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	Appendix A- List of basic nuclear installations as at 31.12.2011 Appendix B - Acronyms and abbreviations TSN law Waste law Commissioner's biographies

MEDICAL USES OF IONISING RADIATION

Chapter 09

MEDICAL AND DENTAL RADIODIAGNOSIS INSTALLATIONS
1. Presentation of the equipment inventory
  1. Medical radiodiagnosis
  2. Interventional radiology
  3. Dental radiodiagnosis
2. Technical rules for radiology and tomography installations
NUCLEAR MEDICINE
1. Presentation of nuclear medicine activities
  1. In vivo diagnosis
  2. In vitro diagnosis
  3. Targeted internal radiotherapy
  4. The new nuclear medicine tracers
2. Nuclear medicine unit organisation and operating rules
EXTERNAL-BEAM RADIOTHERAPY AND BRACHYTHERAPY
1. Description of the techniques
  1. External-beam radiotherapy
  2. Brachytherapy
  3. The new radiotherapy techniques
2. Technical rules applicable to installations
  1. Technical rules applicable to external-beam radiotherapy installations
  2. Technical rules applicable to brachytherapy installations
BLOOD PRODUCT IRRADIATORS
1. Description
2. Blood product irradiator statistics
3. Technical rules applicable to installations
THE STATE OF RADIATION PROTECTION IN THE MEDICAL FIELD
1. Exposure situations in the medical field
  1. Exposure of health professionals
  2. Exposure of patients
  3. Exposure of the general public and environmental impact
2. Some general indicators
  1. Authorisations and declarations
  2. Dosimetry of medical staff
  3. Report on significant radiation protection events
3. The radiation protection situation in radiotherapy
  1. Radiation protection of radiotherapy staff
  2. Radiation protection of radiotherapy patients
  3. Summary
4. The radiation protection situation in nuclear medicine
  1. Radiation protection of nuclear medicine staff
  2. Radiation protection of nuclear medicine patients
  3. Protection of the general public and the environment
  4. Summary
5. The radiation protection situation of patients in conventional radiology and computed tomography
6. The radiation protection situation in interventional radiology
  1. Radiation protection of interventional radiology staff
  2. Radiation protection of interventional radiology patients
  3. Summary
OUTLOOK

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The gradual improvement in the safety of radiotherapy procedures, year after year since 2007, observed by ASN through its inspections, must be continued in order to achieve complete control of procedures and thus guarantee the radiation protection of the patients. In this new quality management culture, ASN will remain particularly attentive in its inspections to the identification and internal analysis of deviations, which is the only way to ensure permanent improvement and progress. The centres which are still understaffed with medical physicists will continue to be the subject of particularly close attention.

In the medical imaging field, following the publication of two decisions in July 2011, jointly with the health administrations and the health professionals, ASN will be organising detailed monitoring of the steps taken to achieve true control of the doses delivered to the patients in conventional radiology and in computed tomography and to improve radiation protection in the field of interventional practices. ASN will in particular remain highly attentive to the question of human resources and the corresponding skills, on the one hand to ensure compliance with the provisions of the Labour Code in operating theatres where radiology equipment is used and, on the other, to enable medical physicists to intervene in all fields of medical imaging, computed tomography and interventional radiology.

In the field of medical physics, the efforts made since 2007 to boost the numbers of medical physicists, must be continued in order to meet the medical imaging needs. In 2012, ASN will prepare recommendations for the health authorities, so that the organisation and implementation of the regulations applicable to medical physicists are consolidated, with regard to the involvement of professionals, other than medical physicists, in the performance of medical physics tasks.

Finally, ASN will play an active part in the work overseen by the French national authority for health, concerning the assessment of clinical practices exposing individuals to ionising radiation for medical purposes. This work began in November 2011

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