COMMON TERMS
EDE
The concept of effective dose equivalent (EDE) was introduced to provide a mechanism for assessing the radiation detriment from partial body irradiations in terms of data derived from whole body irradiations. EDE is expressed in rem and takes into account the quality factor of the radiation, the dose to all the organs that are irradiated and their sensitivity to radiation. The rem has been replaced by the sievert in the SI system of units (1 sv = 100 rem).
RAD
The original unit developed for expressing absorbed dose, which is the amount of energy from any type of ionizing radiation (e.g., alpha, beta, gamma, neutrons, etc.) deposited in any medium (e.g., water, tissue, air). A dose of one rad is equivalent to the absorption of 100 ergs (a small but measurable amount of energy) per gram of absorbing tissue. The rad has been replaced by the gray in the SI system of units (1 gray = 100 rad). www.hps.org
REM (Roentgen Equivalent Man)
A unit in the traditional system of units that measures the effects of ionizing radiation on humans. The rem has been replaced by the Sievert in the SI system of units (1 Sievert = 100 rem). www.hps.org
For diagnostic x-ray exposure, a rem is approximately equivalent to a rad
ALARA
Acronym for "As Low As Reasonably Achievable." It means making every reasonable effort to maintain exposures to ionizing radiation as far below the dose limits as practical. Be consistent with the purpose for which the licensed activity is undertaken, taking into account the state of technology, the economics of improvements in relation to state of technology, the economics of improvements in relation to benefits to the public health and safety, and other societal and socioeconomic considerations. These means are in relation to utilization of nuclear energy and licensed materials in the public interest. www.hps.org
See http://hps.org/publicinformation/radterms/ for additional radiation terms
RADIATION DOSE ESTIMATES FROM COMMONLY USED RADIOPHARMACEUTICALS
(Taken from the Radiation Internal Dose Information Center, RIDIC, dose estimate tables)
Radiopharmaceutical | Typical Dose (mCi) | Organ Receiving Highest Dose | Organ Dose (rad) | Effective Dose Equivalent (rem) |
F18 FDG | 10 | Bladder Wall | 7.0 | 1.1 |
In111 White Blood Cells | 0.5 | Spleen | 11 | 1.2 |
I123 Sodium Iodide | 0.4 | Thyroid | 5.2 | 0.18 |
I131 Sodium Iodide | 25 | Thyroid | 32,500 | 975 |
Xe133 Gas (5min breathing) | 15 | Lung | 0.06 | 0.04 |
Tl201 Chloride | 3 | Heart Thyroid | 3 6.9 | 1.8 |
Tc99m Pertechnetate | 10 | Bladder Wall | 1.3 | 0.39 |
Tc99m Red Blood Cells | 20 | Bladder Wall | 1.6 | 0.54 |
Tc99m Pyrophosphate | 20 | Bone Surface | 2.8 | 0.44 |
Tc99m MDP | 30 | Bone Surface | 3.9 | 0.66 |
Tc99m Mag3 | 10 | Bladder Wall | 5.1 | 0.44 |
Tc99m DTPA - Renal | 20 | Bladder Wall | 5.6 | 0.6 |
Tc99m Sulfur Colloid | 8 | Liver | 2.56 | 0.4 |
Tc99m Disofenin (HIDA) | 5 | G.B. Wall | 2 | 0.47 |
Tc99m Sestamibi (Cardiolite) | 20 | Upper Lg Int. | 3.7 | 1.1 |
Ga67 Citrate | 5 | Bone Surface | 6 | 2.05 |
Tc99m MAA | 4 | Lungs | 1.0 | 0.19 |
Tc99m DTPA Aerosol | 1.1 | Bladder | 0.13 | 0.02 |
EFFECTIVE DOSE EQUIVALENTS FOR COMMON DIAGNOSTIC PROCEDURES
PROCEDURE |
ESTIMATED EDE (mrem)* |
Chest X-Ray |
8 |
Skull X-Ray |
22 |
Cervical Spine |
20 |
Lumbar Spine |
127 |
KUB |
56 |
Upper GI |
244 |
Barium Enema |
406 |
Diagnostic Cardiac Catheterization** |
2500** |
*Adapted from NCRP Report 100 ** W. Huda, "Patient Dose in Radiology,",www.imagingeconomics.com/issues/articles/2001-07_01.asp | |
PROCEDURE |
ESTIMATED EDE (mrem) |
*Adult Head CT |
100-200 |
*Adult Body CT (chest or abdomen/Pelvis) |
500-1000 |
**Coronary Artery Calcium CT |
100-300 |
**Coronary CT Angiography |
500-1200 |
W. Huda, E.L. Nickeloff and J.M. Boone. "Overview of Patient Dosimetry in Diagnostic Radiology in the USA for the past 50 years", Medical Physics, Vol. 35, No. 12, pp 5713-5728*The total dose to the patient increases when scans are performed with and without the administration of iodinated contrast materials. **McCollough, Cynthia H. PhD, et al. Dose Performance of a 64 Channel Dual Source CT Scanner. Radiology, 2007;243:775-784 |
Radiopharmaceutical | Typical Dose (mCi) | Early Fetal Dose (rad) | 3 month Fetal Dose (rad) | 6 month Fetal Dose (rad) | 9 month Fetal Dose (rad) |
F18 FDG | 10 | 1.0 | 0.63 | 0.35 | 0.3 |
In111 White Blood Cells | 0.5 | 0.26 | 0.19 | 0.19 | 0.19 |
I123 Sodium Iodide | 0.4 | 0.030 | 0.021 | 0.016 | 0.014 |
I131 Sodium Iodide | 25 | 6.6 | 6.0 | 21.3 | 25 |
Xe133 Gas (5min breathing) | 15 | 0.023 | 0.003 | 0.002 | 0.001 |
Tl201 Chloride | 3 | 1.1 | 0.64 | 0.52 | 0.3 |
Tc99m Pertechnetate | 10 | 0.4 | 0.8 | 0.5 | 0.3 |
Tc99m Red Blood Cells | 20 | 0.5 | 0.35 | 0.26 | 0.21 |
Tc99m Pyrophosphate | 20 | 0.44 | 0.48 | 0.26 | 0.21 |
Tc99m MDP | 30 | 0.69 | 0.6 | 0.3 | 0.3 |
Tc99m Mag3 | 10 | 0.7 | 0.5 | 0.2 | 0.2 |
Tc99m DTPA - Renal | 20 | 0.9 | 0.8 | 0.4 | 0.34 |
Tc99m Sulfur Colloid | 8 | 0.05 | 0.06 | 0.09 | 0.11 |
Tc99m Disofenin (HIDA) | 5 | 0.3 | 0.3 | 0.22 | 0.12 |
Tc99m Sestamibi (Cardiolite) | 20 | 1.1 | 0.9 | 0.6 | 0.4 |
Ga67 Citrate | 5 | 1.7 | 3.7 | 3.3 | 2.4 |
Tc99m MAA | 4 | 0.03 | 0.04 | 0.054 | 0.04 |
Tc99m DTPA Aerosol | 1.1 | 0.023 | 0.017 | 0.0092 | 0.012 |
FETAL DOSE ESTIMATES FOR COMMON X-RAY EXAMS
Assumes Average Size Adult
Exam |
Average SkinExposure (mR)* |
Conversion FactorDose (mrad/R)** |
Estimated Fetal Dose(mrad) |
AP L-S Spine |
350 |
272 |
95 |
PA Chest - Grid |
15 |
2.0 |
0.03 |
PA Chest - No Grid |
5 |
2.0 |
0.01 |
Abdomen |
300 |
330 |
99 |
Pelvis |
300 |
353 |
106 |
Cervical Spine |
95 |
No detectable contribution |
--- |
Lateral Skull |
70 |
No detectable contribution |
--- |
Extremities |
-- |
No detectable contribution |
--- |
CT Exams*** | CT scans of pregnant patients results in embryo doses that range between 1000 and 3500 mrad when the embryo/fetus is in the direct x-ray beam, but much lower doses when the conceptus does not undergo direct irradiation such as in a chest CT scan. |
* Taken from New York State Department of Health Guide for 400 Speed Film/Screen System.
** Taken from "Handbook of Radiation Doses in Nuclear Medicine and Diagnostic X-Ray", CRC Press, 1980, James G. Kereiakes and Marvin Rosenstein. Assumes Half Value Layer of 3.0 mm. of Al.
*** W. Huda, E.L. Nickeloff and J.M. Boone. "Overview of Patient Dosimetry in Diagnostic Radiology in the USA for the past 50 years", Medical Physics, Vol. 35, No. 12, pp 5713-5728
OCCUPATIONAL EXPOSURE LIMITS
Annual Dose Limit | ALARA I Level | ALARA II Level | |
Whole Body | 5 rem | 0.125 Rem/quarter | 0.375 Rem/quarter |
Extremity | 50 rem | 1.875 Rem/quarter | 5.625 Rem/quarter |
Skin | 50 rem | 0.750 Rem/quarter | 2.25 Rem/quarter |
Lens of Eye | 15 rem | 0.125 Rem/quarter | 0.375 Rem/quarter |
ALARA I - Notify employee.
ALARA II - Notify employee and investigate cause. Take corrective action.