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Our Leadership

Executive Committee

The Executive Committee is composed of representatives of the major founding organizations.

Canada Association of Radiologists (CAR)
David A. Koff
Chair, Canada Safe Imaging
Director, MIIRCAM
Professor Emeritus, McMaster University

Patrick Rogalla
Head, Cardiovascular and Thoracic Division
Site Director, Toronto General Hospital
Director, Computed Tomography
Professor, Joint Department of Medical Imaging, University of Toronto

Canadian Association of Medical Radiation Technologists (CAMRT)
Mark Given
Director of Professional Practice and Research

Canadian Organization of Medical Physicists (COMP)
Bassem Elshahat
Assistant Professor, Oakland University William Beaumont School of Medicine
RSO-Corewell Health William Beaumont University Hospital

University of Waterloo
Helen Chen
Associate Director, Professional Practice Centre for Health Systems
Professor of Practice, University of Waterloo

Radiation Safety Institute of Canada
Natalia Mozayani
President and CEO, Radiation Safety Institute of Canada

Sandor Demeter
Associate Professor, Faculty of Health Science, University of Manitoba

Our Community

Participating Organisations

• Association des radiologistes du Québec
• Canada Health Infoway
• Canadian Association of Medical Radiation Technologists
• Canadian Association of Nuclear Medicine
• Canadian Association of Radiologists
• Canadian Cardiovascular Society
• Canadian Association for Interventional Radiology
• Canadian Organization of Medical Physicists
• Canadian Partnership Against Cancer
• Centre d’Expertise Clinique en Radioprotection
• Choosing Wisely
• MEDEC
• Ontario Association of Medical Radiation Sciences
• Ordre des technologues en imagerie médicale et en radio-oncologie et électrophysiologie médicale du Québec
• Radiation Safety Institute of Canada
• Canadian Heads of Academic Radiology
• Canadian Radiological Foundation

Radiation Risks

The BEIR report VII

Defines “low level” radiation as a range from near zero up to 100 milliSieverts (mSv)

• 30-40 times annual natural background exposure
• 10 times that of a CT scan
• 1000 times that of a chest X-Ray

Linear No Threshold Theory

• According to the Linear No Threshold (LNT) theory, the risk of developing radiation induced cancer (stochastic effects) increases with increasing dose.
• This model has been validated at higher acute radiation doses (>100mSv) from the atomic bomb survivors.
• The dose level at which there is a significant risk is not known, but for radiationprotection purposes, it is assumed that there is a linear risk down to “0” dose.
• For low dose exposures, ≤100 mSv per year, the risk profile is open to discussion.
• Different dose risks models have been proposed, going from increased risks to benefits!
• The Health Physics Society stated recently that the LNT theory cannot be used for risk cancer estimates.

ALARA Principle

• Irrespective of the LNT debate we have to follow best practices and keep radiation exposures and doses “As Low As Reasonably Achievable”.
• This is the ALARA principle which means making every effort to maintain exposures to ionizing radiation as far as below the dose limits as practical.
• Taking into consideration the state of technology and the cost of improvements in relation to benefits to public health and safety.

International Initiatives 

Bonn Call-for-Action

The conference was co-sponsored by the World Health Organization (WHO), hosted by the Government
of Germany and attended by 536 participants and observers from 77 countries and 16 organizations. An important outcome of the conference was the identification of responsibilities and a proposal for priorities for stakeholders regarding radiation protection in medicine for the next decade. This specific outcome is the Bonn Call-for-Action.

The aims of the Bonn Call for Action are to:

1. Strengthen the radiation protection of patients and health workers overall.
2. Attain the highest benefit with the least possible risk to all patients by the safe and appropriate use of ionizing radiation in medicine.
3. Aid the full integration of radiation protection into health care systems.
4. Help improve the benefit/risk-dialogue with patients and the public.
5. Enhance the safety and quality of radiological procedures in medicine.

The Bonn Call-for-Action highlights ten main actions, and related sub-actions, that were identified as being essential for the strengthening of radiation protection in medicine over the next decade. The actions are not listed in order of importance.

The ten main actions:

1. Justification
2. Protection and Safety
3. Manufacturer’s role
4. Education and training
5. Research
6. Global information
7. Incidents and accidents
8. Culture
9. Benefit Risks dialogue
10. Global requirements

The Bonn Call For Action 5 years later

In December 2017, the IAEA, in partnership with the WHO and the Pan-American Health Organization, hosted the International Conference on Radiation Protection in Medicine: Achieving Change in Practice in Vienna, Austria. The goal of this conference was to provide an overview of the actions and developments since the 2012 Bonn conference.

The conference, with 530 participants from 100 countries, five days of presentations and round tables, acknowledged the work performed in numerous jurisdictions around the world to promote the Bonn Call-for-Action and outlined what more should be done to enhance awareness and implementation.

The International Society of Radiology Quality and Safety Alliance (ISRQSA)

The International Society of Radiology collaborates with the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) to focus on the implementation of the Bonn Call for Action and the International Radiation Basic Safety Standards (BSS). These standards have been first published by the IAEA in 1996, to establish basic requirements for protection against the risks associated with exposure to ionizing radiation and for the safety of radiation sources. They result from the collaboration between multiple international organizations and have been developed from widely accepted radiation protection and safety principles. They have been revised and updated in 2014 considering the most recent findings of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) and the latest recommendations of the International Commission on Radiological Protection (ICRP).

The ISR Quality and Safety Alliance (ISRQSA) drives the ISR’s quality and safety agenda, and acts as a convener and facilitator for continental, regional and national radiation protection, quality and safety campaigns. These campaigns are led primarily by radiologists and supported by their regional societies of radiology. Most of them are multi-stakeholder organizations, with medical physicists and radiographers on board, as promoted by Canada Safe Imaging. These campaigns include Image Wisely and Image Gently in the USA, EuroSafe Imaging, Canada Safe Imaging, AfroSafe Rad, LatinSafe, Japan Safe, Arab Safe, AsiaSafe.

ISRQSA and WHO have worked on a 3-year work plan for 2019-2021 to promote WHO’s initiatives. Besides facilitating the implementation of the International Radiation BSS and the Bonn Call for Action, the plan also addresses focal areas such as justification of medical imaging, multidisciplinary/team approach in the use of medical radiation, radiation risk communication, radiation safety culture in healthcare and use of medical imaging in individual health assessment of asymptomatic persons.

ISRQSA Call for Action

The following ISRQSA Call for Action is proposed to serve as a set of internationally relevant recommendations and guidelines for medical radiation safety, management, and informed use. In fulfilling its mission “…to facilitate the global endeavours of the ISR’s member organizations to improve patient care and population health through medical imaging”, the ISR and its Quality and Safety Alliance will function as both a primary actor as as a facilitator through this Call for Action.

The continental, regional, national initiatives

Canada Safe Imaging Stars

The CSI Executive Committee estimated that Canada would benefit from a system based on the EuroSafe Imaging Stars which identify and recognize imaging facilities that embody best practice in radiation protection. These facilities obtain stars on a scale from 1 to 5 based on their level of compliance with recommendations adapted from the Bonn Call for Action.

A revised version has been released by EuroSafe Imaging which better aligns with the European Basic Sasety Standards (BSS) and adapts well to the Canadian healthcare environment. The updated criteria consist of 11 mandatory and 7 additional criteria, covering the previously identified topics of optimization, justification, quality and safety, education, research. The highest level of 5 Stars premium goes beyond the BSS recommendations.

Developing an Imaging Stars network or developing a program distinguishing imaging centres that achieve the embodiment of best radiation safety practice is Action 3 of the International Society of Radiology Call for Action.

Click here to see the new 5 Stars system.

To apply, please follow these instructions:

1. 1. Download the CSI_5-STAR_form available in Excel format.
   2. Answer the form questions and save it under another name.
   3. Email the completed form and supporting documents to [email protected].

Toolkit

Diagnostic Imaging Referral Guidelines — https://car.ca/patient-care/referral-guidelines/

DRL: Canadian Computed Tomography Survey — https://www.canada.ca/en/health-canada/services/publications/health-risks-safety/canadian-computed-tomography-survey-national-diagnostic-reference-levels.html

Radiation Safety Award

Canada Safe Imaging (CSI) was formed in 2015 to address the need for a national strategy and action plan as it relates to radiation safety for medical imaging in Canada, based on the recommendations from the Bonn Call-for-Action.

CSI’s vision is:

• To strengthen medical radiation protection in patients and health care workers and foster a culture of radiation safety in healthcare in Canada.
• To develop an action plan relating to radiation safety for medical imaging care in Canada.
• To support evidence-based best practice guidelines.
• To facilitate a strategic approach to conduct scientific inquiry on the effects of radiation on human health.

The Canadian Radiological Foundation (CRF) is offering a $500 Radiation Safety Award which would be attributed to the best poster presentation aligned with a minimum of one of the five main priorities identified by CSI, namely:

• Optimization
• Justification
• Quality and safety
• Education
• Research

All members (including residents and fellows) are invited to submit abstracts.

CSI & CRF Radiation Safety Award 2024

Dr. Kaitlin Zaki-Metias is the First author of the winning abstract titled, Impact of a Collaborative Small Bowel Obstruction Imaging and Care Protocol with the General Surgery Service on Radiology Workflow and Resource Utilization. Her worked has contributed to decrease CT utilization and therefore radiation exposure in the emergency setting.

CSI & CRF Radiation Safety Award 2023

We are happy to announce that Dr Moulay Ali Nassiri PhD, Physicien médical, MCCPM Groupe de radioprotection, Direction de la qualité, de l’éthique, de la performance et du partenariat (DQEPP), Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, has been awarded the first CSI-CRF award for his project titled: Pilot project for monitoring patient doses of ionizing radiation from medical imaging implanted in Centre intégré universitaire de santé et des services sociaux de l'Estrie.

Resources

Questions about Radiation

• The Free Information Service in Radiation Safety provided by the Radiation Safety Institute of Canada offers medical imaging professionals answers to patient and workplace safety questions, as well as answers to direct patient enquiries about imaging procedures’ exposures and their associated risks.

1 800 263 5803 / [email protected]

• A similar service is offered in French by the Centre d’Expertise Clinique en Radioprotection.

1 877 839 1217 / [email protected]

• RadiologyInfo.org for patients

General Information

• Medical Imaging Primer with a focus on X-ray usage and safety
• ISR free i-Violin webinars
• Radiation Protection Training Program for Patients/Public
• IAEA online training in radiation protection

Publications

• Proposed Priorities for Low-Dose Radiation Research and Their Relevance to the Practice of Radiology: 
  Published Online: Nov 14 2023 at https://doi.org/10.1148/radiol.222590
• Canada Safe Imaging: Promoting Radiation Safety in Healthcare Institutions
  Published Online: Jun 24 2021 at https://doi.org/10.1177/08465371211024921
• Prioritizing Patient Radiation Safety Globally: A Narrative Review Evaluating Global Patient Radiation Safety Initiatives using a SWOT Approach
• Radiation Protection and Safety: Awareness and Implementation of the Bonn Call for Action Priorities in Canada

News

ESR Webinar on Radiation Protection in Plain Imaging

September 24, 2024 - 18:00 CEST

What to Expect?

This webinar will cover key topics such as quality control, dose reduction strategies, and addressing non-justified exams in plain imaging. It is designed for radiologists, radiographers, and medical physicists looking to enhance their skills in these areas.

After completing the webinar, participants will be able to:

1. Implement a quality control program in plain imaging
2. Apply effective dose reduction strategies
3. Identify plain imaging procedures that are no longer justified according to current criteria.

Read more

World Patient Safety Day 2024: Webinar on Improving diagnosis for patient safety in medical imaging

September 17, 2024 – 6 am to 7:30 am (ET)

The webinar aims to raise global awareness of errors in diagnosis contributing to patient harm and emphasize the pivotal role of correct, timely and safe diagnosis in improving patient safety. It will bring together NGOs in official relations with WHO involved in radiation safety and medical imaging. Furthermore, the WHA76.5 resolution on Strengthening Diagnostics Capacity that calls for safe use of diagnostic imaging procedures, and the IAEA’s perspective on quality in medical imaging to prevent errors and ensure patient safety will be presented.

The panelists will discuss their strategies for improving diagnosis for patient safety and how their organizations can foster collaboration with policymakers, health care leaders, health workers, patients, and other stakeholders in advancing correct, timely and safe diagnosis.

This webinar is organized by WHO with contributions from the IAEA, and the following NGOs in official relations with WHO: ICNIRP, ICRP, IOMP, ISR, ISRRT, RAD-AID, WFNMB and WFUMB.

Register here

Read more

Symposium on Monitoring Radiation Exposure in Medical Imaging

The aims of this symposium are as follows:

1. To provide a platform to discuss and disseminate best practices and guidelines related to radiation dose monitoring among healthcare professionals, researchers, policymakers and encourage interdisciplinary collaboration.
2. To highlight technological advancements and innovations in radiation monitoring tools and software.
3. To develop recommendations to help provincial and national authorities in adopting better practices in radiation dose monitoring

Read more

Registration

In preparation for the Symposium on Radiation Exposure Control in Medical Imaging, which will be held in Sherbrooke, Quebec, Canada, September 23-25, 2024, we will appreciate if you could answer this survey on radiation exposure monitoring.

Take the Survey

The objectives of the survey are:

1. Get an overview of the status of patient doses monitoring projects in Canadian healthcare facilities.
2. Collect opinions and proposals from all medical imaging stakeholders on patient dose monitoring.

The results of the survey will be presented and discussed at the symposium aimed at developing Canadian consensus guidelines on patient dose monitoring, based on successful experiences.

From ECR 2024 in Vienna, CSI presents 3 goals for the coming year, according to the ISRQSA request

From ECR 2024, watch EuroSafe Imaging celebrating 10 years of success in radiation safety, March 2, 2024 at 6:45 ET

Discontinuing the Use of Gonadal and Fetal Shielding for Patients, please see here the Canadian Association of Radiologists position statement, supported by CSI

Proposed Priorities for Low-Dose Radiation Research and Their Relevance to the Practice of Radiology
Published Online: Nov 14 2023

Contact Us

[email protected]