Thallium-201 for Cardiac Stress Tests: Residual Radioactivity Worries Patients and Security

Geraci, Matthew J.; Brown, Norman; Murray, David C.

doi:10.1016/j.jemermed.2011.05.093

Cited by 4 publications

(3 citation statements)

References 9 publications

(9 reference statements)

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“…Multiple publications have reported that patients who were administered a radioisotope were subsequently detected and detained for triggering radiation alarms in various government and other public and private locations (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). As a result, many of the authors suggested that patients not only should be educated about the potential for being stopped at security checkpoints but also should receive documentation helping to verify the administration of a diagnostic or therapeutic quantity of a radioisotope.…”

Section: Discussionmentioning

confidence: 99%

“…Radi oactive iodine ( 131 I) is important in diagnosis and therapy for many patients with differentiated thyroid cancer. Multiple articles have reported on the detection at airports, border crossings, and other public facilities of patients who have been administered diagnostic and therapeutic activities of radioactive agents (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Of note, the security personnel are trying to prevent the criminal use of radiologic devices and are not trying to monitor or restrict the movement of patients emitting radiation from nuclear medicine procedures, but the detection of those patients is a well-documented phenomenon.…”

mentioning

confidence: 99%

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Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Bikas

Bethancourt

et al. 2018

J Nucl Med

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Patients treated with 131 I may be identified at security checkpoints at various public facilities. The objective of this survey was to determine the frequency of detection, the spectrum of public facilities, the various methods of management of the situation by security agents, and the spectrum of physician documentation for patients regarding their 131 I therapy. Methods: Data were tabulated from a Thyroid Cancer Survivors' Association, Inc., survey emailed to approximately 15,000 associates and available online from December 2013 to December 2014. Responses were tabulated from respondents who reported that they were 18 y old or older, had received at least 1 131 I treatment for differentiated thyroid cancer, and were responding regarding their last 131 I treatment. Results: Of 621 respondents, 595 reported an attempt to pass through a public facility security checkpoint. Of these 595 patients, approximately 10% (57) were identified as being radioactive. The facility reported by 43 respondents was an airport for 35% (15), border crossing for 33% (14), government building for 19% (8), shopping mall for 7% (3), train station for 5% (2), and steel recycling plant for 2% (1). The security agent's management of the situation reported by 47 respondents included questioning for 81% (38), allowing them to proceed without a change in travel plans for 57% (27), requesting documentation of the therapy for 55% (26), rescanning for 55% (26), calling a member of the treating team for validation for 17% (8), "strip" searching for 4% (2), detaining such that a change in travel plans was required for 6% (3), and prohibiting continued travel for 4% (2). The period of detainment reported by these 47 respondents was less than 30 min for 57% (27), 30 to less than 60 min for 21% (10), 1 to less than 1.5 h for 15% (7), 1.5 to less than 2 h for 2% (1), 2-4 h for 0% (0), and greater than 4 h for 4% (2). Data regarding physician documentation are presented. Conclusion: The detection of radioactivity at a variety of security checkpoints at public facilities after 131 I therapy occurred in approximately 10% of respondents. Travel inconvenience is not infrequent and may require alteration of travel plans. Physicians should take steps to ensure that patients not only have appropriate documentation of their 131 I therapy with them but also have instructions regarding how security agents may verify their 131 I therapy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Bikas

Bethancourt

et al. 2018

J Nucl Med

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“…Due to the relatively longer physical half-life of Thallium-201 (3.05 days), patients being injected with this tracer have been shown to still have residual biological activity even after 5 half-lives (15.2 days) [13], resulting in an increase to the overall radiation dose received by the patient. Studies have detected the presence of Tl-201 in the urine of patients 25 days post-administration of the tracer and residual Tl-201 activity was noted after 61 days post-administration in one case [14].…”

Section: Cardiac Tracers Usedmentioning

confidence: 99%

Current Techniques and Practices for Myocardial Stress Testing—A Comparative Survey between Malta and International Nuclear Medicine Centres

Grima¹,

O'Leary²,

Bezzina³

et al. 2014

OJCD

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Objectives: The study compared cardiac scintigraphy stress scanning practices applied in a National Maltese Nuclear Medicine centre and in international centres. This was achieved through the design of an online survey which investigated participant knowledge of stress testing, and current procedural practice. Methods: An online survey comprising 12 questions was prepared using Survey Monkey. Professional Nuclear Medicine groups such as the Medical-Physics-Engineering community and Virtual Radiopharmacy were targeted. Access to the survey remained open for eight months during which a periodic reminder was sent to optimise the response rate. Forty-three members responded from across Europe and Australasia. Chi-square tests and comparisons between multiple responses using IBM SPSS 20 were used to evaluate the results. Information related to Maltese practice was collated separately for review and comparative purposes. Results: The online survey participants comprised United Kingdom [72%], other European countries [18%] and Australasia [9%]. The majority of respondents [n = 39] reported pharmacological stress testing as being performed either alone or in conjunction with exercise stress testing as the preferred option. Most participants [60%]were aware of local stress test protocols but had limited knowledge in relation to guidelines designed for cases where patients were not suitable for pharmacological stress testing. Conclusion: The survey provided information about procedures within participating centres for scintigraphic cardiac stress scanning. Differences were identified with regards to the preferred radiopharmaceutical tracers and procedural protocols. Further investigation of examination techniques is warranted, with the aim of increasing standardisation of protocol compliance and the application of more suitable practice. K. Borg Grima et al. 218

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Application of Radiopharmaceuticals in Diagnostics and Therapy

Sarkar

Khatana

Mukherjee

et al. 2022

Next-Generation Nanobiosensor Devices for Point-of-Care Diagnostics

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Thallium-201 for Cardiac Stress Tests: Residual Radioactivity Worries Patients and Security

Cited by 4 publications

References 9 publications

Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Current Techniques and Practices for Myocardial Stress Testing—A Comparative Survey between Malta and International Nuclear Medicine Centres

Application of Radiopharmaceuticals in Diagnostics and Therapy

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Thallium-201 for Cardiac Stress Tests: Residual Radioactivity Worries Patients and Security

Cited by 4 publications

References 9 publications

Detection at Public Facilities of 131I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Detection at Public Facilities of 131I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Current Techniques and Practices for Myocardial Stress Testing—A Comparative Survey between Malta and International Nuclear Medicine Centres

Application of Radiopharmaceuticals in Diagnostics and Therapy

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Product

Resources

About

Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients

Detection at Public Facilities of ¹³¹I in Patients Treated for Differentiated Thyroid Cancer: Frequency, Sites, Management by Security Agents, and Physician Documentation Recommended for Patients