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Submitted by Harald Paganetti PhD (Chair of the Science Committee of the IOMP), International Organization for Medical Physics (IOMP)
   Commenting on behalf of the organisation
Document Radiological protection in paediatric diagnostic and interventional radiology

Comments on

Annals of the ICRP: “Radiological protection in paediatric diagnostic and interventional radiology

This is an excellent report with guidance for the use of imaging techniques in diagnostic and interventional radiology.

We do agree with everything that is outlined in this report. However, in our opinion, one important aspect is missing. Namely, the use of Monte Carlo transport algorithms to simulate organ specific doses for radiation risk assessment. Such simulations can be based on the patient CT (if a whole-body CT is available) or using computational phantoms, as has been shown by many groups.

An additional section discussing the role of Monte Carlo simulations might be warranted.

Example publications are (plus references therein):

Organ doses for reference adult male and female undergoing computed tomography estimated by Monte Carlo simulations. Lee C, Kim KP, Long D, Fisher R, Tien C, Simon SL, Bouville A, Bolch WE. Med Phys. 2011 Mar;38(3):1196-206

The impact of anthropometric patient-phantom matching on organ dose: a hybrid phantom study for fluoroscopy guided interventions. Johnson PB, Geyer A, Borrego D, Ficarrotta K, Johnson K, Bolch WE. Med Phys. 2011 Feb;38(2):1008-17

The feasibility of patient size-corrected, scanner-independent organ dose estimates for abdominal CT exams. Turner AC, Zhang D, Khatonabadi M, Zankl M, DeMarco JJ, Cagnon CH, Cody DD, Stevens DM, McCollough CH, McNitt-Gray MF. Med Phys. 2011 Feb;38(2):820-9

On behalf of the IOMP:

Harald Paganetti, PhD

Director of Physics Research in Radiation Oncology, Massachusetts General Hospital
Associate Professor of Radiation Oncology, Harvard Medical School
Chair of the Science Committee, International Organization of Medical Physics (IOMP)