Subsection 4: Optimisation of medical exposure to ionising radiation

The implementation of the optimisation principle referred to in 2° of Article L. 1333-2 aims to keep the dose of ionising radiation as low as reasonably achievable in order to obtain the medical information sought or to achieve the therapeutic objective of the exposure. Optimisation is implemented when equipment is selected and during the performance of each procedure. It includes the assessment of radiation doses or the activity of radioactive…

I. – When exposure to ionising radiation involves a woman of childbearing age, the applicant and the person carrying out the procedure must investigate whether there is any pregnancy, unless this investigation is not relevant to the planned exposure. II. – For women who are pregnant or breastfeeding, or if the possibility of pregnancy cannot be ruled out, the assessment of whether the procedure is justified takes into account the…

Information on the protection of pregnant or breast-feeding women is provided to them prior to any exposure, in particular by means of posters in reception areas and the waiting room.

Equipment, accessories and procedures are used to optimise the doses delivered to children.

I.-The person performing the procedure using ionising radiation for medical diagnosis or radioguided interventional procedures regularly assesses the doses delivered to patients and analyses the procedures performed in the light of the principle of optimisation. The results of the assessments concerning the procedures mentioned in II are communicated to the Institut de Radioprotection et de Sûreté Nucléaire. II -Diagnostic reference levels are established and updated by the French Nuclear Safety…

For external radiotherapy, brachytherapy and internal vectorised radiotherapy, exposure of the tissues and organs targeted by the radiation is assessed and planned on a case-by-case basis, keeping the doses received by organs and tissues other than those directly targeted by the radiation to the lowest possible level while achieving the therapeutic objective of the exposure. The implementation of the exposure is controlled at each stage of the exposure as part…

In the context of research involving humans, when a participant voluntarily agrees to undergo a medical procedure using ionising radiation, the dose or activity levels administered are established on a case-by-case basis in accordance with the research protocol prior to exposure.

Before and after a nuclear medicine procedure for diagnostic or therapeutic purposes or a brachytherapy procedure using permanent implants, the person carrying out the procedure must provide the patient, his or her legal representative in the case of a minor, or, in the case of an adult subject to a legal protection measure with representation relating to the person, to the person in charge of the measure, appropriate oral and…

The principle of optimisation is applied to exposures likely to be received by people involved in supporting and comforting patients. A dose constraint is established, where necessary, by the person performing the procedure to avoid excessive exposure of these people, taking into account the recommendations of good professional practice.

In his report, the person performing the procedure must indicate the information on the basis of which he considered the procedure justified and the information relating to the patient’s exposure, in particular the procedures performed and any information useful for estimating the dose received by the patient.