Radiation dose measurements for staff members involved in holmium-166 preclinical trial

Primary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of surgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recently introduced tyrosine kinase inhibitors, e.g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56:918-928, 1985); Schafer and Sorrell (Lancet 353:1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78:901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis®, IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres®, Sirtex Medical, Lane Cove, Australia) or embedded in a glass matrix (TheraSphere®, MDS Nordion, Kanata, ON, Canada). Since (90)Y-microspheres are not metabolized, they are not registered as unsealed sources. However, the microspheres are delivered in aqueous solution: radioactive contamination is a concern and microspheres should be handled, like other radiopharmaceuticals, as open sources. The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients undergoing such treatment.

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“…Another group evaluated equivalent doses H p (10) and finger doses from 166 Ho exposure [111]. Reported wholebody doses were less than 3 μSv/GBq.…”

Section: Staff Exposurementioning

confidence: 99%

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

Giammarile

Bodei

Chiesa

et al. 2011

Eur J Nucl Med Mol Imaging

209

162

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“…Another group evaluated equivalent doses H p (10) and finger doses from 166 Ho exposure [ 111 ]. Reported whole-body doses were less than 3 μSv/GBq.…”

Section: Staff Exposurementioning

confidence: 99%

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

Weber

Lam

Chiesa

et al. 2022

Eur J Nucl Med Mol Imaging

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Primary liver tumours (i.e. hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC)) are among the most frequent cancers worldwide. However, only 10–20% of patients are amenable to curative treatment, such as resection or transplant. Liver metastases are most frequently caused by colorectal cancer, which accounts for the second most cancer-related deaths in Europe. In both primary and secondary tumours, radioembolization has been shown to be a safe and effective treatment option. The vast potential of personalized dosimetry has also been shown, resulting in markedly increased response rates and overall survival. In a rapidly evolving therapeutic landscape, the role of radioembolization will be subject to changes. Therefore, the decision for radioembolization should be taken by a multidisciplinary tumour board in accordance with the current clinical guidelines. The purpose of this procedure guideline is to assist the nuclear medicine physician in treating and managing patients undergoing radioembolization treatment. Preamble The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide among individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. These guidelines are intended to assist practitioners in providing appropriate nuclear medicine care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set out in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine involves not only the science but also the art of dealing with the prevention, diagnosis, alleviation and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognised that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.

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“…Therefore several tests were performed, including reproducibility, dose linearity, dose rate, and angular dependence using a Cs-137 radiation source. Moreover, EPD has been used to monitor the radiation dose rate for workers' radiation protection (Taleb, 2013), (Fardela, 2018). Furthermore, Suliman et al (2020) reported on the application to scrutinize the level received by some staff, doctors, and workers in the field of nuclear medicine.…”

Section: Introductionmentioning

confidence: 99%

Radiation Dose Rate Measurement for Protection Programs in the Work Environment for the Health Workers: An Experimental Study

Fardela¹,

Suparta²,

Ashari³

et al. 2020

PTQ

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Radiation is the energy emitted from electrons in particles or photons (waves) and is classified into nonionized and ionized. Ionizing radiation demonstrates the ability to disintegrate matter along its path and has proven beneficial in medicine. Exposure to this energy tends to instigate adverse effects on human health and heredity (genetics). However, the radiation is not directly measured but requires a nuclear detector to serve as a monitoring device. Radiation workers’ awareness of ionizing radiation levels in the work environment is one of the most important factors in preventing the negative effects of radioactivity. This is possibly identified using various types of detectors. This experiment aimed to provide an overview of radiation dose rate measurement under two conditions. First is the event of contamination in the work environment. The second involves using a detector to solely determine the dose rate from a single source, e.g., gamma radiation. Therefore, the radiation dose rate was evaluated by maximizing the use of detectors with a GUI as a survey meter for contamination. The highest rate (261.42 μSv / h) was observed at a distance of 5 mm, while the least (69.21 μSv / h) was recorded at 50 mm. Also, a dose rate of 5.4 μSv / h and 1.32 μSv / h was obtained at a 5 mm and 50 mm distance from the radiation source, respectively, following the operation as a gamma survey meter. This result shows strong linearity between both measurements and is estimated to accurately determine the contamination level of radioactive elements, alongside the doses rate of the gamma radiation emitting elements.

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Radiation dose measurements for staff members involved in holmium-166 preclinical trial

Cited by 5 publications

References 9 publications

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

Radiation Dose Rate Measurement for Protection Programs in the Work Environment for the Health Workers: An Experimental Study

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