Accidents involving metals brought into the MRI room are occurring with increasing frequency. The Japan Council for Quality Health Care has released medical safety information about bringing magnetic materials into the MRI room, showing that this is an important safety issue. In our hospital, there were 4 accidents involving metal brought into the MRI room between April 2012 and March 2016. One serious incident was a projectile accident involving scissors carried by a nurse. In response, we have adopted new preventive measures, including specialized uniforms and a color-coding scheme for indicating MRI-safe and MRI-unsafe items (using colored tape, etc.). Here we report on the effect of these accident prevention efforts.

The use of pharmaceuticals requires establishing a safe environment and securing a system to reduce risk. In our isotope inspections, the operational system for using radiopharmaceuticals was insufficient, which became a problem. For this reason, through cooperation between a radiological technologist responsible for radiation safety management and a pharmacist responsible for medicine safety management, we considered the operational system for the preparation and management of radiopharmaceuticals at our hospital. In accordance with the guidelines for handling radiopharmaceuticals, we established a system to reduce risks by reviewing pharmaceuticals, creating checklists, and improving the work environment. By reviewing and improving the system of safety management and safe use in cooperation with other disciplines, it became possible to reduce risk through double checks and to improve the work environment for routine operations. This report describes the efforts made in our hospital.

Our hospital handles radioisotopes for isotope inspection. Responses to disasters at facilities that handle radioisotopes differ from normal disaster responses as countermeasures against radioisotopes are needed. In accordance with notices issued by relevant ministries and agencies, a system should be established that enables response, including cooperation, to accidents involving isotope handling facilities. Therefore, it is necessary not only for individual hospitals to respond with disaster prevention measures, but also for a comprehensive system to be established that includes cooperation with local fire departments. Therefore, since 2014, our hospital has been working in collaboration with Konan City Fire Department to ensure that fire extinguishing and rescue activities can be carried out smoothly within the radiation control area in the event of a disaster. We report here our efforts to strengthen cooperation.

Intra-arterial chemoradiotherapy for advanced oral cancer has recently been reported and can preserve the form and function of the tongue by avoiding surgery at the primary site. We report here a case of advanced tongue cancer treated with intra-arterial chemoradiotherapy that preserved phonation and swallowing function. A 71-year-old man presented with an ulcerative mass, 43×28 mm in size, extending from the left lingual margin to the base of the tongue. The pathological diagnosis was squamous cell carcinoma based on biopsy results, and the clinical diagnosis was left lingual carcinoma (cT3N0M0, stage III) based on imaging findings. A polyurethane catheter was inserted into the left lingual artery, and intra-arterial chemotherapy was administered using docetaxel (15 mg/m2/week, total dose 60 mg/m2) and cisplatin (5 mg/m2/ day, total dose 125 mg/m2) with concurrent radiotherapy (2 Gy/day, total dose 50 Gy). Posttreatment biopsy results showed no tumor cells, and complete response was achieved, thus avoiding surgical resection of the primary site. Six years after completing treatment, the patient remains in good health with no recurrence, metastasis, phonation problems, or dysphagia.