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Medical Imaging Safety in the Developing World

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Radiology in Global Health

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Abstract

Attention to matters of safety is important in any imaging facility. In the context of the developing world, limited resources may complicate the attempt to set up and operate an imaging facility with the highest standards of safety, but it is nonetheless important to see that all applicable safety measures are carried out. Imaging safety involves several general principles, including the need to minimize radiation exposure consistent with answering the clinical question at hand. Safety considerations relevant to patients, staff, and the general public must be addressed. Safety considerations specific to individual modalities include appropriate limitations on exposure in X-ray and CT imaging, attention to hazards from the magnetic field in magnetic resonance imaging, proper preparation and control of radionuclides in nuclear medicine, and avoidance of excessive prenatal imaging procedures with ultrasound. An important general safety consideration for all imaging modalities is assuring proper clinical utilization; proper utilization includes factors such as not performing imaging procedures without medical referral and supervision, attention to image quality to ensure that procedures do not need to be repeated unnecessarily, and carefully considering the clinical appropriateness of any requested imaging procedure. Training and credentialing of staff is also of utmost importance and includes staff who design, prepare, and evaluate a new imaging facility as well as medical staff who acquire, order, or review images. Ensuring imaging safety requires the input of a team of experts, including trained and qualified medical physicists, health physicists, radiation safety officers, clinical safety personnel, installation and service personnel, radiologic technologists, and radiologists. With appropriate attention to safety, diagnostic imaging can provide a very useful component of healthcare services in resource-limited regions.

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Disclaimer and Warning

This chapter serves as an introduction to basic concepts regarding safety that may be useful to individuals setting up or running imaging facilities in the developing world. This information is not intended to be, and should not be relied upon as, a technical manual or instructional document on how to perform various safety measures or mitigations. While reasonable attempts have been made to provide useful information in this chapter, no warranty is made as to the accuracy or completeness of information presented. Especially in the context of imaging in regions with limited resources, it would not be possible to anticipate every potential scenario with relevance to safety that might be encountered. Failure to address appropriate safety measures can result in injury to patients, staff, and the general public. The reader assumes all risks associated with setting up and running a safe imaging operation, and neither the authors nor the publisher assumes any liability for the accuracy, completeness, or applicability of any information covered in this chapter to a particular imaging setting. It is the responsibility of the reader to ensure that properly trained and qualified medical physicists, radiation safety officers, equipment installation and service personnel, clinical safety experts, and regulatory individuals be consulted to assess and address specific safety needs, issues, and requirements in a given imaging facility. Addressing these needs requires that appropriately trained and qualified staff operate the equipment, and that appropriately trained and credentialed healthcare providers oversee the medical utilization of imaging devices.

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Authors and Affiliations

  1. Medical Physics Graduate Program, Departments of Radiology, Biomedical Engineering, and Physics, and Carl E. Ravin Advanced Imaging Laboratories, Duke University Medical Center, 2424 Erwin Road, Suite 302, Durham, NC, 27705, USA

    James T. Dobbins III Ph.D., F.A.A.P.M.

  2. Department of Radiology, Medical Physics, Duke University Medical Center, 3808, Radiology, Durham, NC, 27710, USA

    Donald P. Frush M.D.

  3. Department of Medicine-Gastroenterology, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA

    Christopher J. N. Kigongo M.B.Ch.B., M.P.H.

  4. Department of Radiology, Duke University Medical Center, Erwin Road, Durham, NC, 27710, USA

    James R. MacFall Ph.D.

  5. Radiation Safety Division, Duke University Medical Center, 3155, Durham, NC, 27710, USA

    Robert E. Reiman Jr. M.S.P.H., M.D.

  6. Department of Biomedical Engineering, Duke University Medical Center, Room 136 Hudson Hall, 100 Science Drive, Durham, NC, 27708, USA

    Gregg E. Trahey Ph.D.

Authors
  1. James T. Dobbins III Ph.D., F.A.A.P.M.
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  2. Donald P. Frush M.D.
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  3. Christopher J. N. Kigongo M.B.Ch.B., M.P.H.
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  4. James R. MacFall Ph.D.
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  5. Robert E. Reiman Jr. M.S.P.H., M.D.
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  6. Gregg E. Trahey Ph.D.
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Corresponding author

Correspondence to James T. Dobbins III Ph.D., F.A.A.P.M. .

Editor information

Editors and Affiliations

  1. RAD-AID International, Chevy Chase, Maryland, USA

    Daniel J. Mollura

  2. Lucile Packard Children's Hospital, Stanford University Medical Center, Palo Alto, California, USA

    Matthew P. Lungren

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Dobbins, J.T., Frush, D.P., Kigongo, C.J.N., MacFall, J.R., Reiman, R.E., Trahey, G.E. (2014). Medical Imaging Safety in the Developing World. In: Mollura, D., Lungren, M. (eds) Radiology in Global Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0604-4_7

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  • DOI: https://doi.org/10.1007/978-1-4614-0604-4_7

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