a novel software for user-friendly calculation of radiation risk
TRANSCRIPT
A novel software for
user-friendly calculation
of radiation risk:
RADIORISK 1.3
M. Paterni, C. Carpeggiani, A. Ripoli,
D. Caramella, M. Lazzeri, C. Traino, E. Picano
CNR – Istitute of Clinical Physiology
Background
Awareness of radiological risk is low
among cardiologists, who prescribe
the majority (60-80%) of ionizing test
examinations (totalling today the
dose equivalent of about 150 chest
x-rays per head per year) and are
the most exposed among health
professionals (250-300 chest x-rays
per head per year for most active
interventional cardiologists)
SUIT
Stop Useless
Imaging Testing
Project of the Institute of Clinical
Physiology and of the Tuscany Region
to search new strategies to reduce
inappropriate use of Imaging Testing
RadioRiskSoftware to calculate and communicate radiological risk to patients and doctors
SUIT Project
RadioRisk
Basic function
Natural
source
Professional
sources
Cancer RISK
estimationBEIR VII reference
Personal history of exposure to
ionizing radiation
Medical
sources
Guidelines
Gerber TG et al: Ionizing Radiation in Cardiac Imaging. A
Science Advisory from the American Heart Association
Committee on Cardiac Imaging of the Council on Clinical
Cardiology and Committee on Cardiovascular Imaging
and Intervention of the Council on Cardiovascular
Radiology and Intervention. Circulation 2009;119:1056-
1065
The Royal College of Radiologists (RCR): Making the
best use of clinical radiology services (MBUR), 2007, 6th
edition
Budoff MJ, Achenbach S, et al: Assessment of Coronary
Artery Disease by Cardiac Computed Tomography. A
Scientific Statement from the American Heart Association
Committee on Cardiovascular Imaging and Intervention,
Council on Cardiovascular Radiology and Intervention,
and Committee on Cardiac Imaging, Council on Clinical
Cardiology. Circulation 2006;114:1761-1791
Dose reference
• Reference European guideline
(2001)
• Guidelines of Italian Minister of
Health
• Peer reviewed journal
• Government Agency
• From each exam data file (if
available)
Cancer Risk estimation
• The estimation is base on 100000 studies,
including 87000 Hiroshima and 407000 nuclear
workers
• 2 to 3 confidence intervals of attributable risks
estimate
• X-rays and gamma-rays are a proven carcinogen
(WHO’s International Agency of Research of
Cancer)
• Epidemiological evidence up to now above 50
mSv
• Re-affirm Linear No-Threshold hypothesis
BEIR VII,2006
Main interface of the software
Your subtopics go here
History of exposure to
ionizing radiation
Exposure, charts, risk estimationIndividual
informations
Dose report
Cumulative exposure from each source
Cumulative exposure Annual exposure
Risk report
Cumulative cancer risk
Table of risk and extra
cancer risk from
medical exposure
Annual cancer risk
Other communication approaches
Cigarette smokingTravelling by car Rock climbing
Coal miner working Stay near Hiroshima
on 6 August 1945
Comparison to other risks
Case 1:coronary revascularization
Cumulative (natural + diagnostical) exposure: 262
mSv (13079 chest x-rays)
7000 chest x-rays from diagnostical exposure
Extra cancer risk from medical exposure: 1 in 100
The risk is equal to stay at 89,7 Km from Hiroshima
on 6 August 1945
A 50 years old
man submitted
to coronary
revascularization
Case 2:interventional cardiologist
An interventional
cardiologist with
20 years of
professional
exposure
Cumulative (natural+professional+diagnostical)
exposure: 310 mSv (15503 chest x-rays)
8000 chest x-rays from medical exposure
(professional+diagnostical)
Extra cancer risk from medical exposure: 1 in 100
The risk is equal to stay at 89,1 Km from Hiroshima
on 6 August 1945
RadioRisk mobile version
Reports
Patient database History
Simulation
Conclusions
A simple software program allows
straightforward calculation of:
• cumulative dose
• cancer risk
All data are transferred into images
and simple numbers quantifying
lifetime extra cancer risk
The image of radiation risk is
essential for increasing radiological
awareness in cardiologists