3. The scientific unit of measurement for radiation dose, commonly referred to as effective dose, is the millisievert (mSv)

4. Typical Radiation Doses (From Various Sources)* Watching television 0.01 mSv/year Air travel (r/t from Washington, D.C., to Los Angeles, Calif.) 0.05 mSv Medical chest X-ray (one film) 0.1 mSv Nuclear medicine thyroid scan 0.14 mSv Full set of dental X-rays 0.4 mSv/yr Mammogram (four views) 0.7 mSv Average annual exposure living in the United States 3 mSv/year Average annual exposure from breathing radon gas 2 mSv

5. Nuclear medicine lung scan 2 mSv Nuclear medicine bone scan 4.2 mSv Nuclear cardiac diagnostic test (technetium or Tc-99m) 10 mSv Abdominal CT scan 10 mSv Various PET studies ( 18 F FDG) 14 mSv Tobacco products (amount for a smoker’s lungs from 20 cigarettes a day) 53 mSv/year Cancer treatment (tumor receives) 50,000 mSv

6. Complete Exams Effective Dose mSv (mrem) Intravenous Pyelogram (kidneys, 6 films) 2.5 (250) Barium Swallow (24 images, 106 sec. fluoroscopy) 1.5 (150) Barium Enema (10 images, 137 sec. fluoroscopy) 7.0 (700) CT Head 2.0 (200) CT Chest 8.0 (800) CT Abdomen 10.0 (1,000) CT Pelvis 10.0 (1,000) Angioplasty (heart study) 7.5 (750) - 57.0 (5,700)3 Coronary Angiogram 4.6 (460) - 15.8 (1,580)3

7. Typical Effective Radiation Dose from Diagnostic X Ray—Single Exposure Exam Effective DosemSv (mrem)1 Chest (LAT) 0.04 (4) Chest (AP) 0.02 (2) Skull (AP) 0.03 (3) Skull (Lat) 0.01 (1) Pelvis (AP) 0.7 (70) Thoracic Spine (AP) 0.4 (40) Lumbar Spine (AP) 0.7 (70)

8. SAFETY CONSIDERATIONS Important considerations before a procedure are: 1. the skill sets of the physician 2. the physicians’ and the technologists’ knowledge about their angiographic machine 3. the medical history of the patient 4. the likely difficulty of the procedure 5. the body habitus of the patient.

9. Injury to arm of patient. Patient was draped for procedure and physicians did not realize that she had moved her arm so that it was resting on the port of the X-ray tube during the procedure

10. RADIATION BURNS

12. Protection for Workers

14. Thyroid Cancer / Hyperactive Thyroid RAI treatment is based on the fact that the thyroid actively accumulates iodine, which it uses to produce thyroid hormones required for normal body function. This RAI is like the iodine found in foods such as fish, seaweed, and iodized salt, except that it releases an electron, or beta particle, which creates its therapeutic action.

15. For use in treatment, the RAI is given dissolved in water or as a capsule. It is absorbed quickly by the stomach and intestines, then carried in the bloodstream to the thyroid, where it is taken up by the gland. While in the thyroid gland, the RAI disrupts the function of some of the thyroid cells - the more radioactive iodine given, the more cells cease to function. As the cells stop functioning, excessive amounts of thyroid hormones are no longer produced, and symptoms of hyperthyroidism begin to disappear

16. HYPERTHYROIDISM

17. In general, a distance of one arm's length should be maintained between the person treated and others who spend more than two hours next to the patient in any 24 hour period. This applies especially to children and pregnant women. While brief contact with a person after treatment is acceptable, sleeping together, watching television, going to movies, long care or plane trips should be avoided for approximately 11 days after the treatment.

18. A smoker can accumulate 53 mSv/year of radiation exposure. This is less than a CT scan A.) True B.) False

19. Potential burns from radiation can result form the inexperience of the people operating / maintaining the equipment A.) True B.) False

20. When receiving radiation treatments for thyroid cancer, there are no restrictions on your movement. A.) True B.) False