ASN Report 2018

1  Nuclear-based medical activities  202 1.1 The different activity categories 1.2 Exposure situations in the medical sector 1.2.1 Exposure of health professionals 1.2.2 Exposure of patients 1.2.3 Exposure of the public 1.2.4 Environmental impact 1.2.5 Significant radiation protection events 1.2.6 Risks and oversight priorities 1.3 Regulations 1.3.1 General regulation 1.3.2 Medical devices and radiopharmaceuticals 1.3.3 Radiation protection of patients 1.3.4 Administrative procedures 2  External-beam radiotherapy  206 2.1 Description of the techniques 2.1.1 Three-dimensional conformal radiotherapy 2.1.2 Intensity-Modulated (conformal) Radiotherapy (IMRT) 2.1.3 Stereotactic radiotherapy 2.1.4 Radiotherapy using a linear accelerator coupled to a magnetic resonance imaging system 2.1.5 Contact radiotherapy 2.1.6 Intraoperative radiotherapy 2.1.7 Hadron therapy 2.2 Technical rules applicable to external‑beam radiotherapy installations 2.3 Radiation protection situation in external‑beam radiotherapy 2.3.1 Radiation protection of external‑beam radiotherapy professionals 2.3.2 Radiation protection of external‑beam radiotherapy patients 2.3.3 Significant events in external-beam radiotherapy 3  Brachytherapy  212 3.1 Description of the techniques 3.1.1 LowDose-Rate (LDR) brachytherapy 3.1.2 Pulsed Dose-Rate (PDR) brachytherapy 3.1.3 High Dose-Rate (HDR) brachytherapy 3.2 Technical rules applicable to brachytherapy installations 3.3 Radiation protection situation in brachytherapy 3.3.1 Radiation protection of medical professionnals 3.3.2 Radiation protection of patients 3.3.3 Management of sources 3.3.4 Emergency situations and the management of malfunctions 3.3.5 Significant events in brachytherapy 4  Nuclear medicine  215 4.1 Presentation of nuclear medicine activities 4.1.1 In vivo diagnosis 4.1.2 In vitro diagnosis 4.1.3 Internal targeted radiotherapy 4.1.4 Research in nuclear medicine involving humans 4.2 Layout rules for nuclear medicine facilities 4.3 Radiation protection situation in nuclear medicine 4.3.1 Radiation protection of nuclear medicine professionals 4.3.2 Radiation protection of patients in nuclear medicine 4.3.3 Protection of the public and the environment 4.3.4 Significant events in nuclear medicine 5  Interventional practices using ionising radiation  221 5.1 Overview of the centres and the equipment 5.2 Technical rules for the fitting out of medical rooms 5.3 Radiation protection situation in fluoroscopy-guided interventional practices 5.3.1 Radiation protection of medical professionals 5.3.2 Radiation protection of patients 5.3.3 Events reported relating to fluoroscopy-guided interventional practices 6  Medical and dental radiodiagnosis  224 6.1 Presentation of the equipment 6.1.1 Medical radiodiagnosis 6.1.2 Dental radiodiagnosis 6.2 Technical rules for fitting out radiology and tomography installations 6.3 The pool of computed tomography scanners 6.4 The radiation protection situation in computed tomography 6.5 Events reported in conventional radiology 7  Blood product irradiators  228 7.1 Description 7.2 Technical rules applicable to facilities 8  Synthesis and prospects  228 Medical uses of ionising radiation ASN report on the state of nuclear safety and radiation protection in France in 2018  201