Ionizing radiation in safe patient care

Patients, both national and international, increasingly demand higher safety standards in their healthcare experience.

Herwin Speckter, Manager of Medical Technology at the Centers for Diagnosis and Advanced Medicine and Medical Conferences and Telemedicine (Cedimat), explains that it is already very common for patients to have in-depth knowledge about their studies and treatments, including the risks involved.

Many of them, in nuclear medicine, X-rays, or mammography, ask every day about their risks from radiation.

in medical imaging
In the Department of Medical Imaging, but also in other areas such as Cardiology, Gastroenterology, Surgery, Radiosurgery and Radiotherapy, there are specific risks from the intense use of energetic radiation in modern diagnostic applications and also therapy, says Speckter.

“Shortly after the discovery of X-rays, doctors and scientists found many benefits of the new radiation, for example, in the non-invasive diagnosis of diseases or in the treatment of tumors without a scalpel. However, indicates the specialist, they also realized the high risks of these due to damage to healthy human tissue.

He adds that there are immediate effects to large doses of radiation, such as hair removal or radiodermatitis. Smaller amounts cannot cause immediate sequelae, however, they can introduce the development of cancer and hereditary effects, due to DNA alteration.

double jeopardy
Women have almost twice the lifetime risk of developing cancer after receiving radiation than men. Especially the smallest patients have up to ten times more risk when they receive ionizing radiation during their first years of life.

Therefore, he explains, radiation protection for pediatric patients is so important. Health centers must develop and enforce strict pediatric protocols, he says.

Technical development
During the last two decades, with the technical development and increasing use of computerized axial tomography, multislice CT, the dose of ionizing radiation has increased significantly in the world population. Since 2006-2010, people in developed countries receive more doses from medical studies than from natural radiation.

The expert adds that, in this regard, national and international authorities play an important role. He points out that there are several international organizations, however, the most influential is the International Atomic Energy Agency IAEA, winner of the Nobel Peace Prize in 2005.

“Particularly with Gamma Knife radiosurgery, a device that concentrates immense radioactivity, it is possible to treat more and more patients with complex tumors in delicate places, and to protect eloquent areas in the brain. At the Gamma Knife Dominicano center in Cedimat, innovative techniques have been developed, published and presented internationally.

His innovations have already become internationally accepted standards, especially in radiosurgery for lesions close to the optic nerves, which are highly sensitive to radiation. He adds that even 30% of patients improve their vision after treatment, less than 1% have lost part of their vision due to treatment of perioptic lesions. Unthinkable success a few decades ago”, says the medical physicist.

Speckter refers that an aspect that is not yet so well known is the safety of magnetic resonance imaging. The study is considered totally safe, because the MRI does not apply ionizing radiation to the patient. This is true in those without metal implants.

Instead, more and more people have some metals in their body, after surgery or sometimes as a result of buckshot or war. Since this applies to extremely strong magnetic fields, metals can move or heat up, much like in a kitchen microwave.

Today most metallic surgical implants are compatible and approved for an MRI study. However, for older implants, pellets and particularly cardiac pacemakers or neural stimulators (DBS, VNS, RNS, etc.) one must be very careful, avoiding an accident with even fatal consequences.

For more than a decade, Cedimat has had a resonator with a 3 Tesla magnetic field, the strongest in our country in medicine.

Speckter indicates that this allows to offer a better diagnostic quality of images, especially in the brain, but its attraction force to metals is double, and the energy deposited is four times greater, compared to conventional 1.5 Tesla equipment.

“Applying the most modern international standards, the medical center has pioneered magnetic resonance imaging of patients with various implants, including cardiac pacemakers or neural stimulators,” explains Speckter.

Dominican Republic is at the forefront
Few countries in Latin America have such a high density of cutting-edge equipment in medical technology as the Dominican Republic.

However, it is important to know how to use it wisely, to get the maximum benefits to offer more accurate diagnoses and more efficient treatments, without applying a dose above what is justified.

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Ionizing radiation in safe patient care