is important to receive proper assessments to rule out other reasons for acute respiratory distress (Majeed & Gupta, 2023).
  • Corticosteroids can help reduce pulmonary inflammation in cases of pneumonia (Stern et al., 2017).
  • It can also be used for cases of inflammation, nausea, and vomiting (Anderson et al., 2021).

  • Common corticosteroids include:
    • Dexamethasone (Decadron)
    • Methylprednisolone (Medrol)
    • Prednisone
    • Hydrocortisone

  • Should be used sparingly due to its addictive properties (Majeed & Gupta, 2023).
      • Decrease consumption amount/dosage of corticosteroids throughout usage (starting high but decreasing over time).
Steroid Medication

References