Preface to the Second Edition xi Acknowledgments xiii 1 Nature and Scope of Radiation Protection 1 What is Radiation Protection? 2 Scope of Radiation Protection 2 Diagnostic Radiology Modalities 3 Why Protect Patients and Personnel in Diagnostic Radiology? 3 Framework for Radiation Protection 4 Basic Schemes for Patient Exposure in Digital Radiography, Fluoroscopy, and Computed Tomography 6 Factors Affecting Dose in Diagnostic Radiology 8 Dose Management Techniques 10 Pregnancy: Radiation Protection Considerations 11 2 Diagnostic X-Rays: Essential Physical Factors 13 X-Ray Production 14 Mechanisms for Creating X-Rays 14 X-Ray Spectrum 16 X-Ray Attenuation 20 X-Ray Interactions 23 Increasing kV and Scatter Production 26 3 Radiation Quantities and Units 27 Sources of Radiation Exposure 29 Types of Exposure 30 Quantities and Units for Quantifying Ionizing Radiation 31 Quantities and Units for Quantifying Biologic Risks 33 Radiation Measurement 36 Wearing a Personnel Dosimeter 38 4 Basic Radiobiology 39 What is Radiobiology? 41 Essential Physics and Chemistry 41 Fundamental Concepts of Radiobiology 44 Deterministic Effects (Early Effects of Radiation) 49 Stochastic Effects (Late Effects of Radiation) 51 Radiation Exposure During Pregnancy 54 5 Current Standards for Radiation Protection 55 Radiation Protection Organizations 56 Objectives of Radiation Protection 57 Radiation Protection Criteria and Standards 58 Recommended Dose Limits 60 Diagnostic Reference Levels: A Useful Tool for Optimization of Protection 62 6 Dose Factors in Digital Radiography 65 Digital Radiography: Essential Considerations 66 The Standardized Exposure Indicator: Basics 68 Factors Affecting Dose in Digital Radiography 70 7 Dose Factors in Fluoroscopy 77 Major Components of Fluoroscopic Imaging Systems 78 Factors Affecting Dose in Fluoroscopy 82 Scattered Radiation in Fluoroscopy 87 8 Factors Affecting Dose in Computed Tomography 89 Computed Tomography: A Definition 90 Nobel Prize for CT Pioneers 91 CT Principles: the Basics 91 Multislice CT Technology: The Pitch 93 Dose Distribution in CT 93 CT Dose Metrics 94 Factors Affecting the Dose in CT 96 Dose Optimization in CT 99 9 Dose Management Regulations and Optimization 101 Federal Regulations for Dose Management 103 Equipment Specifications for Radiography 104 Equipment Specifications for Fluoroscopy 106 Procedures for Minimizing Dose to Patients and Personnel 109 Shielding: Design of Protective Barriers 112 Quality Assurance: Dose Management and Optimization 114 10 Pregnancy: Essential Radiation Protection Considerations 117 Rationale for Radiation Protection in Pregnancy 118 Factors Affecting Dose to the Conceptus 119 Estimating the Dose to the Conceptus 120 Continuing/Terminating a Pregnancy After Exposure 120 Dose Reduction Techniques for Pregnant Patients 121 The Pregnant Worker 121 References 125 Index 129.