Occupational Exposure: With Special Reference to Skin Doses in Hands and Fingers

Carnicer, A.; Ginjaume, M.; Sans-Mercé, M.; Donadille, L.; Barth, I.; Vanhavere, F.

doi:10.1007/978-3-642-31167-3_7

Cited by 5 publications

(25 citation statements)

References 29 publications

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“…-radiosynovectomy (RSO), used for more than 40 years to alleviate the pain of chronic arthritis using colloids labelled with 186 Re, 169 Er or 90 Y; -radioimmunotherapy (RIT), using 90 Y-labelled monoclonal antibodies for the treatment of non-Hodgkin-lymphoma (58)(59)(60)(61)(62). Recently, the treatment of neuroendocrine tumours with radioactive peptides (PRRT) has been increasingly applied.…”

Section: Exposure In Nuclear Medicine Therapy 341 Radionuclides In Usementioning

confidence: 99%

“…Recently, the treatment of neuroendocrine tumours with radioactive peptides (PRRT) has been increasingly applied. The most common radiopharmaceuticals for PRRT are somatostatin analogues labelled with 90 Y and especially 177 Lu (16,61,63). With 47,500 treatments in the USA in 2018, 177 Lu-PSMA is increasingly being used for the treatment of patients with PSMA-positive metastatic castration-resistant prostate cancer (64).…”

Section: Exposure In Nuclear Medicine Therapy 341 Radionuclides In Usementioning

confidence: 99%

“…Based on a measurement campaign in 20 nuclear medicine (NM) departments, the ORAMED study concluded that nearly one out of five workers in NM could receive an equivalent skin dose that exceeds the annual dose limit of 500 mSv averaged over any area of 1 cm 2 (2). The scope of the ORAMED project was however limited to diagnostic applications with 99m Tc and 18 F and the use of 90 Y for peptide receptor radiotherapy (PRRT) and radioimmunotherapy (RIT).…”

Section: Introductionmentioning

confidence: 99%

“…Since Vanhavere et al performed a review on the exposure of the extremities in medical workplaces in the context of the CONRAD project (1), several authors have addressed exposure of the extremities in specific areas of NM (4)(5)(6) or addressed the requirements for monitoring in healthcare (7). There is, however, no recent review generally covering extremity exposure in NM.…”

Section: Introductionmentioning

confidence: 99%

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Review of extremity dosimetry in nuclear medicine

Kollaard¹,

Zorz²,

Dabin³

et al. 2021

J. Radiol. Prot.

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The exposure of the fingers is one of the major radiation protection concerns in nuclear medicine (NM). The purpose of this paper is to provide an overview of the exposure, dosimetry and protection of the extremities in NM. A wide range of reported finger doses were found in the literature. Historically, the highest finger doses are found at the fingertip in the preparation and dispensing of 18F for diagnostic procedures and 90Y for therapeutic procedures. Doses can be significantly reduced by following recommendations on source shielding, increasing distance and training. Additionally, important trends contributing to a lower dose to the fingers are the use of automated procedures (especially for positron emission tomography (PET)) and the use of prefilled syringes. On the other hand, the workload of PET procedures has substantially increased during the last ten years. In many cases, the accuracy of dose assessment is limited by the location of the dosimeter at the base of the finger and the maximum dose at the fingertip is underestimated (typical dose ratios between 1.4 and 7). It should also be noted that not all dosimeters are sensitive to low-energy beta particles and there is a risk for underestimation of the finger dose when the detector or its filter is too thick. While substantial information has been published on the most common procedures (using 99mTc, 18F and 90Y), less information is available for more recent applications, such as the use of 68Ga for PET imaging. Also, there is a need for continuous awareness with respect to contamination of the fingers, as this factor can contribute substantially to the finger dose.

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Section: Exposure In Nuclear Medicine Therapy 341 Radionuclides In Usementioning

confidence: 99%

Section: Exposure In Nuclear Medicine Therapy 341 Radionuclides In Usementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Review of extremity dosimetry in nuclear medicine

Kollaard¹,

Zorz²,

Dabin³

et al. 2021

J. Radiol. Prot.

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“…Also, other authors have reported cases of workers performing PET scanning procedures in whom the annual dose limit may exceed the limit of 500 mSv/year [13,[16][17][18][19].…”

mentioning

confidence: 99%

Effective and equivalent dose minimization for personnel in PET procedures: how far are we from the goal?

Lecchi

Malaspina

Sole

2016

Eur J Nucl Med Mol Imaging

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Radiation dose limitation in patients undergoing nuclear medicine procedures is accomplished through adherence to the principles of justification and optimization, while radiation doses to operators are controlled mainly by reducing exposure times, using shielding, and increasing the distance from the source. In both cases, however, a key role in dose management can also be played by innovative technologies, making this an important issue not only for nuclear medicine specialists, medical physicists, and technologists, but also for biomedical engineers and for industry [1][2][3]. 1Whereas the quest to achieve effective dose optimization for patients, in accordance with the ALARA principle, is currently the focus of intensive research and technological development activity, the need to develop and implement new devices to reduce operator exposure to ionizing radiation seems to be a secondary concern. Twenty years ago, for the concerns raised by the radiation energy of the highly penetrating 511 keV annihilation photons, the first study of personnel dosimetry in positron emission tomography (PET) found that the effective radiation doses to technologists in PET centres (mostly carrying out 18 F-FDG studies) were within recommended occupational radiation protection guidelines [4], and since then, comparatively little attention has been paid to the problem of operator exposure.However, in view of the now constantly increasing number of PET procedures being carried out in centres around the world, the use of positron emitters is becoming a real and a growing occupational concern. In this regard, it needs to be appreciated, in particular by those working in nuclear medicine on a day to day basis, that PET requires different radiation protection strategies from those usually adopted in general nuclear medicine, for reducing both the effective and equivalent dose to the extremities below the acceptable levels.Despite the use of routine precautionary measures, including the use of dedicated hot-cells, occupational doses in PET are higher than they need to be in order to obtain good quality examinations. The physical properties of positron emitting radiopharmaceuticals and the optimization of patient doses are both factors that, in addition to the greater number of PET studies now performed, can result in unnecessarily high occupational doses if adequate radiation protection operational procedures for working with positron emitting radionuclides are not envisaged, explained and rigorously adopted across all PET units, in accordance with local conditions.There are in fact three sources of exposure that contribute to the total personnel exposure for a given PET study, keeping in mind that their burden can be shared among different operators: indeed, exposure occurs during i) the patient undergoing the procedure, ii) the vial during the dispensing of the radiopharmaceutical, and iii) the syringe during the injection of the radiopharmaceutical. 1 The decay of positron emitters produces four times the amount of energy in photon...

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