ROMANIA

NATIONAL SYSTEM ON REGISTRATION AND REPORTING OF MEDICAL EXPOSURE

OLGA GIRJOABA National Commission For Nuclear Activities Control

ALINA DUMITRESCU Institute Of Public Health Bucharest Department For Health And Ionizing Radiation

LEGAL BASIS AND RESPONSIBILITIES

Following the request regarding the implementation of Directives requirements the necessary regulations and administrative provisions brought into force by the Romanian health authorities by issuing the Order no.1542/2006 of the Ministry of Health. The provisions of this regulation establish a mechanism to collect and to report the patients doses at the national level, involving in this process all the level diagnostic radiology, nuclear medicine and radiotherapy departments within the country.

LEGAL BASIS AND RESPONSIBILITIES

In order to harmonize at the national level the reporting system, the Order no. 1003/2008 of the Ministry of Health has been published. The license holder shall centralize the data at the institution level The centralized data shall be reported quarterly by the license holder to the Ionizing Radiation Hygiene Laboratory based on territorial assignation. The Ionizing Radiation Hygiene Laboratory forwards the centralized data to the county public health The Institute of Public Health Bucharest centralizes the collected data reported by counties and Bucharest, issues an annually report which is forwarded to the different stockholders.

THE REPORTING SYSTEM: LEVELS

THE REPORTING SYSTEM: LEVELS

THE REPORTING SYSTEM: LEVELS

Institute of Public Health Bucharest

THE REPORTING SYSTEM: GEOGRAPHIC

THE RECORDING SYSTEM: HOSPITAL LEVEL

According to the legally binding provisions, the recording system at the hospital level shall include at least the following information:

THE RECORDING SYSTEM: HOSPITAL LEVEL

According to the legally binding provisions, the recording system at the hospital level shall include at least the following information:

THE RECORDING SYSTEM: HOSPITAL LEVEL

According to the legally binding provisions, the recording system at the hospital level shall include at least the following information:

Diagnostic radiology a) Projection (examination) b)Source-patient distance (cm) c) Field (cm x cm) d) kV e) mA

Nuclear Medicine

Radiotherapy

a) Examination or treatment a) Procedure type type b) Radiopharmaceutic b) Source-patient radionuclide distance (cm) c) Administrated activity (Bq) c) Field (cm2) d) Target volume (cm3) e) The dose/session (Gy)

THE RECORDING SYSTEM: HOSPITAL LEVEL

According to the legally binding provisions, the recording system at the hospital level shall include at least the following information:

Diagnostic radiology Nuclear Medicine Radiotherapy a) DAP indication (mGy x The effective dose a) Number of sesions cm2) estimated b)Skin absorbed dose (mGy) b)The total dose in target volume c) Absorbed dose rate at the intensifier screen surface (mGy) d) CTDI (mGy)

THE REPORTING FORMS: CONTENT

From the beginning there were elaborated as well electronic forms for reporting data.

THE REPORTING FORMS: CONTENT

THE CATEGORIES OF X-RAY EXAMINATIONS

CATEGORIES OF X-RAY EXAMINATIONS

Radiograph y and Radioscopy

EXAMINATION

PROJECTI ON

CO D

Radiograph y and Radioscopy

EXAMINATION

PROJECTI ON

CO D

Radiograph y and Radioscopy

1.Radiology and radioscopy 2.Computer tomography 3.Interventional and angiography 4.Dental

EXAMINATION

COD

EXAMINATION

COD

Computer RX DIAGNOSTIC Tomography

1.Radiology and radioscopy 2.Computer tomography 3.Interventional and angiography 4.Dental

Intervention al radiology and RX DIAGNOSTIC angiography

1.Radiology and radioscopy 2.Computer tomography 3.Interventional and angiography 4.Dental

EXAMINATION

COD

EXAMINATION

COD

Dental RX DIAGNOSTIC radiology

1.Radiology and radioscopy 2.Computer tomography 3.Interventional and angiography 4.Dental

NUCLEAR MEDICINE

Nuclear medicine

Nuclear medicine

Nuclear medicine

X-RAY EXAMINATION FREQUENCY APPROXIMATIONS

X-RAY EXAMINATION FREQUENCY APPROXIMATIONS

X-RAY EXAMINATION FREQUENCY APPROXIMATIONS

We assume that percentages of age and sex for reported number of examination are the same at country level; EXEMPLE: EXEMPLE CT examinationation

ASSESSMENT OF PATIENT DOSE

THE ASSESSMENT OF PATIENT DOSE

For estimating the average effective dose per type of examination, we took into consideration only the DAP readings (or DLP for CT). E (mSV) = DAP x coefficients

FUTURES

FUTURES

THANK YOU FOR ATTENTION!