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ICRP: Free the Annals!

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Submitted by Priscilla Butler, American College of Radiology
   Commenting on behalf of the organisation
Document Occupational Radiological Protection in Interventional Procedures
 

ICRP Occupational Radiological Protection in Interventional Procedures (DRAFT) - March 20, 2017

ACR Comments




Page
#
1st Line
#
Type of Comment
(General/ Technical)
Comments Proposed change
NA NA General Overall, the report is written well and provides useful tips on radiation protection during IR procedures. NA
17 552 Editorial Typo “controlable” should be “controllable”
22 723 Technical Reference needed for lens opacity prevalence  
28 Figure 2.1 Technical The figure is not referred to in the text. On page 25, around line 884, insert, “See Figure 2.1”
28 Figure 2.1 Technical The median and average Es in the figures to not match the median and mean Es provided on page 25 (from the Yoder and Salasky reference. Check original reference to verify the correct values and modify the text and/or graph so that the correct values are used. Also, use either “mean” or “average” (but not both).
28 Figure 2.1 Technical In the first graph (Estimates of E Obtained from Two Dosimeters), “Average E” is not provided as was done in the second graph (Estimates of E Obtained from Ione Dosimeter). Provide “Average E” in first graph
51 1961 Technical Define DRF when first used  
57 2201 Technical Suggest providing recommendations for the required minimum lead equivalent thickness.  Suggest recommendations be based on collar badge dose (ie dose > X mSv requires 0.5 mm, dose between Y and Z requires at least 0.35 mm, …)
   58 2239 Technical Johns et al is not included in the References  
59 Fig. 5.3 Technical The figure is not referred to correctly in the text. (Fig. 5.3 is about thyroid cancer and is referred to in the section on hand dose on page 64.) On page 59, somewhere between lines 2258 and 2268, insert, “See Figure 5.3”. (Also make sure the paragraph also refers to ICRP, 2007 as the figure does.)
60 2308 Technical Use of disposable drapes - Even though disposable drapes will protect staff, they may also increase patient dose. Effectiveness of disposable drapes are questionable and often supported by the companies who makes these products with the stated intention of protecting staff without any discussion on impact on patients. We assume this information is included in the document for completeness. We appreciate that use of such drapes is not included in the executive summary recommendations. We recommend deleting this section. If this is not agreeable to the drafters, we suggest including descriptions of the limitations/effectiveness of such products.   If this section is included, then readers may want to know about the limited effectiveness of “lead brain caps”. (See recent article by Fetterly.)
62 2380 Technical A discussion regarding the increase dose to the contralateral eye as compared to the eye adjacent to the exposure direction is suggested. References that discuss this include:
  • Geber T, Gunnarsson M, Mattsson S. Radiat Measure 2011;46:1248–51.
  • Fetterly K, Schueler B, Grams M, Sturchio G, Bell M, Gulati R. JACC Cardiovasc Interv. 2017 Mar 13;10(5):520-528.
62 2380 Technical A discussion regarding brain dose and radioabsorbent surgical caps is suggested References that discuss this include:
  • Uthoff H, Peña C, West J, Contreras F, Benenati JF, Katzen BT. AJR Am J Roentgenol 2013;200:915–20.
  • Reeves RR, Ang L, Bahadorani J, et al. J Am Coll Cardiol Intv 2015;8:1197–206.
  • Alazzoni A, Gordon CL, Syed J, et al. Circ Cardiovasc Interv 2015;8
  • Fetterly K, Schueler B, Grams M, Sturchio G, Bell M, Gulati R. JACC Cardiovasc Interv. 2017 Mar 13;10(5):520-528.
64 2512 Editorial Figure referrals and naming are out of synch starting with the 2nd Fig. 5.3 on page 65. (There is another Fig. 5.3 on page 59.) Renumber figures in section 5 starting on page 65; change referrals as appropriate starting in line 2512 on page 64.
76 2952 Editorial Typo Delete “,” in “work,;”