| (a) Content. Recognizing that assessing the degree
of radiation safety is a complex task of balancing radiation risk
with optimizing the benefit of the procedure to the patient, rules
are provided that identify certain specific activities or tests as
the practice of medical physics. The purpose of the Act and the rules
is to ensure the radiation safety of the citizens of Texas by restricting
the practice of medical physics to qualified medical physicists.
(b) Role of the service engineers. Service engineers,
when installing or maintaining medical equipment, conduct tests or
perform activities that are similar or identical to tests or activities
identified in these rules. Such tests and activities do not constitute
the practice of medical physics provided that:
(1) neither the service engineer nor his employer represents
that the outcome of the test or activity or the intent of performing
the test or activity ensures the radiation safety of the use of the
medical equipment for either the user, the patient, or a member of
the public; and
(2) neither the service engineer nor his employer concludes
that the medical equipment is radiologically safe, effective or suitable
for use on humans based on the tests or activities performed by the
service engineer; and
(3) neither the service engineer nor his employer certifies
that the medical equipment is radiologically safe and consequently
compliant with any state or federal regulation for the control of
radiation; and
(4) the test or activity performed by the service engineer
is required to install, maintain or repair the medical equipment.
(c) Scope of practice.
(1) The diagnostic radiological physics specialty services
include, but are not limited to, the following:
(A) providing evidence that imaging equipment continues
to meet applicable rules and regulations of radiation safety and performance
standards required by accrediting and regulatory agencies;
(B) acceptance testing or monitoring of diagnostic
imaging equipment;
(C) evaluating policies and procedures pertaining to
radiation and its safe and appropriate application in imaging procedures;
(D) providing consultation in development and management
of the quality control program;
(E) measurement and characterization of radiation from
diagnostic equipment;
(F) specification of instrumentation to be used in
the practice of diagnostic radiological physics;
(G) providing consultation on patient or personnel
radiation dose (effective dose equivalent, fetal dose calculations,
specific organ dose determination, etc.) and the associated risk;
(H) protective shielding design and evaluation of a
diagnostic imaging facility;
(I) conducting performance evaluations of medical radiologic
and fluoroscopic imaging systems which include the following physical
tests and assessments:
(i) kilovolts peak (kVp) and timer accuracy;
(ii) exposure reproducibility and linearity;
(iii) exposure geometry, e.g. source to image distance
(SID) and collimation;
(iv) entrance skin exposure and exposure rate;
(v) beam quality;
(vi) image quality; and
(J) use of assistants by the licensed medical physicist
in accordance with the following: the medical physicist may be assisted
by other properly trained individuals in obtaining test data for performance
monitoring. These individuals must be properly trained and approved
by the medical physicist in the techniques of performing the tests,
the function and limitations of the equipment and test instruments,
the reasons for the tests, and the importance of the test results.
The tests will be performed by or under the general supervision of
the medical physicist, who is responsible for and must review, interpret,
and approve all data and provide a signed report.
(2) The therapeutic radiological physics specialty
services include, but are not limited to, the following:
(A) development of specifications for radiotherapy
treatment and simulation equipment;
(B) development of procedures for testing and evaluating
performance levels of radiotherapy treatment and simulation equipment;
(C) acceptance testing of radiotherapy treatment and
simulation equipment;
(D) calibration and characterization of radiation beams
from therapeutic equipment including radiation quantity, quality,
and distribution characteristics, and assessment of the mechanical
and geometric optics for proper placement of the beam;
(E) providing documentation that radiotherapy treatment
and simulation equipment meet accreditation and regulatory compliance
requirements;
(F) calibration and/or verification of the physical
and radiological characteristics of brachytherapy sources;
(G) specification of the physics instrumentation used
in the measurement and performance testing of therapeutic equipment;
(H) acceptance testing, management, and supervision
of computer systems used for treatment planning and calculation of
treatment times or monitor units. This includes measurement and input
of dosimetry data base and verification of output for external beam
radiotherapy and brachytherapy;
(I) implementation and management of dosimetric and
beam delivery aspects of external beam and brachytherapy irradiation.
External beam delivery aspects include treatment aids, beam modifiers,
and geometrical arrangements. Special procedures are included for
both external beam (e.g. radiosurgery, total body irradiation, total
skin irradiation, intraoperative therapy) and brachytherapy (e.g.
high dose rate, pulsed dose rate and radiolabeled microspheres);
(J) provision of consultation to the physician in assuring
accurate delivery of prescribed radiation dosage to a specific human
patient, and the associated risk;
(K) development and management of quality control program
for a radiation treatment facility that includes applicable facility
accreditation requirements, and the review of policies and procedures
pertaining to therapeutic radiation and its safe and appropriate use;
(L) development and/or evaluation of a radiation safety
program in a therapeutic radiation facility including written procedures
for the protection of patients, workers, and the public; and
(M) protective shielding design and radiation safety
surveys in a radiotherapy facility.
(3) The medical nuclear physics specialty services
include, but are not limited to, the following:
(A) development of procedures for continuing evaluations
of performance levels of radionuclide imaging devices and ancillary
equipment;
(B) providing evidence that radionuclide imaging equipment
continues to meet applicable rules and regulations of performance
and radiation safety required by accrediting and regulatory agencies;
(C) acceptance testing of radionuclide imaging equipment;
(D) development and/or evaluation of a radiation safety
program in a nuclear medicine facility;
(E) determination of radiation shielding necessary
to protect workers, patients, and the public in a nuclear medicine
facility;
(F) development of specifications for radionuclide
imaging instrumentation or equipment;
(G) development and monitoring of a quality control
program for radionuclide imaging equipment, computers and other patient
related radiation detectors such as uptake probes, well counters and
dose calibrators;
(H) providing consultation on patient or personnel
radiation dose (effective dose equivalent, fetal dose calculations,
specific organ dose determination, etc.) and the associated risk;
(I) evaluating policies and procedures pertaining to
the safe and appropriate application of radionuclides;
(J) specification of instrumentation used in the practice
of medical nuclear physics;
(K) verification of calculated radiation absorbed doses
from unsealed radioactive sources and radiolabeled microspheres and
the provision of consultation to the physician in assuring accurate
delivery of prescribed radiation dosage to a specific human patient
and the associated risk in therapeutic nuclear medicine procedures;
and
(L) use of assistants by the licensed medical physicist
in accordance with the following: the medical physicist may be assisted
by other properly trained individuals in obtaining test data for performance
monitoring. These individuals must be properly trained and approved
by the medical physicist in the techniques of performing the tests,
the function and limitations of the equipment and test instruments,
the reasons for the tests, and the importance of the test results.
The tests will be performed by or under the general supervision of
the medical physicist, Cont'd... |
