Strålevernets Novembermøte 2012 VELKOMMEN! Ny organisasjon fra 1.1.2013 Forvaltning av strålevernloven Forskning, overvåkning og LAB Forvaltning av forurensningsloven og atomenergiloven Struktur og seksjonering forhandles og drøftes i disse dager Hilde M. Olerud, seksjonssjef Gardermoen 12. November 2012
2 Hvordan oppnå en ønsket endring der ute? Lover og regler Nettverksbygging - dialog Mest hensiktsmessig virkemiddel avhenger av objekt!
3 Regulations versus professional quality standards 96/29/Euratom BSS 97/43/Euratom Patient directive Recommendation of scientific, medical or professional bodies Material published in well established scientific, medical or professional journals Advise of the medical society GOOD MEDICAL PRACTICE guidelines EURATOM directives, IAEA standards, IEC standards, etc, implemented in national radiation protection regulations INSPECTIONS using the national regulations as reference TECHNICAL or CLINICAL AUDITS using such professional guidelines as reference
4 Strålevernets kvalitetssikrings mandat Kvalitetssikring i stråleterapi, KVIST (10 år) Organisert og del finansiert fra Strålevernet Alle sentra representert, flerfaglig Gir faglige anbefalinger innen administrative, 2,5åv tekniske og kliniske problemstillinger Portal kvist.nrpa.no Virksomhetsrapportering Nettverksbygging, Norsk Stråleterapimøte, Workshops for inntegning/doseplan Teknisk kvalitetskontroll i Mammografiprogrammet (MP) (15 år) Statuskontroller alle apparater 2 åv Veiledning lokal konstanskontroll Evaluering ny teknologi, FoU Kvalitetssikring i diagnostikk, KVIDI Harmonisere protokoller for kvalitetskontroll av diagnostisk utstyr 2,5åv Nettverksbygging, videokonferanser FoU/Overvåkning/Internasjonalt samarbeid NRPA sekretariat Arbeidsgruppe Arbeidsgruppe Arbeidsgruppe Arbeidsgruppe Arbeidsgruppe
Dag 1: Møtearena for diagnostikkfysikk 5 10.00 Pågående FoU i HF ene Bildekvalitet Dose med «Nøtthellen» CT leverperfusjon, spektral avbildning PET, optimalisering skjelettscintigrafi Haukeland, OUS, St.Olav 11.30 Lunsj 12.30 Pågående FoU i HF ene Konstanskontroll DR Electron beam CT AEC mammografi, Mammo tomosyntese EPI-CT prosjektet, CT i rettsmedisin 1500 Radiation doses in medical imaging: Historical development, current radiation knowledge and optimizing tools 15.30 17.00 Diagnostikkfysikk i Norge, tanker om: Kvalitetskontrollregimer FoU, internasjonalt samarbeid, deltakelse i EU rammeprogrammer Erfaringer og utfordringer Synspunkter fra Radiologforeningen og NRF Sykehuset Tønsberg, Haukeland, Strålevernet, OUS INVITERT FOREDRAG Lars Borgen, PhD, Vestre Viken DISKUSJON
Strålevernet i internasjonalt perspektiv Nytt fra HERCA og DDM2 EPI-CT i egne foredrag Hilde M. Olerud, Dr.ing. Seksjonssjef Statens strålevern
7 www.herca.org
8 HERCA acchievments on RP medical HERCA and the U.S.A Food and Drug Administration sign a Memorandum of Understanding on radiation protection optimizing radiation dose from medical imaging and reducing unnecessary radiation exposure to patients from CT Regulators Work With Medical Industry on Radiation Protection At the initiative of HERCA, COCIR CT manufacturers have developed voluntary commitments contributing to the reduction of CT dose HERCA Position Paper on Screening in the framework of the exposure of asymptomatic individuals in healthcare clear distinction between screening and radiological procedures as part of an individual health assessment New version of the dose passbook approved (31/5/2012) coherent with the terminology in the latest draft of the Euratom BSS HERCA Patient release card patient release card after a therapeutic application of radionuclides complements the document 131 I therapy: Patient release criteria
Dose datamed 2 www.ddmed.eu
DDM2 milestones 2011-2012 Kick off January 18 th in Luxembourg 2011 http://www.ddmed.eu/ Interim meeting during ECR, Vienna 2011 Project meeting in Sophia 17. 18. May 2011 in front of training course Videoconference 16 September 2011 Meeting 28. September A.Jahnen/H.M.Olerud, Trondheim Consortium meeting in Helsinki 25. 26. Jan 2012 and interim meeting during ECR2012 In Sophia during DDM2 workshop in Athens 2012 Paris 29.Oct 2012 Final delivery 12. Dec Luxembourg 2012 (WP1) Training course RP154 methodology in Sophia 19. 20. May (WP4) Joint survey WP3&4 Separate Excel sheets X-ray and NM Test countries: Croatia, Italy, Poland, Slovenia and Spain Design of database input and reports of data from database (WP2) DDM2 workshop in Athens 24. 26. April 2012 (WP6) Analysis report writing, editing (WP5)
COUNTRIES THAT PROVIDED DATA in DDM2
X-RAY: EFFECTIVE DOSE 1,20 PER CAPUT (msv) 1,00 0,80 0,60 0,40 0,81 msv 0,99 msv Interventional radiology Computed tomography Fluoroscopy 0,20 Plain radiography 0,00 Nordic countries Europe
IS NO DK SE FI X-RAY: EFFECTIVE DOSE PER 1000 POPULATION (msv) 1800,0 1600,0 1400,0 1200,0 1000,0 800,0 600,0 400,0 200,0 0,0 Plain radiography Computed tomography Fluoroscopy Interventional radiology
Overall total frequency per 1000 of population X-RAY: FREQUENCIES PER 1000 2500,0 POPULATION 2000,0 1500,0 1000,0 500,0 0,0 IS HU CH ES CZ PT DE BE SK IR AT LU IT FR PL LI EE SI NO ME SP CR UK GR SE FI MT DK UA NL MD MA BG RO Plain radiography Fluoroscopy Computed tomography Interventional radiology
EE LU BE HU DE IS NO FR PT IT CZ CH PL LI GR ES ME DK IR AT SP SE SK MA CR MT UA SI NL FI BG MD UK RO AL BY HR CY LV LC TR Overall total collective effective dose per 1000 of population, msv X-RAY: COLLECTIVE EFFECTIVE 2500,0 DOSES 2000,0 1500,0 1000,0 500,0 0,0 Plain radiography Fluoroscopy Computed tomography Interventional radiology
Total collective effective dose from NM procedures, msv per million of poulation NM: COLLECTIVE EFFECTIVE DOSES 300000 250000 200000 150000 100000 50000 0 LU GR FR PT DE AT IT HU MT SI CH CZ NL IS DK NO UK FI CR IR SP PL SE LV MA EE SK ME BG LI MD UA RO AL BY BE HR CY LC ES TR Bone imaging Tumor imaging PET & PET/CT Thyroid total Heart total Lung perfusion Renal total Infection/inflammation total Parkinsonism total Somatostatin receptors imaging CBF total STUK Ritva Bly
INTERNATIONAL POPULATION DOSES FROM RADIOLOGICAL PROCEDURES PER CAPUT msv
On behalf of the DDM2 team!
19 Diagnostikkfysikk i Norge 15:30-17:00 Tanker om: Kvalitetskontrollregimer FoU, internasjonalt samarbeid, deltakelse i EU rammeprogrammer Erfaringer og utfordringer Innspill fra regionale representanter Helse Nord Helse Midt Helse Vest Helse Sør Øst og Private Synspunkter fra NRF radiologforeningen Håkon Hjemly, Lars Borgen
DISKUSJON QC EU FoU MDT staff Penger change utstyr