ASN Report 2015

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of the radiation beam and the use of the adjacent rooms,
including those vertically above and below the treatment
room. This study shouldbe included in the file presented to
support the application for a license to use a radiotherapy
installation, examined by ASN.
In addition, safety systems must indicatemachine status
(operating or not) and must switch off the beam in an
emergency or if the door to the irradiation room is opened.
3.2.2 Technical rules applicable to brachytherapy
installations
The rules for radioactive source management in
brachytherapy are comparable to those defined for all
sealed sources, regardless of their use.
Low Dose-Rate brachytherapy
In cases where permanent implant techniques are used
(seeds of iodine-125 in particular for treating prostate
cancer), the applications are carried out in the operating
theatre with ultrasonography monitoring, and do
not require hospitalisation in a room with radiation
protection.
Pulsed Dose-Rate brachytherapy
This technique uses source afterloaders (generally 18.5GBq
of iridium-192). The treatment takes place in hospital
rooms with radiological protection appropriate for the
maximum activity of the radioactive source used.
High Dose-Rate brachytherapy
As the maximum activity used is high (370 GBq of
iridium-192 or 91GBq of cobalt-60), irradiation can only
be carried out in a roomwith a configuration comparable
to that of an external beam radiotherapy room.
4. BLOOD PRODUCT IRRADIATORS
4.1 Description
The irradiation of blood products is used to prevent post-
transfusion reactions in blood-transfusion patients. The
blood bag is irradiated with an average dose of about
20 to 25 grays. Irradiation is ensured by a self-shielded
device (radiological protection by lead), therefore it can
be installed in a roomwhich does not require additional
radiation protection. Depending on the models, the
irradiators are equipped either with radioactive sources
(1, 2 or 3 sources of caesium-137) with a unit activity of
about 60 terabecquerels (TBq) or with electrical X-ray
generators.
The policy initiated in 2009 to gradually replace the
source-equipped irradiators by X-ray generators has
reversed the composition of the equipment pool which
now comprises more X-ray generators than irradiators
with sources. As at 1st November 2015, the irradiator
pool comprised 30 machines, 5 of which are equipped
with radioactive sources (including one irradiator
undergoing decommissioning), that is to say 16% of
the irradiator pool.
4.2 Technical rules applicable
to facilities
Ablood product irradiatormust be installed in a dedicated
room designed to provide physical protection (fire,
flooding, break-in, etc.). Access to the device, which
must have a lockable control console, must be limited
to authorised persons only.
The layout of irradiators equipped with X-ray generators
must comply with the provisions of ASN’s new technical
resolution 2013-DC-0349 of 4th June 2013 (see
chapter 3). This resolution requires that the layout
and access to the facilities comply with the radiation
protection rules set by French Standard NFC 15-160
in its March 2011 version.
5. THE STATE OF RADIATION
PROTECTION IN THE MEDICAL
SECTOR
Radiation protection in the medical sector concerns
patients receiving treatment or undergoing diagnostic
examinations, health professionals (physicians, medical
physicists,medical radiation technologists, nurses, nursing
auxiliaries, etc.) using or participating in the use of ionising
radiation, and also the population, such as members of
the public who can be present within a health facility,
or population groups that could be exposed to waste or
effluents from nuclear medicine units.
Since 2008, ASNhas periodically produced documents
presenting a national synthesis of themain lessons learned
from inspections, based on indicators that determine
compliance with the regulatory radiation protection
requirements. These syntheses enable the state of radiation
protection in the different areas (radiotherapy, nuclear
medicine, interventional radiology, etc.) to be assessed for
publication in the annual report. The syntheses are based
on the findings established during the year preceding
their publication. ASN also publishes annual or several-
year national appraisals of inspection results; they are
available at .
306 CHAPTER 09: MEDICAL USES OF IONISING RADIATION
ASN report on the state of nuclear safety and radiation protection in France in 2015