This study critically evaluates the outcomes of the first Asynchronous Virtual Course organized by the Latin American Association of Medical Physics (ALFIM), titled “Reference Levels for Diagnosis in Nuclear Medicine”, designed for professionals in the field, comprised both theoretical and practical components. The teaching outcomes were analyzed quantitatively and qualitatively, digital tracking of participant engagement in the pre-recorded theoretical activities on YouTube, as well as the results of the theoretical (Google questionnaire) and practical (exercise and report) formative assessments. Additionally, a quality survey was also conducted to gather participants’ opinions on various aspects of the course. The course had 315 participants from 21 countries. 99 completed the theoretical evaluation with 100% achieving satisfactory results. 43 participants finished the planned practical activities, demonstrating the application of acquired competencies. The quality survey, completed by 40 attendees, indicated that 68% considered this type of course entirely feasible and beneficial, 17% deemed it very feasible, and 15% found it sufficiently feasible. The survey also identified areas for improvement. The strategy for developing virtual courses using YouTube and Google tools is viable and effective for establishing continuous education programs in the region.

Background: Radiotherapy technology has undergone significant advancements, driven by the pursuit of improved tumor control probabilities and reduced normal tissue complication probabilities. This has been achieved primarily through innovative approaches that prioritize high dose conformity on complex treatment targets. The CONVERAY project introduces a groundbreaking teletherapy system featuring a convergent X-ray beam, which enables highly conformal dose distributions by converging photons to a focal spot, thereby achieving exceptionally high fluence rates. Methods: Customized Monte Carlo subroutines have been developed to simulate particle fluence and associated dosimetry effects for the CONVERAY device. This simulation approach facilitated a detailed, step-by-step characterization of radiation fluence and interaction processes, enabling seamless integration with a conventional clinical linear accelerator head. Key physical properties of the radiation beam have been comprehensively characterized for various CONVERAY configurations, providing a solid foundation for evaluating the corresponding dosimetry performance. Results: Monte Carlo simulations successfully tracked the phase state of the CONVERAY device, characterizing the influence of individual components on convergent photon beam production. Simulations evaluated dosimetry performance, confirming the device’s capability to achieve high dose concentrations around the focal spot. Preliminary tests on realistic scenarios (intracranial and pulmonary irradiations) demonstrated promising spatial dose concentration within tumor volumes, while gantry rotation significantly improved dose conformation. Conclusions: This proof-of-concept Monte Carlo study of the CONVERAY prototype provided critical insights into the generation of convergent X-ray beams, validating the device’s ability to achieve its primary objective. Notably, simulation results reveal the potential for exceptionally high dose concentrations within complex treatment volumes, demonstrating promising dosimetry performance.

Background: Interventional cardiology procedures chronically expose healthcare personnel to ionizing radiation, raising concerns about long-term health effects such as cataracts and cancer. Consequently, growing attention has been directed toward advanced shielding technologies capable of substantially reducing occupational dose while improving ergonomic conditions.” Objective: To synthesize the available evidence on the technical performance and radiation attenuation capabilities of Autonomous Radiation Protection Systems (Protego™, Rampart™, and EggNest XR™), used in interventional cardiology settings. Methods: A scoping review was conducted following the PRISMA-ScR framework. Relevant studies were identified through a systematic search of PubMed, EBSCO, Scopus, WOS and Cochrane. Eligible studies included clinical and phantom-based assessments reporting quantitative dosimetric outcomes. Results: Fourteen studies met the inclusion criteria. Protego™ was associated with consistently high reported attenuation, typically ≥95% in studies providing quantifiable measurements; in several investigations, post-shielding doses fell below the detection limits of standard personal dosimeters, whereas Rampart™ demonstrated wider reported attenuation ranges (approximately 16.7–100%) across heterogeneous study designs and measurement protocols and EggNest XR™ exhibited attenuation values ranging from 91.5% to 99.0% in a single phantom-based study. Device performance varied by anatomical site and professional role, with higher attenuation typically observed among primary operators (often exceeding 95% at head and torso levels) compared with more variable reductions in peripheral personnel such as nurses and anesthesiologists, where attenuation occasionally decreased to the 80–90% range depending on positioning and projection. Conclusion: The attenuation results for autonomous shielding systems are promising, particularly for fixed systems, which demonstrate consistently high performance. Given their potential for ergonomic improvement and radiation reduction, Autonomous Radiation Protection Systems (ARPS) are emerging as valuable tools. However, given the limited clinical validation and the heterogeneity of existing study, the implementation of these systems should be supported by site-specific validation and standardized dosimetry protocols.”

Interventional cardiology procedures, particularly coronary angiography (CA) and percutaneous coronary intervention (PCI), are among the most radiation-intensive medical imaging techniques. Accurate estimation of patient radiation dose is essential for risk assessment, dose optimization, and the development of diagnostic reference levels. This scoping review critically analyzes the current literature on dose conversion factors based on kerma-area product (KAP) for estimating effective (E) and organ-specific (HT) doses in adult patients undergoing CA and PCI. A total of 14 studies meeting defined eligibility criteria were included, encompassing methodologies such as Monte Carlo simulations (e.g., PCXMC, Geant4), physical phantoms, and clinical measurements. Reported E/KAP factors varied from 0.14 to 0.33 mSv/Gy·cm², with PCI generally yielding higher values. HT/KAP values were notably highest for lungs and varied based on sex, anatomy, and procedural parameters. Technical factors such as X-ray filtration also significantly influenced dose estimation. The findings highlight substantial methodological heterogeneity and emphasize the need to standardize conversion factor recommendations across settings. Future efforts should focus on integrating personalized dosimetry, artificial intelligence tools, and real-time dose monitoring to enhance radiological safety and ensure consistent practice in interventional cardiology.

Diagnostic reference levels (DRLs) are tools for optimizing medical exposures. We performed a retrospective analysis of 898 adult scintigraphic examinations acquired between 2018 and 2024 at a Peruvian hospital to establish institutional DRLs for eight procedures. Typical values were defined as the median administered activity, and the 75th percentiles were used as institutional action levels to trigger protocol review. Median weight-normalized activities ranged from 0.1 MBq·kg−1 for 131I thyroid uptake testing to 14.5 MBq·kg−1 for three-phase bone scintigraphy; corresponding derived effective dose estimates were ~1–45 mSv and are reported only for population-level benchmarking. Comparison with international DRLs showed broad concordance; however, bone scintigraphy exceeded several reference values by >25%, indicating opportunities for optimization. These results provide the first institutional DRLs reported in Peru, identify priorities for local quality improvement, and support periodic review within an optimization cycle.