LES ACTIVITÉS NUCLÉAIRES : RAYONNEMENTS IONISANTS ET RISQUES POUR LA SANTÉ ET L’ENVIRONNEMENT promoters, investigators, healthcare facilities and professional organisations, is essential to allow the development of innovation in a safe environment for the benefit of patients. From the end of 2025, ASNR has adapted its licensing process to make it easier for centres to take part in clinical trials. It will take a position in 2026 on the basis of a GPRP opinion setting out recommendations for improving radiation protection in clinical trials involving radionuclides. In the field of FGIPs, the inspections carried out show that the situation is improving in terms of radiation protection, although there is still a disparity in the results between interventional imaging departments and operating theatres, which continue to perform less well. Progress in bringing premises into compliance remains slow, despite satisfactory performance in technical inspections, the appointment of Radiation Protection Advisors (RPAs), and quality controls of medical devices. Training in radiation protection and the coordination of preventive measures in situations involving co-activity remain inadequate, particularly among self-employed practitioners, who are often less aware of the regulatory obligations that apply to them as employers. The increasing use of external organisations to provide RPA or medical physics services, also observed in 2025, may weaken the radiation protection culture where such services are not adequately managed, leading to a dilution of responsibilities and a loss of in-house radiation protection expertise. Although progress is being made in formalising POPMs, there are still shortcomings in dose optimisation, especially in operating theatres, with protocols that are sometimes absent or unsuitable and inadequate dose analyses. The culture of reporting adverse events is improving thanks to the introduction of event recording systems. However, the ESRs notified in 2025 involving patient cohorts highlight the need to strengthen radiation protection culture through systematic monitoring and analysis of individual and cumulative dosimetric indicators, and the need to establish structured post-exposure follow-up arrangements for patients based on the dose levels observed. As far as healthcare professionals are concerned, the fact that dose limits were exceeded – in one case on the hands, and in the other case at the lens of the eye – once again highlights the challenges of radiation protection in this area and the need to regularly update individual dosimetry assessments and optimise practices. The inspection campaign of dental practices equipped with Cone Beam Computed Tomography (CBCT), coupled with the results of the analysis of the self-assessment grids, highlighted shortcomings in the traceability of actions (writing of reports with dosimetry information, formalisation of procedures by type of action), dose optimisation (knowledge of optimisation parameters such as Field of Exploration (FOV) size and voxel size, analysis and transmission of dosimetry records), as well as the performance of initial verifications on equipment before first use. In 2025, ASNR will continue with its inspections in the priority sectors, that is radiotherapy, radio-surgery, nuclear medicine, FGIP and computed tomography. In radiotherapy, these inspections are part of the new four-year inspection programme that was distributed to all stakeholders in 2025. As in 2025, specific inspections of the accelerator calibration process will be carried out. In nuclear medicine, particular attention will be paid to radiation protection issues, especially for departments conducting clinical trials. The need to increase the capacity of services for diagnosis (PET) and for ITR, which has consequences for the development of services, will also be the subject of particular attention in the coming years. For FGIPs, OEF from ESRs will be taken into account, and the procedures for informing exposed persons before medical imaging procedures are carried out, for drawing up procedure reports and for defining the criteria and conditions for monitoring exposed persons, will be examined in particular (article 8 of ASN resolution 2023-DC-0660). In addition, ASNR will continue with its targeted inspections on private practitioners employing personnel. Drawing on the lessons learned from the ESRs notified in 2025, ASNR will roll out a specific conventional radiology inspection campaign for centres that carry out paediatric examinations. A self-assessment grid will be made available to nuclear activity managers so that they can assess their regulatory compliance and the implementation of their optimisation approach. ASNR will also be working with professional organisations to develop a communication scale for events notified in imaging and nuclear medicine, along the lines of the existing ASN-SFRO scale for radiotherapy. These events also highlight the need to update the national imaging dose control plan. In regulatory terms, ASNR will in 2026 review ASN resolution 2019-DC-0667 of 18 April 2019 setting DRL values to update the values applicable to mammography procedures and CBCT. The lessons learned from ESRs involving paediatric patient cohorts, which highlighted the need for improved dosimetric assessment, will be taken into account. In addition, ASNR will continue its work on revising ASN resolution 2008-DC-0095 of 29 January 2008 laying down the technical rules governing the disposal of effluents and waste contaminated by radionuclides. Stakeholders and the public will be consulted in 2026 about a guidance and justification document. Finally, innovation, with the growing use of artificial intelligence across all medical applications and the deployment of new techniques and practices, particularly in therapy (radiotherapy and ITR), will be the focus of dedicated work. In 2026, ASNR will organise a seminar on artificial intelligence in medical applications involving ionising radiation. In conjunction with the various institutional stakeholders in the healthcare field and professional organisations, and drawing on its expert groups and in-house research and expertise, it will define the organisational procedures for monitoring new techniques and practices, so that innovation can be deployed within a safe framework for the benefit of patients. In addition, ASNR will examine the follow-up to the Canpri opinion issued in December 2025 on FLASH therapy and the opinion of the Advisory Committee of Experts on Radiation Protection on the deployment of clinical trials involving new RadioPharmaceutical Drugs (RPDs). Finally, ASNR will be involved as a competent authority in the AURORad joint action supported by the European Commission to support the safe use of medical applications using ionising radiation. It will coordinate all the work of the French entities involved in this project. 228 ASNR Report on the state of nuclear safety and radiation protection in France in 2025
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