Percorrer por autor "Rainford, Louise"
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- Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll projectPublication . Rainford, Louise; Santos, Joana; Alves, Francisco; Figueiredo, João; Hoeschen, Christoph; Damilakis, John; Frija, Guy; Andersson, Jonas; McNulty, Jonathan; Foley, Shane; Bacher, Klaus; Nestle, Ursula; Hierath, Monika; Paulo, GracianoBackground: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
- The establishment of computed tomography diagnostic reference levels in PortugalPublication . Santos, Joana; Foley, Shane; Paulo, Graciano; McEntee, Mark; Rainford, LouiseThe aims of this study were to investigate the frequency of Portuguese computed tomography (CT) examinations, identify protocol application and establish diagnostic reference levels (DRLs). CT departments (n=5211) were surveyed nationally (June 2011-January 2012) and CT protocol information and dose data were collected, as were retrospective age-categorised paediatric CT data from three national paediatric centres. The proposed national CT DRLs (CTDIvol) for adults were 75, 18, 14, 18, 17, 36, 22, 27 and 16 mGy for head, neck, chest, abdomen, pelvis, cervical, dorsal, lumbar and joints, respectively. The levels for paediatric head and chest examinations were as follows: 48 and 2 mGy (newborns), 50 and 6 mGy (5 y olds), 70 and 6 mGy (10 y olds) and 72 and 7 mGy (15 y olds). A limited number of current paediatric protocols aligned to recommended international age categorisations. Portuguese DRLs were generally higher than European recommendations, suggesting potential for optimisation. The need for greater standardisation of age-categorised paediatric protocols was identified.
- The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomographyPublication . Santos, Joana; Foley, Shane; Paulo, Graciano; McEntee, Mark F.; Rainford, LouiseThe volume of CT examinations has increased with resultant increases in collective dose values over the last decade.Objective: To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Materials and methods: Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Results: Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Conclusion: Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings.
