Reducing Dose exposure in radiology

	Critical factor	Factors affected to reduce Exposure	patient	radiographer, support staff and radiologist
X Rays	Time	reduce time	reduce dose	reduce workload
				reduce use factor
				reduce occupancy factor - Only essential personnel in room when exposing
		Exposure rates	high rate reduction	Reduce radiation exposure level
				Do not activate x-ray tube if staff are near
	Dose		Reduce Dose, optimise dose	reduce time, reduce exposure
	Distance	Inverse square law	increase tube patient distance	increase distance, maximise distance from radiation source and patient stand >2m from patient
	Shielding	ALARA principle	Reduce primary radiation	Reduce secondary radiation and stray radiation
		Beam quality	Increase kVp, Decrease mAs, Decrease PD and decrease IQ
		Filtration	Remove low keV energies, reduce PD and improve IQ
		Reduce field size	Reduce field size, decrease PD
		Shield critical organs	Increase shielding, decrease PD. Gonadal shielding
		SOD	Increase source object distance, decrease PD
		Image receptor speed	Increase image receptor speed, require less photons to achieve OD, decrease PD, decrease IQ, Increase Quantum mottle
		Monitoring and QC	routine monitoring dosages to avoid dosage creep
				Reduce scatter radiation
				Reduce leakage radiation
		Personnel protection	protective shielding for non-radiated anatomy	Lead apron
				thyroid shield and lead glasses
				protective gloves
				ceiling mounted for high workload interventional labs
			minimise access to radiation areas	minimise access to radiation areas
	Contamination Control		reduce exposure	reduce exposure
Diagnostic radio-isotopes	Time	Use the radioisotopes with shortest half life	reduce dose	Only essential personnel exposed to radiation source
		Exposure rates	high rate reduction	Reduce radiation exposure level
			Stop breast feeding
	Dose		Reduce Dose, optimise dose	reduce time, reduce exposure
			Use appropriate radiopharmaceutical, correct activity, correct preparation and administration	shielded vial - source
	Distance	Inverse square law		maximise distance from radiation source and patient stand >2m from patient
				Maximise distance of imaging table to technologist
	Shielding	ALARA principle		Reduce secondary radiation
				Never handle unshielded radiation sources by hand
		Personnel protection		Lead apron
				thyroid shield and lead glasses
				protective gloves
		Access control	minimise access to radiation areas	minimise access to radiation areas
	Contamination Control	Appropriate disposal of radioisotopes	reduce exposure	reduce exposure
			Disposal of waste - urine	prevent environmental contamination
			Disposal of radiopharmaceuticals