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CAR - Canadian Association of Radiologists

The Canadian Association of Radiologists is the national specialty association for radiologists, dedicated to medical imaging excellence in patient care

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You are here: Home / About / Associates / Canada Safe Imaging (CSI)

Canada Safe Imaging (CSI)

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About Our Leadership Our Community Radiation Risks International Initiatives Canada Safe Imaging Stars Resources News Contact Us
About

About

Canada Safe Imaging (CSI) was formed in 2015 to address the need for a national strategy and action plan in Canada, to strengthen medical radiation protection in patients and foster a culture of radiation safety in healthcare in Canada.

CSI represents a collaborative undertaking between government agencies, professional associations, universities, colleges, national research institutions and hospitals. Within each sector, a multi-disciplinary approach has also been adopted, involving partners, researchers, technologists, medical and health physicists and other health care providers using or prescribing the use of radiation.

Canada Safety Imaging is part of a network of radiation safety campaigns worldwide under the auspices of the International Society of Radiology.

Mission

To provide Canadian contextualized guidelines and tools for patient radiation safety.

Responsibilities

  • Promote knowledge translation and adoption of and adherence to good radiation safety practices and standards as they relate to the Canadian medical environment;
  • Undertake future potential strategies and initiatives to enhance medical imaging radiation safety and care;
  • Shape and promote a strategic research agenda for radiation protection of patients in Canada

Context

Today’s medical imaging technologies provide unprecedented visibility into the body. As medical imaging technologies and techniques continue to evolve rapidly so has their utilization and subsequent exposure of patients to ionizing radiation.

Even if the technology has significantly improved and doses of radiation have decreased, the risk of exposure did not disappear and needs to be taken into consideration when tests using ionizing radiations are prescribed. As many things we take for granted, we don’t see any more the risks attached to the technology as it becomes part of our life. But there is a need to remain vigilant, raise awareness and educate healthcare professionals and population at large about the risks and benefits of ionizing radiations in medicine.

In 2012 the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) launched an initiative that was supported by 77 countries and 16 organizations, titled the “Bonn Call For Action,” which outlines ten major strategies for promoting radiation protection. In response, a new campaign was formed, which brings together many stakeholders to strengthen medical radiation protection across Canada following an inclusive approach. The delivery of health care is a provincial responsibility but a focused national strategy and a unified effort is needed to ensure radiation safety in medical imaging for all Canadians.

Canada Safe Imaging (CSI) was formed to address this need for a national strategy and action plan as it relates to radiation safety for medical imaging care in Canada.

Our Leadership

Our Leadership

Executive Committee

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

David A. Koff, MD, FRCPC
Department of Radiology, McMaster University
Director, MIIRCAM
Chair, Canada Safe Imaging (Hamilton, ON)

David Wormald, MRT (R) (MR), BA, MBA, C.Dir
President, St Joseph Health Centre (Guelph, ON)

Patrik Rogalla, , MD, PhD, MBA
Professor of Radiology; Head, Cardiovascular and Thoracic Division; Site Director, Toronto General Hospital
Deputy Department Head, Innovation; Director, Computed Tomography, Joint Department of Medical Imaging
University of Toronto (Toronto, ON)

Bassem Elshahat, PhD, DABR (DMP), MCCPM (NM)
Assistant Professor; Oakland University William Beaumont School of Medicine (Rochester, MI, USA)

Sandor Demeter, BSc., MD, MHP, FRCPC (Nuclear Medicine, Public Health), ABPM, FACPM, ABNM
Associate Professor, Faculty of Health Sciences, University of Manitoba
University of Manitoba (Winnipeg, MB)

Helen Chen, BA, MS, PhD
Professor of Practice; Associate Director, Professional Practice Centre for Health Systems, University of Waterloo
University of Waterloo (Waterloo, ON)

Natalia Mozayani, MBA
President and CEO, Radiation Safety Institute of Canada
Radiation Safety Institute of Canada (Toronto, ON)

Our Community

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 Interventional Radiology Association
  • Canadian Organization of Medical Physicists
  • Canadian Partnership Against Cancer (CPAC)
  • 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 du Québec
  • Radiation Safety Institute of Canada
  • Canadian Heads of Academic Radiology
  • Canadian Radiological Foundation
Radiation Risks

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 a 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, less than 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 economics of improvements in relation to benefits to the public health and safety.
International Initiatives

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; and
  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.

 

ISRQSA

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 taking into account 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 English and French, 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 plans 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

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 (6). 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 Canadian version adapted to our healthcare environment will support the work already performed by Accreditation Canada in providing a more comprehensive tool to assess compliance with international recommendations and best practices.

The Canadian version has also five levels of stars and applicants will have to demonstrate that they fulfill a number of criteria for each level as outlined in table 2 and 3. The criteria have been divided in six sections: optimization, justification, quality and safety, education, research and regulatory compliance.

 

 

 

 

 

Resources

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]

Webinars
Coming soon

Publications
Coming soon

General Information
Coming soon

News

News

CSI & CRF Radiation Safety Award - Deadline is December 15, 2022

Canada Safe Imaging Award - click here for Abstract Guidelines and Format

 

 


Contact Us

Contact Us

[email protected]

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email: [email protected]

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