The Duties and Responsibilities of the Radiation Safety Officer

The Duties and Responsibilities of the Radiation Safety Officer

Leave a comment Nuclear Medicine, Quality Control, Radiation Safety
The Duties and Responsibilities of the RSO

In this week’s video, Eric from Olympic Health Physics provides an overview of the duties and responsibilities of the RSO or Radiation Safety Officer.

This video covers the regulatory requirements and expectations of a medical RSO following the guidance in NUREG 1556, Vol. 9, Rev. 3. that is specific to medical licensees.

What Is a Radiation Safety Officer?

The Radiation Safety Officer or RSO is the person within a medical licensee facility who is responsible for overseeing and implementing the radiation safety program. They are the ones responsible for ensuring that the facility is compliant with all of the regulations and overseeing that radiation safety program.

Twelve General Duties and Responsibilities of the RSO

We’re going to go through some of the typical duties and responsibilities of the Radiation Safety Officer. It’s important to note there can be many additional duties assigned to the RSO. Below, we outline twelve general duties of the Radiation Safety Officer in relation to the regulatory requirements and expectations of a medical RSO following the guidance in NUREG 1556, Vol. 9, Rev. 3. that is specific to medical licensees.

1. Stop Work Authority

The first duty of the Radiation Safety Officer is Stop Work Authority. What does this mean?

It means that the Radiation Safety Officer has the ability to stop any work involving radioactive materials. This is usually spelled out in what’s called a Delegation of Authority that comes from the facilities administration and assigned by facility administration, as well as the Radiation Safety Officer. Stop Work Authority is usually used whenever there are unsafe work practices and something needs to be fixed or changed before the work can continue.

2. Overseeing the ALARA Program

The Radiation Safety Officer has a responsibility to ensure that radioactive doses are kept ALARA. ALARA is an acronym that stands for As Low As Reasonably Achievable. Within the facility, the RSO is responsible for ALARA and implementing an ALARA program.

3. Managing Radioactive Materials Usage

They also oversee all radioactive materials uses, including monitoring and surveying of all areas where radioactive materials are either used or stored.

4. Implementing Policies and Procedures

The RSO is responsible for drafting and implementing policies and procedures that deal specifically with the security of radioactive material, emergency procedures and operations that employ radioactive materials.

5. Training For Workers Handling Radioactive Materials

The Radiation Safety Officer typically conducts training for radioactive materials workers. They’re going to be providing training about the use and safety of radioactive materials within the facility.

6. Transportation, Delivery, and Radioactive Materials Limits

They are also  responsible for the safe transportation and delivery of radioactive materials. The RSO ensures the packages are checked in properly, that there are surveys of packages and all deliveries are documented. Radiation Safety Officers also ensure that the facility’s possession limits are adhered to. The possession limits are outlined in the radioactive materials license for the facility. The RSO is responsible for making sure that the facility doesn’t exceed radioactive material possession limits.

7. Dosimetry Program

The RSO is also going to oversee and potentially implement the dosimetry program. Dosimetry is how we measure or monitor radiation doses, such as occupational radiation exposure, for staff. 

8. Security of Radioactive Materials

Security of radioactive materials fall under the jurisdiction of the Radiation Safety Officer to ensure that any radioactive material is going to be secured from unauthorized removal. This is typically done in one of two ways. Either the radioactive material is going to be under lock and key of some sort, or it can also be under constant surveillance. So the radiation safety officer will be responsible for making sure that radioactive materials are secured in one of these two ways.

9. Documentation of the Radiation Safety Program

Documentation is a really big topic because any time we’re dealing with radioactive materials, we have to document most of the processes that go with them. Some of the documentation include surveys, inventory, receipt, and disposal of waste. All of these activities should be documented.

10. Liaison With Regulators

They’re also going to serve as a liaison with regulators and report any medical events or anything that’s a reportable event. The RSO will report events either to the state, if they’re in agreement state or to the NRC, if they’re not in an agreement state.

11. Managing the Radioactive Materials License

The Radiation Safety Officer may manage the radioactive materials license. This can include implementing any license conditions within the radioactive materials license, as well as submitting any amendments to the regulatory agency for changes to the license. Amendments are typically going to be for things like:

• changing an authorized user
• changing the radiation safety officer
• changing the address of the facility
• changing the name of the facility
• changing the proposed uses or the locations of those uses

All the above are typical things that would require submitted amendments.

12. Implement Corrective Actions

And lastly, the RSO implements any corrective actions for deficiencies or inefficiencies that are found in a radiation protection program, audits or external inspection conducted by a regulatory agency.

Duties of the RSO

So this gives you a high level overview of the duties and responsibilities of the Radiation Safety Officer. The RSO may have more duties than what we’ve listed here. It’s usually up to the organization on what those responsibilities and duties will be for the RSO, but this will give you a pretty good place to start to understand the role of an RSO.

Questions and comments about RSO duties? Feel free to shoot them over to us. We’ll be happy to respond to any questions or comments that you have around Radiation Safety Officers and be a resource for you.

Our team is dedicated to ensuring that your facilities’ radiation safety program functions in accordance to regulatory standards, sound radiation safety principles, and most importantly serves to protect staff, patients, and the general public from the hazards associated with ionizing radiation. To this end, Olympic Health Physics can provide a physicist to your organization to fulfill the Duties of the Radiation Safety Officer. To learn more, check out our RSO Services or click the link below. 

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An ACR MRI Safety Manual Overview

Leave a comment Magnetic Resonance Imaging, Quality Control
An ACR MRI Safety Manual Overview

In this post, we are providing an overview of the 2020 ACR MRI Safety Manual.

In 2013, the ACR published a white paper on MRI safety, and then in 2020 there was an update to that white paper that came in manual form. The intent of this manual was to be used directly by radiology technologists and imaging centers to have policies and procedures that would be more directly applicable to safety in the clinical environment.

Most of the manual is essentially unchanged from the 2013 white paper. There are sections that are identical and there are other sections that are largely the same. Then, there’s been some changes since the 2013 white paper into the 2020 manual.

Watch the video below on our YouTube channel as Eric walks you through an overview of the ACR Safety Manual for Magnetic Resonance Imaging procedures. 

What Are The Significant Changes in The 2020 Manual?

The most significant change is the designation and delegation of duties of:

  • the MR MD or the MR Medical Director
  • the MR SO or the MR Safety Officer, and
  • the MR SE or the MR Safety Expert

The manual does a really good job of outlining a good MRI safety program structure with these three positions. 

Is The Manual a Requirement for ACR Accreditation?

One thing to point out about the manual is that even though it uses words like shall, will and must, the manual itself is not a requirement of ACR accreditation.

Whenever you apply for ACR accreditation or are inspected by an ACR inspector, they’re not going to check to see if you’ve implemented this particular manual. They’re going to look to see that you have safety policies in place. Those safety policies can be the ones out of the manual, which is the intent of them providing the MR Safety Manual. However, they can also differ from what’s in the manual. You are not necessarily beholden to the exact verbiage that’s in the manual, but it’s a really good starting point for developing your own policies and procedures for your specific MRI department.

ACR Manual on MR Safety

An Overview of the ACR Manual

The manual itself is 56 pages long. It’s quite a thorough manual and it provides excellent information on MRI safety. The idea behind it is that you use the manual and that you implement the policies and procedures in the manual, or at least some version of them in your own policies and procedures for your MRI department. You can find this MRI safety manual on the ACR website.

Table of Contents

The Table of Contents provides an overview of the manual’s general layout. You can see there are many different sections within the manual. Within these sections, there are specific policies or procedures that you’re going to need to be compliant with the ACR.

The Table of Contents from the ACR Manual on MR Safety
Example of MRI procedures and policies listed in the ACR Manual on MR Safety

Examples of Policies and Procedures

Within the safety manual, you can find policies or procedures on elements such as:

  • policies on personnel and non personnel
  • who MR technologists are
  • the differences between level one and level two trained staff
  • policy for screening right here staff as well as patient screening

We also have pediatric policy as well as policy for pregnancy. The manual cover things like sedation, as well as contrast policy. It covers implants, devices and objects and how we screen for them.

The manual discusses several things in the MRI environment, such as the different MRI zones, the MRI contrast agent safety and responding to codes. There is coverage on hearing protection as well as thermal heating. All of those topics are going to be found in the manual.

There’s also a new appendix. Appendix one talks about the organizational structure for the MRI safety program. Appendix two reviews facility safety designs. And Appendix three reviews emergency preparedness. 

And that’s a snapshot on the ACR MRI safety manual that came out in 2020. We’re sure there will be newer versions of this at some point in the future, but for now, this is a really good place to start and use as a resource for the development of your own policies and procedures in creating a safer MRI department for staff, patients and visitors.

If you have questions about the MRI safety manual or questions about MA safety in general, feel free to drop a comment or send us an email. We’ll be happy to take a look at your MRI department, talk about your policies and procedures and see how we might be able to help.

If you require assistance with your MRI safety program or MRI physics testing, please reach out or click here to learn more about our medical and health physics services. You can also always reach out to us if you have questions or want more information on why you should partner with us. 

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Veterinary Radiation Shielding Design for X-Ray

Leave a comment Radiography, Veterinarian
Veterinary Shielding Design for X-Ray

In this post, we’re going to be talking about veterinary radiation shielding designs for X-Ray.

Watch the video below on our YouTube channel as Eric walks you through what a veterinary radiation shielding design is for, what information is required to prepare a design, and the calculations used to create it.

What Are We Shielding in Veterinary Medicine?

When creating a radiation shielding design for veterinary medicine, we’re shielding the x-ray units that are installed in veterinarian hospitals. Oftentimes, we will also shield dental spaces, although we aren’t talking about dental today.

Why Do We Need Shielding At All?

The reason that we need shielding is so that we can demonstrate that we are not exposing members of the public or employees to radiation unnecessarily. We want to create a shield around the x-ray unit and the room that the x-ray unit is in to ensure that the radiation produced stays in that space. This includes either primary radiation or scatter radiation.

Factors Required For Shielding a Veterinarian Radiographic Space

What are the factors that we need to consider when we’re shielding a veterinarian radiographic space?

There are actually a number of factors. All of the information that we need comes from a guidance document called NCRP, Report Number 148, which is Radiation Protection in Veterinary Medicine. The appendix walks us through exactly how to do a shielding design. The pieces of information that we need are:

  • The maximum operating Kv (max kVp). This is the maximum operating Kv that you’re going to use clinically.
  • The average mAs that you’re going to use clinically
  • How many patients per week on average are going to receive x-ray imaging

What is Workload?

Using the three values from above, we can determine the workload or how much radiation is going to be generated within the radiology space for a given week. We then convert that to milliamp minutes per week to get the workload.

What is the Use Factor?

We also need to know the use factor. The use factor is how often the x-ray tube is pointed or radiation is incident on a particular barrier. Oftentimes if you’re in a single story building, there’s no occupancy above or below the x-ray space. Then we only consider scatter radiation. If you have a multiple story building and you are directing the useful beam either into the floor or into a wall, then we need to consider the use or how often it’s going to be pointed at a particular wall to understand the primary radiation. In most veterinarian applications, the x-ray tube is just pointed at the floor. Most veterinarian hospitals are in a single story building, or if it isn’t in a single story building, the x-ray will be on the first floor with nothing below. In those cases we can just assume scatter radiation, which is a little bit easier to deal with from a shielding perspective.

What is the Occupancy Factor?

In addition to the workload and the use factor, we also need to know the occupancy factor. The occupancy factor is a description of what is in the surrounding areas that are around the x-ray room. For example, is there a hallway on the other side or is it a office, a bathroom or is it an outside exterior to the building? We need to know what is around the x-ray room so that we can apply the correct occupancy factor.

A Floor Map or Blueprint

The best way for us to do this is to get a floor map, and that floor map should be to scale so that we know what the distances are from the x-ray unit itself to each of the different barriers. With that floor map, we can measure those distances and we can also determine what is on the other side of each wall.

From there, we need to know a description of what is in each barrier that is already in the room. Are we talking about just standard gypsum wallboard? Are we talking about exterior walls with concrete masonry unit blocks? Concrete blocks? What is in the walls already? Has the room previously been shielded or is there already maybe lead in the walls?

We also want to know this information before we get started on the shielding design. Oftentimes we can get that information if it’s an older building using an as-built blueprint from the architect or potentially we could use a previous shielding design that was done in the past.

The Shielding Design Calculation

From all of the information gathered above, we calculate the shielding design using the following formula, where each value equals:

W = Workload

U = Use Factor

T = Occupancy Factor

We multiply those numbers together and divide by PD squared.

P = Design Goal. The design goal is the amount of radiation dose that we’re allowed to go through the wall.

D = Distance From the X-Ray Source to the Barrier

Putting it All Together

Once we complete the calculation using the formula, we can use this information to go back to a lookup table in our guidance documents and NCRP Report Number 148. We look up that value against the max operating voltage, the max kVp, and determine the amount of shielding that needs to be put into the barrier for a veterinarian x-ray.

Oftentimes we find that we can shield the room with simple drywall or perhaps additional layers of or thicker drywall or gypsum wallboard. There are some applications where we need to put lead into the walls because it would be too much drywall stacked on top of each other.

Height of Shielding

When we prescribe any kind of shielding, it needs to extend from the floor to a height of seven feet, and any barrier penetrations for things like outlets or duct work would need to be backed or somehow stopped with the equivalent material that’s prescribed in the rest of the wall.

Additionally, for veterinarian x-ray installations, we oftentimes don’t see control rooms. This is standard practice in veterinarian medicine. The last thing to know about veterinarian shielding designs is that even though we may not need to put lead in the walls, oftentimes the actual shielding design is going to be required by a regulatory agency, normally a state.

If you’re installing a new x-ray unit in a veterinarian suite, it’s important to understand the actual requirements for producing a radiation shielding design for veterinarian spaces.

Conclusion

If you have questions about radiation shielding design for veterinarian applications, feel free to reach out.

We’ll be happy to review your particular situation and give you ideas on the best way that you can shield your x-ray room and make sure that you’re keeping your department, your clinic, or your hospital safe for your staff and your visitors.

If you require assistance with a veterinary radiation shielding design, including CT and dental, please reach out or click here to learn more about our shielding design services. You can also always reach out to us if you have questions or want more information on why you should partner with us. 

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How Does AutomA Work?

Leave a comment Computed Tomography
How Does AutomA Work?

In this post, we’re going to be talking about AutomA, what it is and how to use it.

Whether you have a GE CT Scanner or you’re interested in getting a GE CT Scanner, we will provide you with an overview of what AutomA is all about.  

Watch the video above on our YouTube channel as Eric walks you through exactly what AutomA and SmartmA are and uncovers some of the mystery surrounding these GE CT Scanner options.

Before we get too, it’s important to understand that this post uses the terms AutomA and SmartmA interchangeably to mean GE’s version of automated exposure control or tube current modulation. They are somewhat different and we’re going to talk about the differences.

What is AutomA?

When we’re using AutomA, we’re using a GE version of tube current modulation.

With AutomA, we’re able to modulate the dose in the Z axis. As we scan a patient from head to toe, the tube current is going to modulate based on the size, shape and density of the material that you’re going through. For example, if you’re scanning through the chest, we may be able to use a lower mA, whereas if we’re scanning through the abdomen and pelvis, we may need to use a higher mA. AutomA is going to automatically adjust the amount of mA that’s used as you’re scanning from the chest into the abdomen.

What is SmartmA?

Smart AutomA is a rotational RMA, allowing the scanner to change the mA in the X and Y planes. As the tube rotates around the patient, the mA is going to modulate up and down based on whether or not there’s more anatomy to penetrate and the anterior projection versus the lateral projection. To summarize, AutomA is only in the Z direction. So it’s a limited version of tube current modulation, whereas if you turn on SmartmA you get modulation in all three planes, the X, Y and Z plane. With either of these features enabled, it’s important for you to ISO center the patient.

What is the Importance of IsoCentering Your Patient?

When using either AutomA or SmartmA, it’s important for you to isocenter the patient. Isocentering the patient is important because you want to have an accurate size–shape model. AutomA is going to use your scout as well as the noise index to calculate how much mA the scanner should use as it scans through the patient.  

What is Noise Index?

Before we discuss noise index, let’s talk a little bit about noise. Noise is going to be inversely related to the number of x–rays. We can think of x–rays and mA as being equivalent to each other. As a result, when we increase our mA or we produce more x–rays, we’re going to decrease the amount of noise in our image. This creates better images.

The opposite is also true. If we decrease the amount of x–rays or decrease our mA, we will increase the noise and create noisier images. The noise index is going to approximately equal the noise or the standard deviation in the central region of an image using a standard or uniform phantom. With your patient images, you can draw a region of interest in the center of the image and the noise index or the standard deviation should closely mimic your noise index that was set for the scan. 

What is the Importance of Noise Index Values?

The other detail to know about AutomA or SmartmA is that the noise index value is going to be set for the first perspective reconstructed image series. You want to set your noise index values understanding the thickness of the first reconstructed slice. If it’s 2.5 millimeters or 5 millimeters, you’re going to want to set that noise index based on the slice thickness. For example, if you have a noise index of ten and the first reconstructed image series is a 5 millimeter, then your noise index or the standard deviation in that five millimeter slice should be close to ten. But if your first reconstructed image is 0.625, then AutomA is going to use a lot more mA to account for the loss of data in the thinner slices. 

The GE CT Scanner Panel for mA Control

Let’s take a look at what this actually looks like on a GE scanner. On the scanner panel photo below, we can see that AutomA is turned on and SmartmA is not turned on. If you want to turn on SmartmA, you just click the button to turn it on. The panel also shows the reference noise index as well as the noise index. 

The Reference Noise Index is the default noise index for a given protocol, whereas the Noise Index is the noise index that’s going to be applied for that specific scan or patient.

We also have dose steps. The dose steps will increase or decrease the noise index by about 5% and then have an opposite effect of about 10% on the mA. You can click either of these buttons, the up or down on the dose steps and see how it changes the noise index compared to the reference noise index.

You’ll also note on here that you have an mA range with a minimum and a maximum. The great thing that GE does is apply that maximum mA so that you know you’ll never exceed a particular CTDI or radiation dose for a given patient.

You do want to pay attention to the mA that is given to the patient or the resultant KTVI whenever you’re doing dose reviews to make sure that you’re not maxing out this mA on every single patient. One challenge we see quite frequently is when AutomA is being used, every patient gets the maximum dose. 

You can turn on the Manual mA and enter in the value of the mA that you want to apply for the scan and that will turn off both AutomA and SmartmA. GE does have some newer versions of software and while they look different, all the metrics are called the same and they work in the same way. You can take these concepts here and  apply that them to the newer versions of software.

Conclusion

This pretty much covers the basics of AutomA and SmartmA, what noise index means, how noise index works, how to set your mA range and how to use AutomA and SmartmA to benefit your patients. This can ensure they’re receiving the correct radiation dose. This also helps you to produce consistent image quality from patient to patient and providing quality care to your patients.

If you have questions about AutomA, SmartmA, or how tube current modulation works for GE scanners, feel free to send us a note, drop us a comment and let us know how we can help you. 

Ensuring your equipment is operating properly through an annual CT Physics Evaluation may be the best first step in providing a safe environment for your patients. Our CT Physics Evaluations are designed to be compliant with ACR, TJC, IAC, and State requirements for accreditation and compliance purposes.   You can also always reach out to us if you have questions or want more information on why you should partner with us. 

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