September 15, 2014

Dr. Kathleen E. Rueter, DDS, MS, LLC

499 SW Upper Terrace Dr. #B,
Bend, OR 97702
Tel: 541-610-4791
Fax: 541-388-7924
Email: krueter@gmail.com

RE: DIAGNOSTIC X-RAY ROOM SHIELDING DESIGN REPORT

Dear Dr. Rueter,

Enclosed please find the shielding design report for the Carestream CS 9000 cone beam CT x-ray
installation for the new room location. Please review the report carefully for any inaccuracies and
notify us for any revisions.

You should check Oregon Administrative Rules, Chapter 333, for any additional regulations you
need to meet. You can access the state regulations via the following website address:
http://www.oregon.gov/DHS/ph/rps/xray.shtml

Please check with State of Oregons website for registration forms and applications.

Retain a copy of the report to document the calculated shielding required to meet dose limits
prescribed in Oregon Administrative Rules, 333-120-0100 and 333-120-0180.

Oregon Administrative Rules, 333-120-0020 requires you to develop, document and implement a
radiation protection program. If you would like assistance developing a site-specific Radiation
Protection Program, please contact our office for a quote, or for any other questions or services
we can help you with.


Sincerely,


William DeForest, MS, DABR, CHP
Health Physicist
ProPhysics Innovations, Inc





September 15, 2014



J udith Smith, Administrative Specialist
Radiation Protection Services
800 NE Oregon St. Suite 640
Portland, OR 97232


Dear Ms. Smith,


Enclosed please find a copy of the Diagnostic X-ray Room Shielding Design Report for:

Facility Name: Dr. Kathleen E. Rueter, DDS, MS, LLC
Facility Address: 19797 Village Office Ct. Bend, OR 97702
Contact: Dr. Kathleen E. Rueter
Mailing Address: 499 SW Upper Terrace Dr. #B, Bend, OR 97702
Contact Tel: 541-610-4791
Contact Fax: 541-388-7924
Contact Email: krueter@gmail.com
Facility Type: Dental
Machine Type: Cone Beam CT
Facility Workload: 5 CBCT scans/week; less than 1 pan/scan/week


Should you have any questions regarding this shielding plan, please contact me at (800) 835-3615.

Thank you for your attention to this matter.

Sincerely,


William DeForest, MS, DABR, CHP
Health Physicist
ProPhysics Innovations, Inc











PLAN REVIEW SHIELDING REPORT

Dr. Kathleen E. Rueter, DDS, MS, LLC
19797 Village Office Ct. Bend, OR 97702
Carestream CS 9000 cone beam
September 15, 2014

Floor Plan Shielding Recommendations
Floor Plan
Section
Protecting Type Recommended Shielding
AB Operator SC 1.25 gypsum (See Note 1)
BC Restroom SU 1.25 gypsum (See Note 1)
CD Mech/Med Gas SU 1.25 gypsum (See Note 1)
DE Exterior SU 5/8 gypsum (See Note 1)
EF Exterior SU 5/8 gypsum (See Note 1)
FG Entrance SU 1.25 gypsum (See Note 1)
GA Operator SC Control access (See Note 2)
Ceiling Adjacent Tenant SU Any structural material (See Note 1)
Floor Crawl Space SU Any structural material (See Note 1)
P =primary; S =secondary; C =controlled; U =uncontrolled

-----------------------------------------------------------------------------------------------------------------

Carestream CS 9000 Imaging Mode Calculation Constants & Variables
Imaging Mode Nweek
(scans)
kVp K
1
mode
(mR)
CBCT scan 5 80 0.18
Pan scan <1 80 0.11

--------------------------------------------------------------------------------------------------------------

Additional Variables & Calculated Transmission
Floor Plan
Section
Pweek
(mR)
Dbarrier
(ft)
T Ktotal/barrier/all modes
(mR/week)
Transmission
B(x)barrier
AB 10 6 1 0.30 33.13
BC 2 5.4 0.2 0.07 26.84
CD 2 8.7 0.05 0.01 278.63
DE 2 5.2 0.025 0.01 199.08
EF 2 3.7 0.025 0.02 100.79
FG 2 3.5 0.2 0.18 11.27
GA 10 3.3 1 1.00 10.02
Ceiling 2 8.5 1 0.15 13.30
Floor 2 4 0.05 0.03 58.90


Dr. Kathleen E. Rueter, DDS, MS, LLC
19797 Village Office Ct. Bend, OR 97702
Carestream CS 9000 cone beam
September 15, 2014

Definition of Terms

Nweek - number of scans for the imaging mode per week

K
1
mode unshielded air kerma measured at 1 meter from source per imaging mode scan

Pweek exposure limit per week

Dbarrier distance to the barrier of interest plus 1 foot

T occupancy factor

Ktot//barrier/all modes total weekly unshielded air kerma for all imaging modes at the barrier of interest

B(x)barrier radiation transmission through a given barrier material (x)

--------------------------------------------------------------------------------------------------------------------------------

Table Notes and Additional Information

Any recommended gypsum shielding is the total thickness of gypsum suggested for the floor plan
section to reduce the radiation dose below regulatory limits. Example: 1.25 of gypsum
recommendation is met if there is 5/8 gypsum on each side of the wall. If the recommended gypsum
thickness exceeds the existing thickness of gypsum in the wall, the additional gypsum required can be
installed on either side of the wall i.e. whichever side is preferable.

Areas beyond the floor plan sections immediately adjacent to the imaging area have been considered
when determining shielding recommendation.

Note 1 - The calculated dose at this section of the floor plan and areas beyond this section is less than
the regulatory occupational or public dose limits. Any planned or existing construction is adequate.

Note 2 - Although the calculated dose at GA is less than the regulatory occupational or public dose
limits and no shielding material is recommended, access to the imaging area from these points should
be controlled during exposures to keep dose levels As Low As is Reasonably Achievable(ALARA). As
a written radiation protection program is required by state regulation, the details of controlling
access should be outlined in the facilitys program for future reference, safety training and
records inspection. The state agency may impose additional requirements, at any time, as it
deems appropriate or necessary to minimize danger to public health, safety or property.

Stationary X-ray systems shall be required to have the X-ray exposure control permanently mounted in
a protected area so that the operator is required to remain in that protected area during the entire
exposure. {Oregon Administrative Rules, Chapter 333, Division 106-0305(2)(b)(A)} The protected
area is defined in OAR 333-106-0005(77)(a)(b), to include a minimum safe distance from the source.
The control switch is located 6 ft from the scatter source and the calculated dose at the control switch
position is ~0.30 mrem per week to the public and to the operator. At the stated workload the dose is
well below the regulatory limit.

(continued)
Dr. Kathleen E. Rueter, DDS, MS, LLC
19797 Village Office Ct. Bend, OR 97702
Carestream CS 9000 cone beam
September 15, 2014


Wall shielding/construction should extend from the finished floor to a height of at least 84 inches.

All shielded barriers, including view windows and frames, doors and door frames, should be of the
specified shielding equivalencies or greater and should have no voids.

Any penetrations in the shielding should be designed to afford the same shielding equivalency as
specified for that barrier.

Penetrations in the shielding (electrical boxes, cables, fasteners, etc.) should be secured in place with
mechanical fasteners or by welding. Metal screws do not require lead caps and the use of tapes,
adhesives or plastic materials as a fastener is not recommended.

ProPhysics Innovations, Inc. is not responsible for errors in shielding requirements based on inaccurate
information provided by the plan review requestor.

IMPORTANT - This plan review is specific for the information provided by the requestor. Any
changes in equipment, room layout, occupancy of adjacent areas, changes in x-ray workload, upgrades
to additional imaging modalities, changes in field size of imaging receptors, or any other condition that
may contribute to an increased risk of radiation exposure will require re-evaluation of the shielding by a
qualified physicist. If there are any doubts about what may constitute a change, please contact
ProPhysics Innovations.

These shielding specifications have been prepared in accordance with guidelines set forth in National
Council on Radiation Protection and Measurements Report(s) No. 145 & No. 147, and Oregon
Administrative Code.

The state agency may impose additional requirements, as it deems appropriate or necessary to minimize
danger to public health, safety or property.


Shielding Calculations Performed by:



William DeForest, MS, DABR, CHP
Health Physicist
ProPhysics Innovations, Inc








Dr. Kathleen E. Rueter, DDS, MS, LLC
19797 Village Office Ct. Bend, OR 97702
Carestream CS 9000 cone beam
September 15, 2014