Objective To analyze the external radiation dose rate and radiation protection measures during treatment of a patient with hepatocellular carcinoma (HCC) who underwent ⁹⁰Y selective internal radiotherapy (⁹⁰Y-SIRT). Methods A male HCC patient who received ⁹⁰Y-SIRT with an activity of 4.65×10⁹ Bq was selected as the research subject using retrospective analysis. External radiation dose rate meters were used to detect ambient dose equivalent rates around the radiation worker, the HCC patient, and the workplace during treatment. Surface contamination meters were used to detect surface contamination levels of the radiation worker and the workplace. Results The ambient dose equivalent rate around the interventional radiology staff during treatment ranged from 3.7 to 39.0 μSv/h. The patient's ambient dose equivalent rate of surgical site at distances of 30, 100, and 200 cm ranged from 45.0 to 5.6, 4.4 to 0.4, and 0.4 to 0.1 μSv/h respectively without protection, and 14.0 to 3.4, 3.2 to 0.3, and 0.4 to 0.1 μSv/h respectively when the surgical site was covered with a 1.0 mmPb lead rubber drape after 0.0 to 161.0 hours of the surgery. In the nuclear medicine department, ambient dose equivalent rate of the workplace ranged from 0.4 to 740.0 μSv/h. The ambient dose equivalent rate around all monitoring points in the digital subtraction angiography operating room accounted at 0.1 μSv/h, and the observation ward ranged from 0.1 to 0.2 μSv/h. The β surface contamination levels of the radiation worker and workplace were below the minimum detection limit (0.16 Bq/cm²). Conclusion Radiation doses for both HCC patients and radiation worker remained within acceptable limits when appropriate protective equipment was used. A well-designed workplace layout is essential to ensure effective implementation of radiation protection.

Objective To assess and understand the service capabilities and existing problems of radiation health technical service institutions in Jiangsu Province, China, and provide a basis for improving in-process and post-process supervision as well as enhancing radiation health technical service capabilities. Methods Thirty radiation health technical service institutions in Jiangsu Province were selected as quality monitoring objects from the National Occupational Health Technical Service Institution Management Information System. Evaluations were conducted using a standardized national assessment checklist, and a comprehensive risk assessment was performed by combining the results of laboratory test capability comparisons. Results The 30 institutions all passed the quality monitoring, with an average score of （76.62 ± 5.07）. Comprehensive risk assessment identified 8 (26.67%) high-risk institutions, 22 (73.33%) medium-risk institutions, and 0 (0%) low-risk institutions. Conclusion The overall service quality of radiation health technical service institutions in Jiangsu Province is acceptable. However, further training and supervision are needed to improve technical service capacity and reduce service risks.

Objective:To understand the current situation of radiological health technical service institutions in Jiangsu province, analyze the existing problems, and to provide a basis for optimizing radiological health technical service resources in our province.Methods:Through the Jiangsu Provincial Radiation Health Information Management Platform to inquire basic information of institutions, we investigated, collected, organized, and analyzed the qualification recognition and technical service related information of radiological health technical service institutions in the province.Results:As of December 31, 2022, there had been 57 institutions in Jiangsu province, with public and private institutions accounting for 43.9% and 56.1%, respectively, including 4 Grade A and 47 Grade B ones for radiation protection evaluation, and with 61.4%, 22.8%, and 15.8% of these situated in the southern, central, and northern regions of Jiangsu, respectively. The number of professionals in public institutions, on an average, was less than in private institutions ( t=-3.55, P<0.05), and the proportion and number of personnel with enior professional title were higher in public institutions than in private institutions( χ2=39.16, P<0.05). On an average, the number of professional technical personnel, the proportion of personnel with senior professional title, and the number of items of equipment for radiation protection evaluation were all higher in Grade A institutions than in Grade B institutions( t=4.00, χ2=11.28, t=7.68, P<0.05). Private institutions have completed 98.2% of radiation protection evaluation tasks, 95.6% of radiation health protection testings, and 84.0% of personal dose monitoring work in 2022. Conclusions:The distribution of institutions in the southern, central, and northern regions of Jiangsu is unbalanced, and private institutions have a much higher number of technical services than public institutions. Therefore, it is necessary to guide institutions to register in the central and northern regions of Jiangsu, encourage public institutions to actively undertake technical services.

Objective:To understand the current situation of radiological health technical service institutions in Jiangsu province, analyze the existing problems, and to provide a basis for optimizing radiological health technical service resources in our province.Methods:Through the Jiangsu Provincial Radiation Health Information Management Platform to inquire basic information of institutions, we investigated, collected, organized, and analyzed the qualification recognition and technical service related information of radiological health technical service institutions in the province.Results:As of December 31, 2022, there had been 57 institutions in Jiangsu province, with public and private institutions accounting for 43.9% and 56.1%, respectively, including 4 Grade A and 47 Grade B ones for radiation protection evaluation, and with 61.4%, 22.8%, and 15.8% of these situated in the southern, central, and northern regions of Jiangsu, respectively. The number of professionals in public institutions, on an average, was less than in private institutions ( t=-3.55, P<0.05), and the proportion and number of personnel with enior professional title were higher in public institutions than in private institutions( χ2=39.16, P<0.05). On an average, the number of professional technical personnel, the proportion of personnel with senior professional title, and the number of items of equipment for radiation protection evaluation were all higher in Grade A institutions than in Grade B institutions( t=4.00, χ2=11.28, t=7.68, P<0.05). Private institutions have completed 98.2% of radiation protection evaluation tasks, 95.6% of radiation health protection testings, and 84.0% of personal dose monitoring work in 2022. Conclusions:The distribution of institutions in the southern, central, and northern regions of Jiangsu is unbalanced, and private institutions have a much higher number of technical services than public institutions. Therefore, it is necessary to guide institutions to register in the central and northern regions of Jiangsu, encourage public institutions to actively undertake technical services.

Objective:To investigate WS 582-2017 Specifications for testing of quality control in X and γ ray stereotactic radiotherapy system (hereinafter referred to as WS 582-2017) with respect to its current status, existing problems and evaluation since its implementation in Beijing, Chongqing, Jiangsu and Sichuan. Methods:The evaluation of this standard was carried out by means of field survey, questionnaire survey and expert seminar. In accordance with the WS 582-2017 implementation assessment programme, a total of 153 professionals involved in the implementation of WS 582-2017 from 80 radiological health technical service institutions, health supervision institutions and medical institutions of two municipalities and two provinces were surveyed in 2023. The investigation was carried out by using a combination of cluster sampling and stratified sampling and through sampling professionals with of different institution characteristics and different technical titles. The general survey method was used for Jiangsu province, while the cluster sampling method was used for others, with 153 individulas from 80 institutions being sampled for the investigation.Results:The awareness rate of WS 582-2017 was 80.39%, of which 90.85% considered it to be scientific and rigorous, 81.05% considered it to be operational and 97.39% considered it to be in consistency with the relevant regulatory standards, 90.20% considerd it to have played an important role in promoting radiological protection optimization for radiotherapy, 90.85% considered the implementation of it to have played a significant role in the quality control of standarded testing of radiotherapy equipment, and 86.93% considered the implementation of it to have played a significant role in enhancing the professional competence of relevant technicians.Conclusions:The overall implementation of WS 582-2017 in two municipalities and two provinces is good, with scientific and operable technical contents and the remarkable effect achieved in its implementation. However, the WS 582-2017 needs to be further improved in some areas, and training on the standard needs to be strengthened to improve the awareness rate of it.

Objective To investigate the implementation status and problem of WS 582-2017 Specifications for Testing of Quality Control in X and γ Ray Stereotactic Radiotherapy System (hereinafter refer to as "WS 582-2017") in Jiangsu Province since it was published, and evaluate the scientific, rational, applicable, and operational aspects of the standard. Methods A total of 122 professionals from 54 medical institutions, radiation health technical service institutions, and health supervision institutions in Jiangsu Province who were involved in the use of WS 582-2017 were selected as the research subjects using a judgmental sampling method. A survey was conducted on the implementation of the standard, technical content, implementation effects, opinions and suggestions on the standard and implementation work. Results The WS 582-2017 awareness rate was 76.2%, and the training participation rate was 62.4%. Among the 93 individuals who were aware of WS 582-2017, 92.5% believed that the standard was scientifically rigorous, 73.1% believed that the standard was highly operational, 96.8% believed that the standard was consistent with relevant regulations and standards, 87.1% believed that the standard played an important role in promoting the optimization of radiation protection in radiotherapy, 89.2% believed that the standard played an important role in standardizing the quality control inspection of radiotherapy equipment, and 86.0% believed that the standard played an important role in improving the professional competence of relevant technical personnel. The tracking evaluation score of the standard in Jiangsu Province was 81.9 points. Conclusion The overall implementation of WS 582-2017 in Jiangsu Province is good, with good scientific and operational technical content and great implementation effects. But the content of the standard needs to be further improved, and training needs to be strengthened to increase the awareness of the standard.

Objective To evaluate the implementation, application, problems, and suggestions associated with the WS 262-2017 Specification for Testing of Quality Control in γ-Ray Sources Afterloading Brachytherapy among radiation workers in Jiangsu Province, China, and to provide a scientific basis for further revision and implementation of this standard. Methods A questionnaire survey was conducted among employees of public and private institutions involved in radiation health technology services, radiation health supervision, and medical services in Jiangsu Province who carried out afterloading testing, supervision, and treatment. The survey primarily focused on the implementation status, technical content, and implementation effect of WS 262-2017, and the results were summarized and analyzed. Results A total of 185 valid questionnaires were collected, and 73.5% of the respondents were aware of the standard. Among the respondents who were aware of the standard, 29.4% did not participate in relevant training, and 41.2% did not use or infrequently used the standard. Moreover, 94.1% of survey respondents considered the standard to be scientifically robust and free of issues, 88.6% responded that the main technical content of the standard was highly operable, and 97.8% agreed that the main content of the standard was coordinated and consistent with relevant regulatory standards. In addition, 88.6%, 90.8%, and 87.0% of survey respondents reported that this standard provided significant assistance and played an important role in optimizing radiation protection, quality control and testing of radiation therapy equipment, and improving professional skills for technical personnel. Conclusion Radiation workers in Jiangsu Province have a high awareness rate of WS 262-2017 and believe that this standard is scientifically rigorous and plays an important role. There is no need for revision, but relevant departments should strengthen the promotion and training concerning the standard.

Objective:To investigate WS 582-2017 Specifications for testing of quality control in X and γ ray stereotactic radiotherapy system (hereinafter referred to as WS 582-2017) with respect to its current status, existing problems and evaluation since its implementation in Beijing, Chongqing, Jiangsu and Sichuan. Methods:The evaluation of this standard was carried out by means of field survey, questionnaire survey and expert seminar. In accordance with the WS 582-2017 implementation assessment programme, a total of 153 professionals involved in the implementation of WS 582-2017 from 80 radiological health technical service institutions, health supervision institutions and medical institutions of two municipalities and two provinces were surveyed in 2023. The investigation was carried out by using a combination of cluster sampling and stratified sampling and through sampling professionals with of different institution characteristics and different technical titles. The general survey method was used for Jiangsu province, while the cluster sampling method was used for others, with 153 individulas from 80 institutions being sampled for the investigation.Results:The awareness rate of WS 582-2017 was 80.39%, of which 90.85% considered it to be scientific and rigorous, 81.05% considered it to be operational and 97.39% considered it to be in consistency with the relevant regulatory standards, 90.20% considerd it to have played an important role in promoting radiological protection optimization for radiotherapy, 90.85% considered the implementation of it to have played a significant role in the quality control of standarded testing of radiotherapy equipment, and 86.93% considered the implementation of it to have played a significant role in enhancing the professional competence of relevant technicians.Conclusions:The overall implementation of WS 582-2017 in two municipalities and two provinces is good, with scientific and operable technical contents and the remarkable effect achieved in its implementation. However, the WS 582-2017 needs to be further improved in some areas, and training on the standard needs to be strengthened to improve the awareness rate of it.

Objective: To validate the method for measuring the TPV and OAR doses and 2D dose distribution in IMRT through using TLD and radiochromic film. Methods: Eight medical linear accelerators (Valian, Elekta, Siemens) were selected. The polystyrene phantom provided by IAEA was CT scanned and the image obtained was transferred to TPS for formulation of treatment plan, prescription of PTV and OAR doses and calculation of corresponding monitoring unit (MU), IMRT was performed on the phantom using 6 MV X-ray. Irradiated TLDs and films were measured and evaluated at the Secondary Standard Dosimetry Laboratory at the Radiation Safety Institute of Chinese Center for Disease Control and Prevention. Results: According to IAEA requirement, the relative deviations between TLD-measured and TPS-planned doses were within ±7.0% for the prescribed PTV and OAR doses. As measured result, the PTV values for 8 accelerators were in the range of 0.6% to 5.9%, consistent with the IAEA requirements, whereas the OAT values for 8 accelerators were within -0.6% to 7.0%, consistent the requirements. As IAEA required, the 2D dose distribution passing rate of 3 mm/3% should be higher than 90%. The film-measured and TPS-planned values for 8 accelerators were within 90.2% to 100.0%, consistent with the requirements. Conclusions TLD and radiochromic film are feasible in validating the PTV and OAR doses and the 2D dose distribution pass rate in IMRT. This method can be widely used in quality audit and internal verification in IMRT in medical institutiions on a large scale.

Objective To measure the accuracy of multi-leaves collimator (MLC) leaves positions in intensity modulated radiation therapy (IMRT) for verification purpose.Methods Solid water homogeneous phantom with size of 30 cm× 30 cm was scanned by CT scanner.The scanned images were delivered to radiation therapy plan system (TPS) to formulate the therapy plan.The MLC leaves created 5 strips of exposure field,each 3 cm long and 0.6 cm wide.The strip-to-strip distance was 3 cm.With 6 MV X-rays,the SSD was 100 cm at the maximum dose point.The MU per strip was 250 MU.EBT2 radiochromic films each of 25 cm×25 cm were placed on the 30 cm×30 cm homogeneous solid phantom and covered with 1 cm thick solid phantom slabs for delivering of IMRT.Results For 7 of 8 accelerators,the differences of film-measured and TPS-planned MLC leaf position for every fence field were within ± 0.5 mm as required by IAEA,with only other one being-0.6 mm,not consistent with the IAEA requirements.The film-measured position difference between each pair and all pairs of leaves for 8 accelerators were all in line with IAEA's requirements.The film-measured actual width difference between each pair and all pairs of leaves was within ±0.75 mm as required by IAEA for 4 accelerators and outside ±0.75 mm for the other three,not consistent with the IAEA requirements.The standard deviation of film-measured actual width between each pair and all pairs of leaves for 6 accelerators were ≤ 0.3 mm,as required by IAEA,whereas ＞0.3 mm for the other two,not consistent with IAEA requirements.Conclusions The film dosimetric verification of IMRT is an important part of its quality assurance,featuring simple,reliable and highly accurate positioning and can meet measurement requirement.