Annals of the ICRP RSS feed: Current Issue. The International Commission on Radiological Protection was founded in 1928 to advance for the public benefit the science of radiological protection. The ICRP provides recommendations and guidance on protection against the risks associated with ionising radiation, from artificial sources as widely used in medicine, general industry and nuclear enterprises, and from naturally occurring sources. These reports and recommendations are published six times each year on behalf of the ICRP as the journal Annals of the ICRP . Each issue provides in-depth coverage of a specific subject area. Subscribers to the journal receive each new report as soon as it appears so that they are kept up to date on the latest developments in this important field. While many subscribers prefer to acquire a complete set of ICRP reports and recommendations, single issues of the journal are also available separately for those individuals and organisations needing a single report covering their field of interest. A complete list of currently available ICRP reports can be found here http://www.icrp.info/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Annals of the ICRP0146-6453394August 2009 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.icrp.info/article/PIIS0146645310000138/abstract?rss=yesEditorial board10.1016/S0146-6453(10)00013-8Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-3IFCIFChttp://www.icrp.info/article/PIIS0146645309000700/abstract?rss=yesPreventing Accidental Exposures from New External Beam Radiation Therapy Technologies10.1016/j.icrp.2009.12.001Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-312http://www.icrp.info/article/PIIS0146645310000035/abstract?rss=yesICRP Publication 86, ‘Prevention of accidental exposures to patients undergoing radiation therapy’, was published in 2000 (). The usual life span of the ICRP recommendations exceeds, sometimes by far, a full decade. Consequently, it may appear somewhat surprising to see ICRP publishing a new document focusing on the risks of accidents in radiotherapy less than 10 years after ICRP Publication 86.New technologies, new risks10.1016/j.icrp.2010.02.002Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-335http://www.icrp.info/article/PIIS0146645309000724/abstract?rss=yesContents10.1016/j.icrp.2009.12.003Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-378http://www.icrp.info/article/PIIS0146645309000712/abstract?rss=yesOver the years, the International Commission on Radiological Protection (ICRP), referred to below as ‘the Commission’, has issued many reports providing advice on radiological protection and safety in medicine (ICRP Publication 105 is a general overview of this area). These reports summarise the general principles of radiation protection, and provide advice on the application of these principles to the various uses of ionising radiation in medicine and biomedical research.PrefaceICRP10.1016/j.icrp.2009.12.002Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-3910http://www.icrp.info/article/PIIS0146645309000761/abstract?rss=yes(a) The decision to implement a new technology for radiation therapy should be based on a thorough evaluation of the expected benefits, rather than being driven by the technology itself. To ensure safe implementation, a step-by-step approach should be followed.Executive summaryICRP10.1016/j.icrp.2009.12.007Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-31112http://www.icrp.info/article/PIIS0146645309000736/abstract?rss=yes (1) New technologies have been introduced into radiation therapy with the principal aim of improving treatment outcome by means of dose distributions which conform more strictly to tumour (clinical target) volumes. A highly conformal dose distribution allows for dose escalation in the target volume without increasing the radiation dose to neighbouring normal tissues, or for a reduction in radiation dose to normal tissues without decreasing the dose to the target. These new technologies encompass the increased use of multileaf collimators (MLCs), IMRT, volumetric arc therapy (VMAT), tomotherapy, image-guided radiation therapy (IGRT), respiratory gating, robotic systems, radiosurgery, newer and more complex treatment planning systems (TPSs), virtual simulation, and ‘all-inclusive’ electronic patient data management systems.Chapters 1 and 2ICRP10.1016/j.icrp.2009.12.004Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-31323http://www.icrp.info/article/PIIS0146645309000748/abstract?rss=yes (36) This section provides an overview of the major new technologies and processes from the safety perspective, exploring them with the purpose of identifying potential weaknesses. As is often the case with predictive exercises, an initial degree of speculation may be unavoidable and, therefore, acceptable, provided that quantitative or semi-quantitative tools are subsequently used to assess likelihood of the scenarios and remove the unrealistic ones from futher study. In this context, this section is a preliminary exercise in safety assessment to familiarise oneself with the questioning approach. It is useful to compare potential weaknesses identified in this section with actual case histories of events described in Section 4 and Annex A, and with results of prospective safety assessments.Chapters 3 and 4ICRP10.1016/j.icrp.2009.12.005Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-32559http://www.icrp.info/article/PIIS014664530900075X/abstract?rss=yes (160) While valuable lessons can be learnt from the detailed analysis of incidents and accidental exposures which have occurred, these lessons are necessarily limited to reported experience. Undoubtedly, there are potential incidents which have not yet happened but which are possible, and actual incidents which have not been openly reported. Re-occurrence of these types of incidents can only be avoided if they are anticipated. Furthermore, increased complexity in the clinic places new demands on the selection of quality control checks. The approach of following all-inclusive lists of tests and all possible controls may become impractical within the context of limited time and resources. Therefore, particularly with technological and process changes in radiation therapy, retrospective approaches are not sufficient and all-inclusive quality control checks may not be feasible. There is, thus, a need for prospective, structured, and systematic approaches to the identification of system weaknesses and the anticipation of failure modes, including the evaluation and comparison of potential risks from each identified failure mode. Such approaches should allow rational selection of the checks to be performed, and facilitate the distribution of resources in a manner likely to be most beneficial to the patient.Chapters 5 and 6ICRP10.1016/j.icrp.2009.12.006Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-36179http://www.icrp.info/article/PIIS0146645309000773/abstract?rss=yes(A1) This annex is a supplement to Section 4 in the main text. It contains incidents without severe consequences reported to ROSIS, a voluntary web-based safety reporting system for radiotherapy (http://www.rosis.info). The reports provide different examples of errors with new technologies or techniques, and the paragraphs are summarised interpretations of the reports. Although they are not accidental exposures, the reports also contain lessons that can be used to prevent accidental exposures elsewhere.Annex A. Short reports on incidents without SEVERE consequences from the Radiation Oncology Safety Information SystemICRP10.1016/j.icrp.2009.12.008Annals of the ICRP 39, 4 (2009)2009-08-01Annals of the ICRP2009-08-01394S0146-6453(10)X0003-38186