Assignment 2 Flashcards
According to the Inter-Society Council for Radiation Oncology Blue Book, what does structure include?
the staff, equipment, and facility
According to the Inter-Society Council for Radiation Oncology Blue Book, what does process cover?
the pre- and post-treatment evaluation and the actual treatment application
According to the Inter-Society Council for Radiation Oncology Blue Book, how is outcome documented?
by the frequency of accomplishing stated objectives usually tumor control, and by the frequency and seriousness of treatment-induced sequelae
define sequelae
the afteraffects of a disease, condition, or injury; a secondary result
What book, published in 2012, provides a blue print for contemporary radiation oncology facilities in terms of structure, process, and personnel requirements?
Safety Is No Accident: A Framework for Quality Radiation Oncology and Care
who has the overall responsibility for the conduct of the entire radation treatment process
the radiation oncologist
Calibration of radiation generators or sources is the exclusive responsibility of whom?
the medical physicist
Next to calibration and quality assurance of radiation equipment, what is the physicist’s role?
treatment planning
What are the 5 categories that describe the roles and responsibilities of physicists?
- equipment (Teletherapy, Brachytherapy, Simulator)
- treatment planning (Teletherapy & Brachytherapy)
- dosimetry
- radiation protection
- academic/ administrative
The final treatment plan is approved by the _________ after discussing the plan with the _________
radiation oncologist
physicist
Who controls the use of all reactor-produced materials (by product materials) in the U.S.?
the U.S. Nuclear Regulatory Commision (USNRC)
Who regulates the use of naturally occurring radioactive materials (e.g. radium) and x-ray machines?
individual states
New NRC regulations go through the usual _______ and _________process as is customary for the enactment of any federal regulation.
public
congressional hearing
Who has the responsibility of implementing the radiation protection program?
Radiation Safety Officer (RSO)
What must each medical institution licensee establish to oversee the use of byproduct material?
a radiation safety committee
What is a written directive?
a prescription
If, because of the emergent nature of the patient’s condition, a delay in order to provide a written directive would jeopardize the patient’s health, what is acceptable?
an oral directive
A written directive must be prepared within (what length of time?) of the oral directive.
48 hours
what is teletherapy
external beam radiation therapy
For teletherapy, what must the written directive contain?
- patient’s name
- the total dose
- dose per fraction
- # of fractions
- treatment site
What term has replaced the formerly used terms of “misadministration” and “recordable event?”
medical event
what is byprodcut material
Radioactive material produced by a nuclear reactor; a radioisotope
Is an event that results from patient intervention considered a “medical event?”
no
what is the definition of “effective dose equivalent”
The sum of the weighted dose equivalents for individual tissues or organs
what is a “leaking sealed source”
a radioactive material or byproduct whose material is escaping the capsule in which it is encased.
when must a licensee report a medical event
- A dose that differs from the prescribed dose by more than 5 rem effective dose equivalent, 50 rem to an organ or tissue, or 50 rem shallow dose equivalent to the skin
- A dose that exceeds 5 rem effective dose equivalent, 50 rem to an organ or tissue, or 50 rem shallow dose equivalent to the skin from any of the following:
- A dose to the skin or an organ or tissue other than the treatment site that exceeds the dose defined in the written directive by 50 rem or 50% (or more). This excludes seeds, in the case of permanent implants, that migrated outside the correct treatment site.
How many Sieverts are in 5 rem?
.05 Sv
How many Sieverts are in 50 rem?
.5 Sv
The licensee authorized to use radiopharmaceuticals must possess a dose calibrator to measure activity administered to each patient. The calibrator must be checked for constancy of response, accuracy of calibration, linearity, and source geometry dependence. How long must the records of these checks be retained?
3 years
The licensee must possess calibrated survey instruments. When must calibration of the survey meter be done?
- before first use
- following repair
- annually
How long must records of each survey instrument calibration be retained?
for 3 years
Must the licensee leak test the source before its first use?
yes, unless the licensee has a leak test certificate from the supplier
How often must subsequent leak tests be performed?
at intervals not to exceed 6 months
If the leakage test reveals the presence of 0.005 microcurie or more of removable contamination, what must happen?
the source mst be withdrawn from use and appropriately stored
How often must the licensee conduct a physical inventory of all sources in possession and measure ambient dose rates?
quartly
How long must records of the surveys referred to in question 35( physical inventory of all sources) be maintained?
3 years
When can a patient who is administered a radiopharmaceutical be released from medical care?
a. the measured dose rate at a distance of 1 m from the patient is less than 5 mrem/hour, or
b. the activity remaining in the patent is less than 30 microcurie.
When can a patient who is administered a permanent brachytherapy implant be released from medical care?
until the measured dose at a distance of 1 m from the patient is less than 5 mrem/hr
When can a patient with a temporary implant be released from medical care?
- all sources have been removed
- the patient is surveyed with a radaition detector to confirm that all sources have been removed
How long must the licensee retain records of surveys referred to in questions 37, 38, and 39(patient with radiopharmaceutical)?
3 years
A licensee shall provide radiation safety instructions to all personnel caring for the patient undergoing implant therapy. How long must these instruction records be retained?
3 years
Can a licensee house a patient receiving implant therapy in the same room as a patient who is not receiving radiation therapy?
no, unless an exception is justified by the NRC
In the case of patients receiving brachytherapy, what must the sign posted on the patient’s door read?
“radioactive material”
Can individuals under the age of 18 visit a patient receiving brachytherapy?
only on a patient-by-patient basis with the approval of the authorized user and the RSO
If a patient receiving brachytherapy dies or has a medical emergency, who must be notified immediately?
RSO
What safety precautions are specific to the teletherapy room door?
a. Door interlocks that prevent the beam from turning on when the door is open, and
b. Prevents the beam from turning back on after a door interlock interruption without closing the door and resetting the beam on at the console
Are radiation therapists permitted to treat patients without a permanent radiation monitor?
no, a permanent radiation monitor must continuously montior beam status
Are radiation therapists permitted to treat patients without equipment that allows for continuous observation of the teletherapy room from the console?
No, the teletherapy room must have equipment that allows for continuous observation of the patient from the teletherapy unit console during irradiation.
A licensee shall perform full calibration measurements on the teletherapy unit if spot check measurements indicate that the output differs more than ___% from the output obtained at the last full calibration, corrected for radioactive decay.
5%
Does a licensee need to perform full calibration measurements on the teletherapy unit after the source is replacement? How about after the teletherapy unit is relocated? How about after the teletherapy unit is repaired?
yes to all three
How often does a licensee need to perform full calibration measurements on the teletherapy unit?
at intervals not exceeding 1 year
Does a licensee need to retain a record of each calibration for the duration of the teletherapy unit?
yes
In the case of malfunction of a safety mechanism, what must be done?
the licensee shall lock the control console in the off position and not use the unit until necessary repairs have been made
In the case of a teletheraphy unit that contains a sealed source of cobalt-60 or cesium-137, what must be done a) before medical use, b) after each installation of a teletherapy source, and c) after making any change for which an amendment is required?
the licensee shall perform a radiation survey of the facility
What must the survey (of a teletheraphy unit that contains a sealed source of cobalt-60 or cesium-137) referred to in question 55 verify?
a. That the leakage from the source head with the beam in the off position doesn’t exceed 2 mrem/hour on average & 10 mremn/hour maximum, both measured at a distance 1 m from the source
b. That dose rates outside the room in the restricted and unrestricted areas don’t exceed the limits specified by the NRC
In rem, what is the maximum permissible whole-body exposure for individuals in the restricted area per calendar quarter?
1.25 rem
In the unrestricted area, radiation levels must not exceed _____ mrem in any 1 hour, _____ mrem in any 1 week, and _____ in any 1 year.
2
100
0.5
) In the case of a teletheraphy unit that contains a sealed source of cobalt-60 or cesium-137, a licensee shall have the teletherapy unit fully inspected and serviced at a minimum of once every ______ years.
5 years
