Les mesures fines des faibles radioactivités par la spectrométrie gamma nécessitent l’optimisation de la géométrie de détection et la connaissance du schéma de niveaux des raies gamma. Ainsi, on peut augmenter le taux de comptage et par conséquent, réduire l’incertitude statistique des pics spectraux exploités pour le calcul de l’activité des radio-isotopes en rapprochant le plus possible l’échantillon du détecteur. Cependant, l’augmentation du volume de l’échantillon demande une correction de l’auto-absorption des émissions par l’échantillon même, et le rapprochement du détecteur est à l’origine du phénomène de pic-somme. L’utilisation de MCNPX a permis de mettre en évidence les effets séparés de la densité de l’échantillon et le nombre atomique effectif dans l’atténuation des photons d’énergie inférieure à 100 keV. Les facteurs de correction du pic-somme sont obtenus par MCNPX, GESPCOR et ETNA. Ainsi, une base des données pour 244 radionucléides a été établie pour des géométries SG50 et SG500 au contact d’un détecteur. Dans une application à la radioprotection, des échantillons de matériaux de construction ont été analysés par la spectrométrie gamma. L’Uranium-238, le Thorium-232 et le Potassium-40 ont été identifiés et corrigés des effets sus-cités. La dosimétrie de leurs rayonnements gamma a permis d’évaluer les indices de risque, la dose absorbée et la dose efficace annuelle reçues provenant de ces matériaux. Les simulations par MCNPX corroborent le modèle de calcul de la dose absorbée. Il a permis aussi d'étudier la distribution de la dose dans les habitations de différentes dimensions. Les résultats obtenus sont en accord avec les limites règlementaires. / Precisely measuring weakly radioactive samples by gamma-ray spectrometry requires optimizing the detection geometry and knowledge of the gamma-ray decay scheme. One can thus increase the counting rate and reduce the statistical uncertainty of the spectral peaks used to determine radioisotope activities. However, an increased sample volume requires a correction for the self-absorption of y-rays in the sample itself, and approaching a sample to the detector gives rise to coincidence summing. MCNPX simulations permitted finding the separate influence of sample density and effective atomic number of the sample in the attenuation of photons with energies less than 100 keV. Peak-summing corrections were obtained with MCNPX, GESPCOR and ETNA. Thus a data base for 244 radionuclides could be established for SG50 and SG500 geometries in contact with a planar detector. In an application of the results to the health physics domain, construction materials were analyzed. Naturally-occurring Uranium-238, Thorium-232 and Potassium-40 activities were identified and corrected for the above-mentioned effects in order to evaluate the risk indexes, the absorbed dose and the annual effective dose received from different dimensions built of these materials. MCNPX simulations corroborated the model used to calculate the absorbed dose and gave its distribution in an enclosed space. The results obtained are within the recommended norms.

O desenvolvimento da tecnologia de tomografia computadorizada (TC) trouxe maiores possibilidades em medicina diagnóstica. É um método não invasivo de se explorar o corpo humano detalhadamente. Com o aumento das aplicações em TC, aumenta a preocupação com as altas taxas de dose administradas quando comparada com outras modalidades de diagnóstico por imagem. A comunidade científica e os fabricantes uniram esforços para alcançar níveis menores de dose possíveis, sem comprometer a qualidade da imagem diagnóstica. O maior e relativamente novo avanço nessa busca para diminuir os níveis de dose é o controle automático de exposição (CAE) em TC. Esses sistemas foram projetados para ponderar a distribuição de dose ao longo do comprimento de varredura e entre pacientes, levando em consideração o tamanho e as diferentes densidades de tecidos irradiados. Baseando-se na geometria de aquisição em TC, os sistemas CAE são altamente complexos. Sendo assim, sua forma de funcionamento ainda não é inteiramente conhecida. O presente trabalho tem como objetivo avaliar o desempenho clínico dos sistemas CAE, suas susceptibilidades ao usuário e, com isso, ajudar na otimização de dose em pacientes. A abordagem utilizada para avaliar os sistemas CAE de três dos maiores fabricantes de TC no Brasil, General Electric, Philips e Toshiba, foi pela extração dos valores de corrente anódica do cabeçalho da sequência de imagens no padrão DICOM, medição e análise do ruído das imagens dessas sequências e a medição da distribuição da dose ao longo do comprimento de varredura nas superfícies e dentro de dois simuladores de paciente de formatos diferentes. A variação da corrente anódica de cada equipamento de TC associada à qualidade da imagem resultante fornece o desempenho do sistema CAE. As medições de distribuição de dose fornecem o perfil de dose resultante da modulação de corrente. Medições com e sem o sistema CAE acionado foram feitas para quantificar a importância em termos de dose desses sistemas. Os resultados obtidos permitem otimizações no uso dos sistemas CAE e, consequentemente, a redução da dose no paciente sem comprometer a qualidade diagnóstica da imagem. / The development of the computed tomography (CT) technology has brought wider possibilities on diagnostic medicine. It is a non-invasive method to see the human body in details. As the CT application increases, it raises the concern about patient dose, because the higher dose levels imparted compared to other diagnostic imaging modalities. The radiology community (radiologists, medical physicists and manufacturer) are working together to find the lowest dose level possible, without compromising the diagnostic image quality. The greatest and relatively new advance to lower the patient dose is the automatic exposure control (AEC) systems in CT. These systems are designed to ponder the dose distribution along the patient scanning and between patients taking into account their sizes and irradiated tissue densities. Based on the CT scanning geometry, the AEC-systems are very complex and their functioning is yet not fully understood. This work aims to evaluate the clinical performance of AEC-systems and their susceptibilities to assist on possible patient dose optimizations. The approach to evaluate the AEC-systems of three of the leading CT manufacturers in Brazil, General Electric, Philips and Toshiba, was the extraction of tube current modulation data from the DICOM standard image sequences, measurement and analysis of the image noise of those image sequences and measurement of the dose distribution along the scan length on the surface and inside of two different phantoms configurations. The tube current modulation of each CT scanner associated to the resulted image quality provides the performance of the AEC-system. The dose distribution measurements provide the dose profile due to the tube current modulation. Dose measurements with the AEC-system ON and OFF were made to quantify the impact of these systems regarding patient dose. The results attained give rise to optimizations on the AEC-systems applications and, by consequence, decreases the patient dose without compromising the diagnostic image quality.

Ce travail traite de la maîtrise des émissions d'aérosols radioactifs en médecine nucléaire. Ces émissions ont lieu lors des examens de scintigraphie pulmonaire réalisés avec des aérosols marqués au technétium 99 métastable. Nous avons développé une méthode, utilisant une enceinte d'essai, qui permet de quantifier ces émissions au niveau du générateur. Nous avons mesuré une activité émise dans l'environnement. Une méthode dédiée à la mesure des émissions provenant du patient lors de la ventilation est également proposée et a été employée sur une patiente. Les résultats des différentes mesures et évaluations sont exposés dans ce mémoire. Nous avons caractérisé et modélisé la ventilation d'un service de médecine nucléaire entier à l'aide d'un logiciel de CFD (Computational Fluid Dynamics). Cela nous a permis d'étudier la dissémination de l'aérosol radioactif et de comparer les résultats à des mesures d'activité volumique de l'air ambiant. Le modèle numérique de ce service a été utilisé pour tester des solutions de confinement et aider à définir la position de capteurs de surveillance de la contamination de l'air. Une méthode originale combinant l'étude de position du personnel et la simulation de dissémination de l'aérosol émis, a servi à confirmer les niveaux d'exposition de plusieurs catégories professionnelles et enrichir les études de poste.

O desenvolvimento da tecnologia de tomografia computadorizada (TC) trouxe maiores possibilidades em medicina diagnóstica. É um método não invasivo de se explorar o corpo humano detalhadamente. Com o aumento das aplicações em TC, aumenta a preocupação com as altas taxas de dose administradas quando comparada com outras modalidades de diagnóstico por imagem. A comunidade científica e os fabricantes uniram esforços para alcançar níveis menores de dose possíveis, sem comprometer a qualidade da imagem diagnóstica. O maior e relativamente novo avanço nessa busca para diminuir os níveis de dose é o controle automático de exposição (CAE) em TC. Esses sistemas foram projetados para ponderar a distribuição de dose ao longo do comprimento de varredura e entre pacientes, levando em consideração o tamanho e as diferentes densidades de tecidos irradiados. Baseando-se na geometria de aquisição em TC, os sistemas CAE são altamente complexos. Sendo assim, sua forma de funcionamento ainda não é inteiramente conhecida. O presente trabalho tem como objetivo avaliar o desempenho clínico dos sistemas CAE, suas susceptibilidades ao usuário e, com isso, ajudar na otimização de dose em pacientes. A abordagem utilizada para avaliar os sistemas CAE de três dos maiores fabricantes de TC no Brasil, General Electric, Philips e Toshiba, foi pela extração dos valores de corrente anódica do cabeçalho da sequência de imagens no padrão DICOM, medição e análise do ruído das imagens dessas sequências e a medição da distribuição da dose ao longo do comprimento de varredura nas superfícies e dentro de dois simuladores de paciente de formatos diferentes. A variação da corrente anódica de cada equipamento de TC associada à qualidade da imagem resultante fornece o desempenho do sistema CAE. As medições de distribuição de dose fornecem o perfil de dose resultante da modulação de corrente. Medições com e sem o sistema CAE acionado foram feitas para quantificar a importância em termos de dose desses sistemas. Os resultados obtidos permitem otimizações no uso dos sistemas CAE e, consequentemente, a redução da dose no paciente sem comprometer a qualidade diagnóstica da imagem. / The development of the computed tomography (CT) technology has brought wider possibilities on diagnostic medicine. It is a non-invasive method to see the human body in details. As the CT application increases, it raises the concern about patient dose, because the higher dose levels imparted compared to other diagnostic imaging modalities. The radiology community (radiologists, medical physicists and manufacturer) are working together to find the lowest dose level possible, without compromising the diagnostic image quality. The greatest and relatively new advance to lower the patient dose is the automatic exposure control (AEC) systems in CT. These systems are designed to ponder the dose distribution along the patient scanning and between patients taking into account their sizes and irradiated tissue densities. Based on the CT scanning geometry, the AEC-systems are very complex and their functioning is yet not fully understood. This work aims to evaluate the clinical performance of AEC-systems and their susceptibilities to assist on possible patient dose optimizations. The approach to evaluate the AEC-systems of three of the leading CT manufacturers in Brazil, General Electric, Philips and Toshiba, was the extraction of tube current modulation data from the DICOM standard image sequences, measurement and analysis of the image noise of those image sequences and measurement of the dose distribution along the scan length on the surface and inside of two different phantoms configurations. The tube current modulation of each CT scanner associated to the resulted image quality provides the performance of the AEC-system. The dose distribution measurements provide the dose profile due to the tube current modulation. Dose measurements with the AEC-system ON and OFF were made to quantify the impact of these systems regarding patient dose. The results attained give rise to optimizations on the AEC-systems applications and, by consequence, decreases the patient dose without compromising the diagnostic image quality.

Nous mettons au point un dosimètre passif capable de détecter les neutrons rapides et thermiques, destiné à la fois à la dosimétrie d'ambiance et personnelle. Ce dosimètre détecte les neutrons au moyen de convertisseurs appropriés (polyéthylène et cadmium). Cette étude s'est appuyée sur des simulations Monte Carlo, qui ont aidé à la conception géométrique du dosimètre et au choix des matériaux. La caractérisation expérimentale du dosimètre montre que les réponses à ces neutrons en termes de H*(10) et Hp(10) sont linéaires, avec des seuils de détection de 2 mSv pour les neutrons rapides et de 0, 19 mSv pour les neutrons thermiques. Les dépendances angulaires sont satisfaisantes selon les recommandations de la norme ISO 21909. Un facteur de calibration de (9,5 +- 0,5)x10 puissance -2 mSv.cm2/signal RPL a été obtenu pour les neutrons rapides de la source calibrée de 241Am-Be de l'IPHC. Ce facteur est de (9,7 +- 0,3)x10 puissance-3 mSv.cm2/signal RPL pour les neutrons thermalisés. / We characterize a passive dosimeter capable of measuring both fast and thermal neutrons for ambiant and persona! dosimetry. These neutrons can be detected in a mixed neutron-gamma field with appropriate converters (polyethylene for fast neutrons, cadmium for thermal neutrons). Monte Carlo simulations with MCNPX helped with the geometrical conception of the dosimeter and the choice of materials. The responses of the RPL dosimeter to these neutrons are linear in H*(1 O) and Hp(10) with detection limits of 2 mSv for fast neutrons and 0.19 mSv for thermal neutrons. The angular dependencies are satisfactory according to the ISO 21909 norm. A calibration factor of (9.5 +- 0.5)x10 exponent -2 mSv.cm2/RPL signal is obtained to the fast neutrons of the IPHC's 241 Am-Be calibrator. This factor is (9.7 +- 0.3)x10 exponent -3 mSv.cm2/RPL signal for the thermalized neutrons.

Cette étude porte sur l’apport de nouvelles fonctionnalités à des matériaux élastomères qui seront utilisés pour la réalisation de gants. Des additifs possédant des propriétés antimicrobiennes ainsi que des charges possédant des propriétés radioprotectrices sont insérées dans des matrices polymères. La méthode de mise en œuvre utilisée est l’enduction par trempage, l’impact de ces additifs sur les propriétés rhéologiques de solutions dans lesquelles les élastomères sont dissous sont analysées. L’incorporation de certaines amines peut entraîner une vulcanisation des élastomères en solution. Après la réalisation d’échantillons par trempage, la stabilité thermique des élastomères est étudiée par analyse thermogravimétrique ainsi que par une analyse infrarouge. Certains oxydes métalliques peuvent modifier la dégradation thermique d’élastomères comportant des groupes chlorés en favorisant la déchlorination. L’impact des additifs sur les élastomères vulcanisés a également été étudié, ces mesures ont permis de mettre en évidence l’impact de certains additifs sur la vulcanisation ainsi que les interactions charges-élastomère par la mise en évidence de l’effet Mullins. Enfin, une méthode de détermination des propriétés radioprotectrices des élastomères a été mise en place afin de déterminer les formulations fournissant la meilleure atténuation aux rayonnements ionisants. / The aim of this study is to give new functionalities to elastomers that will be used as gloves. Some antimicrobials and radioprotective additives will be incorporated in different polymer matrixes. The elastomers have been realized by dip coating, the impact of the additives on the rheological properties of the solutions of elastomers was analysed. Some amines can interact with the elastomers in the solvent and accelerate the vulcanization. The thermal stability of the charged elastomers has then been investigated by thermogravimetric analysis and infrared measurments. Some metallic oxides interact with elastomers containing chlorine and change the dehydrochlorination process. The impact of the additives on the mechanical properties of vulcanized elastomers has been studied, the impact of some additives on the vulcanization and the existence of strong charge-polymer interactions have been demonstrated. Finally, a method to measure the radioprotective properties of filled elastomers has been developed to measure the attenuation of the composite against ionizing radiations.

La scanographie est une technique d’imagerie médicale performante offrant des bénéfices considérables pour le diagnostic et le suivi médical des patients. Néanmoins, la question des effets adverses potentiels induits par l’exposition aux rayons-X se pose, tant au niveau individuel qu’en termes de santé publique du fait de la fréquence du recours à cette procédure. Des premières études épidémiologiques suggèrent une augmentation du risque de cancer associée à l’exposition à la scanographie durant l’enfance ou l’adolescence. Néanmoins, l’interprétation de ces résultats reste controversée et les connaissances sur le risque de cancer radio-induit à ce niveau d’exposition et pendant l’enfance demeurent limitées.En France, la cohorte « Enfant Scanner » est mise en place par l’IRSN pour étudier l’incidence de cancer dans une population de près de 110 000 enfants ayant reçu des examens par scanographie avant l’âge de 10 ans dans 21 centres hospitaliers universitaires. Cette étude participe au projet européen Epi-CT, coordonné par le Centre International de Recherche sur le Cancer, intégrant neuf cohortes nationales sur la base d’un protocole commun. A partir de la cohorte française, cette thèse s’intéresse à caractériser les expositions des enfants recevant des examens diagnostiques par scanographie et à fournir des éléments de quantification du risque de cancer associé.Une évaluation dosimétrique est réalisée à partir des protocoles radiologiques utilisés en pédiatrie entre 2000 et 2011 dans les services hospitaliers participant. Cette étude présente l’évolution des expositions au cours de la période ainsi que la variabilité des pratiques dans les services. Les résultats montrent l’existence d’une marge d’optimisation des protocoles utilisés pour limiter l’exposition des patients, en particulier pour des explorations de la tête qui sont les examens les plus fréquents en pédiatrie.Une évaluation du risque de cancer potentiellement induit par des actes de scanographie pédiatrique a été réalisée, sur la base d’estimations de risque obtenues pour d’autres contextes d’exposition aux rayonnements ionisants. Les résultats montrent que chaque examen pourrait être associé à un excès de risque de tumeur du système nerveux central (SNC), de cancer du sein, de la thyroïde ou de leucémies compris entre 0,01‰ et 5‰. Le risque de cancer serait jusqu’à 7 fois supérieur pour des patients âgés de 1 an par rapport à des enfants de 10 ans. Les incertitudes attachées à ces prédictions de risque ont été quantifiées par simulations.A partir du suivi d’incidence de la cohorte, la relation dose-réponse a été étudiée entre le risque de tumeurs du SNC, de leucémies et de lymphome, et les doses cumulées aux organes d’intérêt reçues lors d’examens par scanographie. Aucune augmentation significative de risque n’a été mise en évidence. En 2011, le suivi dans la cohorte – 4 ans en moyenne– était en effet très court. Les analyses ont néanmoins caractérisé l’impact de syndromes d’immunodéficiences et d’autres facteurs génétiques de prédisposition au cancer sur les estimations de risque, et mis en évidence l’importance de prendre en compte l’indication des examens dans ce type d’étude.Le suivi de la cohorte doit être poursuivi afin de fournir des estimations de risque plus robustes. L’extension de la durée de suivi de cette population ainsi que les résultats attendus à partir d’autres études, notamment dans le cadre du projet Epi-CT, devraient constituer, dans les 5 prochaines années, une avancée tout à fait significative sur la question des risques associés à la scanographie. A ce jour, les prédictions réalisées dans le cadre d’évaluations de risque demeurent incertaines, en particulier pour les tumeurs du SNC, mais constituent une aide pour orienter le recours à la scanographie. Des efforts d’optimisation des procédures radiologiques demeurent, par ailleurs, encore nécessaires pour réduire les doses délivrées en pédiatrie ainsi que les risques possiblement associés / Computed tomography (CT) is a powerful imaging technique that provides great benefits for diagnosis and medical management of patients. Nonetheless, the widespread use of this procedure raises many concerns about the potential adverse effects induced by X-rays exposure, both in clinical practice and in terms of public health. First epidemiological studies have suggested an increased risk of cancer associated with CT scan exposures in childhood or adolescence. The interpretation of these results is, however, controversial, and evidence about radiation-induced risks of cancer is still limited at this level of exposure and during childhood.In France, the "Enfant Scanner" cohort was set up by IRSN to study the incidence of cancer among more than 100,000 children who received CT scans before the age of 10 in 21 university hospitals. This study is part of the European Epi-CT project – coordinated by the International Agency for Research on Cancer – which includes nine national cohorts set up on the basis of a common protocol. The current thesis, based on the French cohort, focuses on characterizing the exposure of children receiving diagnostic CT scans and quantifying the risk of cancer associated with these exposures.Dosimetric assessment was performed from the radiological protocols used in paediatrics between 2000 and 2011 in the participating hospitals. This study presents the evolution of the exposures during the period and the variability of practices in the radiology departments. The results show that there is a leeway for optimizing the procedures and limiting the exposure of patients, especially for scans of the head that account for most of the examinations in paediatrics.From these exposure measurements, a quantitative assessment of cancer risk potentially induced by CT scans in paediatrics was performed – on the basis of estimates of risk in other contexts of ionizing radiation exposure. The results show that each CT scan could be associated with an excess risk of tumours of the central nervous system, breast cancer, thyroid cancer or leukaemia ranging from 0.01‰ to 5‰. Cancer risks may be up to 7 times higher for patients aged 1 year compared to 10 year olds. Uncertainties attached to these risk predictions were quantified by simulations.From the follow-up of cancer incidence in the cohort, the dose-response relation was studied between the risk of tumors of the central nervous system, leukaemia and lymphoma, and cumulative X-ray doses to the organs of interest from CT scans. No significant increased risk was observed. Indeed, in 2011, the duration of the follow-up, i.e. 4 years on average, was very short. The analyzes have nevertheless characterized the impact of (acquired or hereditary) immunodeficiencies and other genetic factors predisposing to cancer on the risk estimates, and highlighted the importance of considering the indication of examinations in studies on CT scans.The follow-up of the cohort should be extended to provide more robust risk estimates. Extension of this study as well as expected results from other cohorts, particularly within the Epi-CT project, would provide, in the next 5 years, significant progresses on the issue of the potential adverse effects of CT. To date, risk predictions from quantitative risk assessment are still uncertain, especially for cerebral tumours, but should help to guide the use of CT. In addition, efforts for optimizing the radiological procedures are still needed to reduce the doses delivered in paediatrics and the potential associated risks.

O sistema microPET/CT é um importante equipamento utilizado nas pesquisas de imagem diagnóstica em pequenos animais. O radiofármaco mais usado nesta tecnologia é o fluordeoxiglicose marcado com flúor-18. Este estudo tem como objetivo efetuar o controle radiológico no laboratório de pesquisa microPET/CT do Centro de Radiofarmácia do IPEN-CNEN/SP, de forma a satisfazer tanto as normas nacionais como as recomendações internacionais. O laboratório está classificado pela equipe de radioproteção da instalação como área supervisionada, nas quais embora não seja obrigatória a adoção de medidas específicas de proteção e segurança, devem ser submetidas reavaliações regulares das condições do ambiente de trabalho. Visando assegurar a proteção radiológica dos trabalhadores diretamente envolvidos no manuseio do equipamento, realizou-se o monitoramento do local de trabalho e a avaliação do controle de dose individual. Inicialmente foi feito o monitoramento pré-operacional, isto é, o levantamento radiométrico no laboratório. Além disso, mediu-se nível de radiação externa nas instalações do laboratório e suas adjacências, por meio da colocação de nove dosímetros termoluminescentes (TL) de CaSO4:Dy, em locais previamente selecionados. Os indivíduos ocupacionalmente expostos foram avaliados mensalmente por meio do uso de dosímetros TL posicionados no tórax e por medidas de corpo inteiro, tomadas a cada seis meses. O período do estudo foi de dois anos, com início em abril de 2014. Para o controle do microPET/CT realizou-se testes de desempenho de acordo com o protocolo padrão do equipamento e em conformidade com a norma desenvolvida pela força tarefa para estudos com PET em animais Animal PET Standard Task Force. O presente estudo permitiu demonstrar que os níveis de radiação das áreas (estimativas de dose ambiente e dose efetiva), assim como a blindagem do equipamento estão adequados de acordo com os limites da exposição ocupacional. Ressalta-se a importância de se seguir rigorosamente os princípios de radioproteção, já que se trata de pesquisas com fontes radioativas não seladas. / Micro PET/CT scanner is an essential tool generally used for small animal molecular imaging. Fluorine-18-labeled fluorodeoxyglucose is the most widely used radioisotope in this technique. The present study aimed to evaluate the radiation levels in a micro PET/CT research laboratory of the Radiopharmacy Center at IPEN-CNEN / SP, in order to accomplish both national standards and international recommendations. The radioprotection team has classified the laboratory as supervised area; even this laboratory does not require the adoption of specific measures for protection and safety, should be done regular re-evaluation of the conditions of occupational exposures. Workplace monitoring and individual control assessment were carried out to ensure the radiological protection of all workers directly involved in handling the scanner. Initially, there was conducted a radiometric survey, as well as measurements of the external radiation level in the workplace and its surroundings. To achieve this goal, there were placed nine thermoluminescent dosimeters of CaSO4:Dy in preselected locations. Monthly evaluations of the occupationally exposed individuals were carried out through the use of TL dosimeters, ported in the workers´ chest. Moreover, whole body measurements were performed every six months. The study period was about two-years which started in April 2014. All tests to evaluate micro PET/CT performance were based on the standard protocol of the equipment in accordance with the standard developed by the Animal PET Standard Task Force. Present study\'s results demonstrated that the ambient radiation levels (ambient and effective estimated radiation dose), as well as the effective shielding equipment are both adequate. This study emphasizes that it is essential to strictly follow the principles of radioprotection in workplace, whenever researches involve radioactive unsealed sources.

O sistema microPET/CT é um importante equipamento utilizado nas pesquisas de imagem diagnóstica em pequenos animais. O radiofármaco mais usado nesta tecnologia é o fluordeoxiglicose marcado com flúor-18. Este estudo tem como objetivo efetuar o controle radiológico no laboratório de pesquisa microPET/CT do Centro de Radiofarmácia do IPEN-CNEN/SP, de forma a satisfazer tanto as normas nacionais como as recomendações internacionais. O laboratório está classificado pela equipe de radioproteção da instalação como área supervisionada, nas quais embora não seja obrigatória a adoção de medidas específicas de proteção e segurança, devem ser submetidas reavaliações regulares das condições do ambiente de trabalho. Visando assegurar a proteção radiológica dos trabalhadores diretamente envolvidos no manuseio do equipamento, realizou-se o monitoramento do local de trabalho e a avaliação do controle de dose individual. Inicialmente foi feito o monitoramento pré-operacional, isto é, o levantamento radiométrico no laboratório. Além disso, mediu-se nível de radiação externa nas instalações do laboratório e suas adjacências, por meio da colocação de nove dosímetros termoluminescentes (TL) de CaSO4:Dy, em locais previamente selecionados. Os indivíduos ocupacionalmente expostos foram avaliados mensalmente por meio do uso de dosímetros TL posicionados no tórax e por medidas de corpo inteiro, tomadas a cada seis meses. O período do estudo foi de dois anos, com início em abril de 2014. Para o controle do microPET/CT realizou-se testes de desempenho de acordo com o protocolo padrão do equipamento e em conformidade com a norma desenvolvida pela força tarefa para estudos com PET em animais Animal PET Standard Task Force. O presente estudo permitiu demonstrar que os níveis de radiação das áreas (estimativas de dose ambiente e dose efetiva), assim como a blindagem do equipamento estão adequados de acordo com os limites da exposição ocupacional. Ressalta-se a importância de se seguir rigorosamente os princípios de radioproteção, já que se trata de pesquisas com fontes radioativas não seladas. / Micro PET/CT scanner is an essential tool generally used for small animal molecular imaging. Fluorine-18-labeled fluorodeoxyglucose is the most widely used radioisotope in this technique. The present study aimed to evaluate the radiation levels in a micro PET/CT research laboratory of the Radiopharmacy Center at IPEN-CNEN / SP, in order to accomplish both national standards and international recommendations. The radioprotection team has classified the laboratory as supervised area; even this laboratory does not require the adoption of specific measures for protection and safety, should be done regular re-evaluation of the conditions of occupational exposures. Workplace monitoring and individual control assessment were carried out to ensure the radiological protection of all workers directly involved in handling the scanner. Initially, there was conducted a radiometric survey, as well as measurements of the external radiation level in the workplace and its surroundings. To achieve this goal, there were placed nine thermoluminescent dosimeters of CaSO4:Dy in preselected locations. Monthly evaluations of the occupationally exposed individuals were carried out through the use of TL dosimeters, ported in the workers´ chest. Moreover, whole body measurements were performed every six months. The study period was about two-years which started in April 2014. All tests to evaluate micro PET/CT performance were based on the standard protocol of the equipment in accordance with the standard developed by the Animal PET Standard Task Force. Present study\'s results demonstrated that the ambient radiation levels (ambient and effective estimated radiation dose), as well as the effective shielding equipment are both adequate. This study emphasizes that it is essential to strictly follow the principles of radioprotection in workplace, whenever researches involve radioactive unsealed sources.

Made available in DSpace on 2016-04-27T13:10:23Z (GMT). No. of bitstreams: 1 Monica Oliveira Bernardo.pdf: 3960791 bytes, checksum: cdb03a40c1d26631a8419067ae0e81eb (MD5) Previous issue date: 2013-12-17 / Radiological examinations have greatly increased, especially in children after craniocerebral trauma (CCT). Recent studies indicate a higher incidence of cancer and cataracts in children undergoing computed tomography (CT) compared to those without exposure. Some countries have promoted campaigns to avoid unnecessary CT and reducing the radiation dose. Objectives: 1. To assess whether the reduction of radiation dose in CT affect exam interpretation and diagnosis in children with CCT. 2. To stimulate discussion and implementation of measures to reduce the radiation dose received by children requiring health care and, also, stimulating awareness of pediatricians and families about the radiation dangers. Methods: We selected two groups of CT from children with CCT that underwent to CT performed in Philips 64 channels Multi Slice CT scanner at Unimed Hospital (Sorocaba-SP) from January to August 2012. We initially selected the 30 last CT performed with usual radiation dose in children. Then to the next CT for CCT we apply the protocols to reduce radiation load (approximately 50%) according to the guidelines of The Alliance for Radiation Safety in Pediatric Imaging. We reduced the kilovoltage (KV) to the maximum shown by tomography equipment and set a limit to the milliamperes per second (mAs) according to analysis of the tomography equipment after the completion of digitized radiography tomography, according to thickness and length of area of the patient being examined. We oriented the technical team to restrict the exam to the extent of the area requested by the doctor. The two CT series were presented to 19 pediatricians and 02 neurosurgeons from the Emergency Unit and to 7 radiologists from Unimed Hospital blind to the technical differences. The participants answered a specific questionnaire asking if they noticed any difference comparing the two series of exams; if they had any difficulty in making the diagnosis and taking the necessary conduct; if they need any training to exam the CTs and to assess the load of radiation and, finally, if they consider useful to implement a booklet for each child to register his/her radiological examinations. Results: Four participants noticed differences between the CT series and reported greater "noise" (image graininess) in those with reduced radiation load, had no difficulty in making a diagnosis and take the right conduct; most would like to have training and education on radioprotection and all agreed that the booklet to register and control radiological examinations would be useful for education and surveillance of parents and health professionals. Conclusion: This study showed that is possible to reduce the radiation dose in CT scans of children up to 50% without loss in the diagnosis accuracy; health professionals are motivated for continuing education and have attitudes to reduce the load of radiation. The direction of the hospital implemented the booklet to record radiological examinations. The campaign was publicized in the local media and on websites of Unimed Sorocaba and Unimed Brazil and has been well accepted by the hospital community and families / Os exames radiológicos têm aumentado muito, especialmente em crianças pós-trauma crânio-encefálico (TCE). Estudos recentes indicam maior incidência de câncer e catarata em crianças submetidas à tomografia quando comparadas àquelas sem exposição. Alguns países já promovem campanhas para evitar exames desnecessários e reduzir a dose de radiação. Objetivos: 1. Avaliar se a redução da dose de radiação em tomografias computadorizadas (TC) de crânio prejudica a interpretação do exame e o diagnóstico em crianças com TCE. 2. Desencadear no ambiente de trabalho a discussão e implementação de medidas capazes de reduzir a dose de radiação recebida por crianças que necessitem atenção à saúde estimulando também a conscientização dos pediatras e dos familiares. Métodos: Selecionamos dois grupos de TC de crianças com TCE, realizados em tomógrafo Philips Multi Slice de 64 canais no Hospital da Unimed de Sorocaba no período de janeiro a agosto de 2012. Inicialmente selecionamos as 30 últimas TC realizadas com dose de radiação habitual. A seguir, aos próximos exames, aplicamos os protocolos de redução da carga de radiação (aproximadamente 50%) segundo as diretrizes da The Alliance for Radiation Safety in Pediatric Imaging. Reduzimos a Quilovoltagem (KV) ao máximo demonstrado pelo equipamento de tomografia e estabelecemos um limite para a Miliamperagem por segundo (mAs) de acordo com a análise do equipamento de tomografia após a realização da radiografia digitalizada na tomografia, de acordo a espessura e o comprimento da área a ser analisada do paciente. Orientamos a equipe técnica para que restringisse a extensão do exame somente à região solicitada no pedido médico. As duas séries de exames foram apresentados a 19 pediatras, 2 neurocirurgiões da Unidade de Emergência e a 7 radiologistas do Hospital da Unimed Sorocaba que desconheciam as diferenças técnicas. Os participantes responderam por um questionário específico se encontraram diferenças entre os exames; se tiveram dificuldade em fazer o diagnóstico e tomar a conduta necessária; se sentiam necessidade de capacitação para avaliar os exames e a carga de radiação e se consideravam útil a implantação de uma caderneta individual de registro dos exames radiológicos. Resultados: Quatro participantes viram diferenças entre os exames e referiram maior "ruído" (granulação da imagem) naqueles com redução da carga de radiação; não tiveram dificuldade em realizar o diagnóstico e orientar a conduta; a maioria gostaria de ter capacitação e educação preventiva e todos concordam que a caderneta de controle de registro de exames radiológicos seria útil para a educação e vigilância dos pais e profissionais de saúde. Conclusão: O estudo evidenciou ser possível reduzir a dose de radiação em TC de crianças em até 50% sem prejuízo no diagnóstico e na conduta; os profissionais de saúde estão motivados a se capacitarem e a ter atitudes visando reduzir a carga de radiação. A direção do hospital implantou a caderneta de registro de exames radiológicos. A campanha foi divulgada na mídia local e nos sites da Unimed de Sorocaba e na Unimed do Brasil e tem sido bem aceita pela comunidade hospitalar e familiares