ICRP Publication 105: Radiological Protection in Medicine Volume 105, Annals of the ICRP Volume 37 Issue 6

Abstract This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report consolidates that advice.

Table of Contents

1. Background
2. Scope of Ionising Radiation in Medicine
3. Brief Summary of Biological Basis for Radiological Protection
4. Dosimetric Quantities
5. The Framework of Radiological Protection in the New Recommendations
6. Unique Aspects of Radiological Protection in Medicine for Patients
7. Discussion of the Term 'Practice'
8. Justification of a Radiological Practice in Medicine
9. Optimisation of Protection for Patients in Medical Exposures
10. Diagnostic Reference Levels
11. Individual Dose Limits
12. Preventing Accidents and Emergencies in Medicine
13. Emergency Medical Situations with Radioactive Materials
14. Education and Training
15. Institutional Arrangements
16. Practical Methods of Protection Other than for Patients
Appendix. Focused Evaluations of Radiological Protection in Medicine