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Hi Mike, I looked thru it. It didn’t find anything specifically about fluoro rooms being upgraded needing a radiation shielding survey performed. That one passage about “Any changes in design or shielding which affects radiation exposure levels</div>
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<p class="MsoNormal"><span style="font-size:11.0pt">Hi Mike,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:11.0pt">I looked thru it. It didn’t find anything specifically about fluoro rooms being upgraded needing a radiation shielding survey performed. That one passage about “</span><span style="font-family:"Times New Roman",serif;background:yellow;mso-highlight:yellow">Any
changes in design or<o:p></o:p></span></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-family:"Times New Roman",serif;background:yellow;mso-highlight:yellow">shielding which affects radiation exposure levels adjacent to those rooms, requires prior approval by RC</span><span style="font-family:"Times New Roman",serif">”
is confusing because it starts out with Radiation Therapy. And then, I thought RC isn’t involved with DX?<span style="background:yellow;mso-highlight:yellow"><o:p></o:p></span></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">All the passages I’ve found are written in a general tone or way that leaves room for interpretation.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">It seems the only thing that can be construed in the regs is (as Laura mentioned) writing a
<b>statement</b> in your reports that the dose to the public will be lower than a certain amount.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">But do you necessarily need a survey measurement for that (the way NCRP 147 says)?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Nima<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">P.S. I didn’t find the JC document that mentions fluoro either. It’s CT and NM , but not fluoro?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"> Mike Nimmo <mike.t.nimmo@gmail.com>
<br>
<b>Sent:</b> Monday, September 8, 2025 2:13 PM<br>
<b>To:</b> Nima Kasraie <Nima.Kasraie@UTSouthwestern.edu><br>
<b>Cc:</b> intl_dxmedphys_wd_osu_list@lists.osu.edu<br>
<b>Subject:</b> Re: [Intl_DxMedPhys] Are shielding surveys for replacements required?<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Hi Nima, It is in the Title 25 Texas Administrative Code Chapter 133, Hospital Licensing rules. Attached. Thanks, On Mon, Sep 8, 2025 at 1:</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">38
PM Nima Kasraie via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list@</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">lists.</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">osu.</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">edu>
wrote:</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white"><o:p></o:p></span></p>
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<p class="MsoNormal">Hi Nima,<o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal">It is in the Title 25 Texas Administrative Code Chapter 133, Hospital Licensing rules. Attached.<o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal">Thanks,<o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal">On Mon, Sep 8, 2025 at 1:38<span style="font-family:"Arial",sans-serif"> </span>PM Nima Kasraie via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>> wrote:<o:p></o:p></p>
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<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Hi all, If you replace a fluoro room with a similar model and vendor with no changes to room shielding and walls, do you still need to do a shielding survey, legally
speaking? TJC says yes. But what about the states? For example, in Texas, I<o:p></o:p></span></p>
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<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">Hi all,</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">If you replace a fluoro room with a similar model and vendor
<b>with no changes to room shielding and walls</b>, do you still need to do a shielding survey,
<b>legally speaking</b>?</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">TJC says yes.
</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">But what about the states?</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">For example, in
<b><span style="color:#EE0000">Texas</span></b>, I find no mention of the state regs where they<b>
</b>compel a shielding survey for diagnostic X-ray/fluoroscopy rooms. It’s not in TAC 289.227, nor any of the adopted rules I could find.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">But if the state doesn’t ask for it, can they expect a post-installation shielding confirmation—especially for high-dose fluoro rooms—even if that
expectation isn't explicitly stated in 227?</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">I find it hard to accept that the state wouldn’t have any specific language on this issue.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt">Nima</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p align="right" style="margin-bottom:0in;text-align:right"><b><span style="font-size:17.0pt;font-family:"Helvetica",sans-serif;color:#004C97;letter-spacing:-2.25pt">UT</span></b><b><span style="font-size:17.0pt;font-family:"Helvetica",sans-serif;color:#004C97">
Southwestern</span></b> <o:p></o:p></p>
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<p align="right" style="margin:0in;text-align:right"><span style="font-size:13.0pt;font-family:"Helvetica",sans-serif;color:#636466">Medical Center</span><o:p></o:p></p>
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<p align="right" style="margin-top:3.75pt;text-align:right"><span style="font-size:10.0pt;font-family:"Helvetica",sans-serif;color:#636466">The future of medicine, today.</span><o:p></o:p></p>
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<p class="MsoNormal"><br clear="all">
<o:p></o:p></p>
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<span class="gmailsignatureprefix">-- </span><o:p></o:p></p>
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<p class="MsoNormal">Mike Nimmo<o:p></o:p></p>
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