Rad Bio Risk Flashcards

1
Q

Maximum Permissible Dose (MPD)

A

That amount of radiation which in the light
of present knowledge will not produce any
serious, harmful, or deleterious effects on
the individual receiving it

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2
Q

Occupational limits

A

5.0 rem/year (5,000 mrem)
50 mSv

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3
Q

Non-occupational limits

A

0.5 rem/year (500 mrem)
5 mSv

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4
Q

dental personnel avg =

A

0.2 mSv

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5
Q

sources of radiation exposure to the US population
~ of
radiation
exposure

A

1/6

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6
Q

In May 2007, the American College of
Radiologists published a white paper
cautioning the medical profession that
Americans are being exposed to record
amounts of ionizing radiation.
* (2) have
risen sharply in this time period.

A

Nuclear medicine and CT exams

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7
Q

Medical imaging
> –% of
radiation
exposure ! ! !

A

50

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8
Q

Estimated Dependence of Lifetime Radiation-Induced Risk of Cancer
on Age at Exposure for Two of the Most Common Radiogenic Cancers.

Cancer risks decrease with increasing —
latency periods for solid tumors are
typically —
children have more years of life during
which a potential cancer can be expressed
children are inherently more —

A

age
decades
radiosensitive

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9
Q

children are inherently more radiosensitive (2)

A

●larger proportion of dividing cells
●less shielding of radiation
sensitive organs

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10
Q

*Females < 10 yo, ~ times more likely to develop
fatal cancer than 50 yo!! (i.e., 15.5% - 2.8%)
*20 yo females are ~ times more likely to develop
fatal cancer than 50 yo!! (i.e., 9.5% - 2.8%)
*30 yo females are ~3 times as likely more develop fatal
cancer than 50 yo!! (i.e., 8.5% - 2.5%)
*40 yo females are ~ times as likely more develop fatal
cancer than 50 yo!! (i.e., 2.8% - 2.5%)

A

5.5 to 6.0
3.0 – 3.5
3
1.5

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11
Q

Males < 10 yo, ~ X more likely to develop fatal cancer
than 50 yo!! (i.e., 12.5% - 2.5%)
*20 yo males are ~ times as likely to develop fatal cancer
than 50 yo!! (i.e., 7.5% - 2.5%)
*30 yo males are ~times as likely to develop fatal cancer
than 50 yo!! (i.e., 7.0% - 2.5%)
*40 yo males are ~ times as likely to develop fatal cancer
than 50 yo!! (i.e., 3.0% - 2.5%)

A

4 to 5
3
2.8
1.2

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12
Q

skipped
Age in
years
Female
% Risk of Fatal Radiation
Induced Cancer
10
20
30
40
50

A

16.8
9.5
8.5
4.0
2.8

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13
Q

skipped
Male
Risk of Fatal Radiation
Induced Cancer
10
20
30
40
50

A

12.5
7.5
7.0
3.0
2.5

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14
Q

Pediatric tissues at
greatest level of
radiosensitivity due to

A

rate of cellular and
organ growth

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15
Q

Greater life expectancy
puts children at —
greater risk of being
afflicted with a radiation
induced cancer

A

2-10

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16
Q

Female orthodontic patients in the age group 11-15 who have more than 1 CBCT in
2 years have a risk of – deaths per million CBCT exposures (median dose of 300
uSv. )

17
Q

CBCT Risks
* Female orthodontic patients in the age group 11-15 who have more than 1 CBCT in
2 years have a risk of 71 deaths per million CBCT exposures (median dose of 300
uSv. )
* maximum doses of machines were

18
Q

In this small group the risk increases to – deaths per million CBCT exposures
– ~2.8 deaths per 10,000 CBCT exposures
– ~1.0 death per 1,000 CBCT exposures

19
Q

skipped
— new ortho patients with 3 CBCTs each over a 2 year period

20
Q

skipped
with –% females patients aged 11-15 years, then 190 girls every 2 years. In about
10 years the risk of causing one death is high

21
Q

US dentists may cause 967 cases of cancer per year from dental radiography
Use of — and selection criteria could reduce this to 237

A

rectangular collimation

22
Q

The trend in orthodontic treatment is to replace lower dose panoramic and
cephalometric radiography with

A

higher dose cone beam computed tomography

23
Q

exposing a girl of 10 to 14 years to 3 CBCTs over a 2-year period, the risk of this
child developing cancer is about

A

1:6,000 (vs 1:1,000,000)

24
Q

although there was evidence of some bias in our original risk estimates, re-analysis of the cohort with additional clinical data still showed an increased cancer risk after

A

low dose radiation exposure from CT scans in young patients

25
Threshold Non-Linear Curve (3)
* Small exposures to a substance do not produce measurable changes * A threshold must be reached before changes are observed * Most biologic effects are non- linear
26
Radiation Erythema * 250 Rads – * 500 Rads – * 750 Rads –
Threshold radiation Erythema Dose (TED) Average radiation Erythema Dose Maximum radiation Erythema Dose
27
skipped 1959 In 1959, dental radiation dose was
1 Rad/ second with an 8” focal distance 10 mA, 65 kV (Ennis and Berry) 28 Maximum allowable x-ray exposure limits were 50% of TED; i.e., 125 Rads
28
skipped 1959In 1959, dental radiation dose was 1 Rad/ second with an 8” focal distance 10 mA, 65 kV (Ennis and Berry) 29 One periapical exposure averaged -- seconds; i.e., 120 impulses or 2.00 s; this equates to 20mAs; 1,250/20 = -- exposures delivers the TED 1/3 of the TED is delivered with ~-- intraoral dental exposures (one FMS)
2 62 20
29
skipped 2020 It takes 417 mAs/1.4 mAs = ~--- exposures 1/3 of the TED is delivered with ~--- intraoral dental exposures In 2020, 8” focal distances at 7mAs and 0.2 s (7mA * 02s = 1.4 mAs) 1.4 mAs/ exposure
298 298
30
Linear Non-Threshold Curve - 1 (2)
* Dose is proportional to the response * No matter how small the dose, there is some damage
31
Linear Nonthreshold Curve -2 (2)
* No threshold * Minimal damage at first with increased rate of damage with increased dose
32
SELECTION CRITERIA FDA/ADA * Imaging requires --- * Need a specific ... * An --- is required to make this assessment
justification question or a diagnostic task where radiographs will provide unique information not readily available from other diagnostic means initial clinical exam
33
Patient Shielding During Dentomaxillofacial Radiology Recommendation 1 - Recommendation 2 -
Recommendation 1 * discontinuing shielding of the gonads, pelvic structures, and fetuses during all dentomaxillofacial radiographic imaging procedures Recommendation 2 * thyroid shielding not be used during intraoral, panoramic, cephalometric, and CBCT imaging as the risks of thyroid cancer are negligible from contemporary maxillofacial imaging radiation doses 48
34