In a medical sector experiencing perpetual innovation, 2024 was marked by an unprecedented acceleration in the development of innovative medical techniques using ionising radiation. Innovations in all medical fields This acceleration is particularly noteworthy in the field of Internal Targeted Radiotherapy (ITR) where, following the generalised use of therapies employing lutetium-177, there are an increasing number of clinical trials with new radio- nuclides of interest such as actinium-225 or lead-212. In the radiotherapy field, pre-clinical research is being developed on the flash effect, which consists in delivering a very high dose rate in a very short period of time, which could significantly reduce the time needed for certain treatments. In the field of fluoroscopy-guided interventional practices, the multiplication in the number of indications and the increasing complexity of the procedures reflect the variety of practices and the conditions in which they are performed. Innovation sometimes lies in the design of the technical dispensation platform, as is the case with the ZAP-X® self-shielded external radiotherapy system, which would make it possible to provide treatment with less constraints concerning the layout and outfitting of the premises. These innovations offer new hope for the patients, and there is significant pressure to rapidly incorporate them into the health care system. Their rapid development, unlike the lengthy time-frames inherent in the nuclear industry, nonetheless constitutes a radiation protection challenge. Measuring the radiation protection challenges and even more so identifying and then implementing the means needed to manage them, are based on developing professional knowledge and skills, on acquiring and sharing data, some of which will only be available in the medium term, on providing appropriate infrastructures and on mobilising a large network of stakeholders and players. The particular case of internal targeted radiotherapy In the field of ITR, the medical procedure entails particular radiation protection issues for the patients and their carers and comforters, the workers and the environment. These issues are sometimes incompletely evaluated, notably when new radionuclides or new vectors are being used. It is essential that knowledge of dosimetry and metrology be developed for the alpha and beta emitters used in ITR, and the data in the possession of the promoters, or collected by research teams during clinical trials, must be better shared with all the stakeholders. Finally, the health care system must become organised so that the additional data needed are collected, notably those concerning medium and long-term patient monitoring, radiological surveillance of the health care personnel, and the experience feedback Radiation protection faced with the challenges of innovative medical techniques 01 I 02 I 03 I 04 NOTABLE EVENTS 2024 18 ABSTRACTS – ASN Report on the state of nuclear safety and radiation protection in France in 2024
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