Picture this scenario: you’ve just injured your leg and, upon seeking medical attention, your doctor has recommended you get an X-ray. You have been informed that you need to bring your Alberta Health card, photo identification, and medical requisition form provided by your doctor to your appointment.

When you arrive at Insight Medical Imaging, you are greeted and checked in by one of our receptionists. Since X-ray imaging is provided as a walk-in service, you may need to wait for a few other patients before it is your turn. You may also need to change into a gown. Once it’s your turn, a technologist will greet you and invite you to go in for your scan.

Seeing as how you have just injured your leg, you are stressed and in pain, and you ask if your partner can accompany you into the room for your imaging exam. The technologist informs you that your partner is not allowed into the actual X-ray room, leaving you frustrated and confused. However, this policy is in place for a specific safety reason: preventing unnecessary exposure to scatter radiation.

What is Scatter Radiation?

As defined by the National Cancer Institute, scatter radiation is secondary radiation that spreads in different directions from a beam when that beam interacts with any substance, such as body tissue, a wall, or a table. Common forms of diagnostic imaging that produce scatter radiation at Insight Medical Imaging include CT imaging, fluoroscopy, X-ray, mammography, bone mineral densitometry, and body composition analysis.

Note that the strength of scatter radiation is much lower than the primary radiation beam. Fear of radiation exposure should not keep you from necessary diagnostic imaging exams, but that is why the benefits outweigh the risks only for the patient who needs the exam.

What Does it Mean for Me as a Patient?

As a patient, our goal is to perform your diagnostic imaging exam to the best of our ability and provide your doctor with the necessary information so you can get on the road to recovery as soon as possible. Whenever we are exposing our patients to radiation, we take precautionary steps to ensure they are receiving the lowest possible dose of radiation necessary to produce high-quality images.

Radiation strength varies depending on what body part is being examined, the size and weight of the patient, and the type of exam. For example, a spinal CT scan of a patient weighing 200 pounds will require more radiation strength than a chest X-ray of a 70-pound adolescent. To protect our patients from scatter radiation, we provide safety items, such as lead vests, which act as a barrier, preventing the radiation from hitting other parts of your body, such as reproductive organs.

How do Technologists Deal With it?

At Insight Medical Imaging, safety is a top priority. Our technologists perform thousands of exams per year, so it is imperative we provide them with the correct equipment, procedural requirements, and safety guidelines. Some exams have protective lead aprons and thyroid collars, while other exams require staff to stand a certain distance away from the imaging equipment, in what is called the “safety zone,” where scatter radiation is negligible. We also make all staff members wear radiation dosimeters, so we can monitor exposure levels throughout their career. Whether it is a staff member, patient, or anyone visiting our clinic, we preach ALARA at Insight Medical Imaging.

What is ALARA?

ALARA is an acronym that stands for “as low as reasonably achievable.” The point of ALARA is to minimize radiation exposure. A small dose of radiation that has no related benefit should be avoided, no matter how small the exposure.

In other words, patients and staff should not be exposed to radiation without a concrete medical or diagnostic purpose. As dictated by the College of Physicians and Surgeons and the Alberta College of Medical Diagnostic and Therapeutic Technologists, the governing bodies for radiologists and technologists in Alberta, there are three ALARA safety measures to focus on:

• Time: Minimizing the time of radiation exposure will reduce the radiation dose.
• Distance: Increasing the distance between the patient and the radiation source will reduce exposure by the distance squared.

Our Radiation Exposure Policy

At Insight Medical Imaging, our top priority is the safety of our patients and staff. We take matters relating to radiation exposure extremely seriously. ALARA principles are very important to our team, as is reducing exposure to excess scatter radiation for our patients.

Therefore, we do not allow significant others in the imaging room when we are using ionizing radiation for imaging. In select and rare circumstances, significant others may enter the room so long as they remain behind the safety barrier and window. We understand diagnostic imaging can be stressful, which is why we try to complete your exam efficiently.

We also realize that support from your significant other can help you through tough times, so we do make some exceptions in situations where the exams do not rely on ionizing radiation and the room is deemed safe by technologists, such as pregnancy ultrasounds. We are not trying to make your exam more stressful by keeping significant others out of a room with radiation. We are merely trying to protect everyone involved in the process and adhere to our industry’s governing principles and bylaws.

At the end of the day, we want to capture the best images possible so your doctor can make a timely and accurate diagnosis, helping you get back to your life.

References

1. Abrantes, A., Rebelo, C., Sousa, P., Rodrigues, S., Almeida, R.P., Pinheiro, J., … Ribeiro, L. (2017). Scatter Radiation Exposure During Mobile X-Ray Examinations, 17(1). Retrieved from https://healthmanagement.org/c/healthmanagement/issuearticle/scatter-radiation-exposure-during-mobile-x-ray-examinations
2. Health Physics Society. (n.d.). ALARA. Retrieved from http://hps.org/publicinformation/radterms/radfact1.html
3. Jaquith, K. (2018). The ALARA Principle: 3 Safety Measures To Follow. Retrieved from https://blog.universalmedicalinc.com/the-alara-principle-3-safety-measures-to-follow/
4. Lancs Industries. (2015). What is Scatter Radiation. Retrieved from http://www.lancsindustries.com/2015/what-is-scatter-radiation/
5. National Cancer Institute. (n.d.). NCI Dictionary or Cancer Terms. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/scatter-radiation
6. NDT Resource Center. (n.d). Secondary (Scatter) Radiation and Undercut Control. Retrieved from https://www.nde-ed.org/EducationResources/CommunityCollege/Radiography/Physics/scatterradcontrol.htm
7. Radiation Protection for The X-Ray Technologist. (n.d.). Scatter Radiation. Retrieved from  https://sites.google.com/a/maricopa.edu/radiation-protection-for-the-x-ray-technologist/technologist-protection/scatter-radiation
8. Sprawls, P. (1996). Physical Principles of Medical Imaging. Retrieved from http://www.sprawls.org/ppmi2/SCATRAD/
9. Trinh, A.M., Schoenfeld, A.H., Levin, T.L. (2010). Scatter Radiation from Chest Radiographs. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19997727
10. Vlachos, I., Tsantilas, A., Kalyvas, N., Delis, H., Kandarakis, I., Panayiotakis, G. (2015). Measuring Scatter Radiation In Diagnostic X-Rays For Radiation Protection Purposes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25911405