Radiological protection in paediatric diagnostic and interventional radiology

Draft document: Radiological protection in paediatric diagnostic and interventional radiology
Submitted by Streffer Christian, University Clinics Essen, Germany
Commenting as an individual

I have read this draft on a very important topic with great interest and pleasure. Nevertheless I would like to make few remarks which may or may not lead to an improvement:

---the term "severity" is used in three paragraphs: in para 16 with reference to deterministic effects which is quite correct. In paras 12 and 13 it is used in connection with detriment and stochastic effects and this can be misunderstood. It should be made clear that severity is meant here with respect to the type of effect (e.g. the type of hereditary effect). It has nothing to do with dose dependance. A breast cancer has in the ICRP terminology always the same severity independent of the clinical or pathological stage. I propose to have a look to the glossary of ICRP 2007 with respect to the definition of "detriment".   

---It may be useful to say a bit more about the age dependance of the radiation risk with respect especially to thyroid and to a certain degree to female breast. In the risk for thyroid cancer the age-gradient is very steep and there is certainly a difference between infants and older children. This is also the case with respect to the latent period. It is interesting that these are organs which are under under endocrinological control with respect to cell proliferation and growth (see paras 4 and 5).

---It may be interesting to indicate that the organ doses are most important.

---I appreciate that it is strongly pointed out the importance of the radiological protection for infants with respect to field size etc. but I wonder why the neonates are only mentioned once (in para 50). For neonates these parameters are even more critical.

I hope my remarks are useful, otherwise forget about.

Best wishes
Christian Streffer