Italian report for radioprotection of neonatal intensive care unit (NICU) patients

Introduction Clinical improvements are increasing survival chances of preterm infants. It is necessary to conciliate survival and future quality of life, especially for therapeutic choices involving radiation exposures of newborns. Purpose Within this context, the Italian Association of Medical Physics (AIFM) is drafting a report to establish good standards practices for every professional involved in NIC Units. Materials and methods Data from 16 Italian institutions were processed, investigating attenuation properties of 7 different models of incubators with measurements simulating in-contact and in-potter detector positioning. The incidence of clinical questions to justify X-ray exams was investigated. Even more significant, an overview of the actual practical procedures and radiographic techniques was performed, pointing out several criticalities. Results Measurements show that only two incubator models provide a 10% attenuation while others are over 30%. Furthermore, filtering the radiation beam with 1 mm Al + 0.1 mm Cu results in attenuation decrease of 20–30%. The presence of a scale may introduce a further 40% attenuation. Some criticalities were observed in practical procedures as lack of knowledge of instruments and protocols, bad patients positioning, detector artifacts and improperly use of gonads shield devices. Finally, we estimated the distribution of entrance air KERMA at patient surface and median DAP, that resulted 10 mGy cm 2 , lower than European reference level of 14 mGy cm 2 . Conclusion Our study pointed out a great variability of practices, protocols and radiation exposures parameters, requiring the drafting of a report to establish common guidelines. Nevertheless the drafting of protocols is assigned to the single institution that has to comply with the technical requirements reported in the document. Disclosure There is no conflict of interest to declare.