Radiation Safety Guide for Nuclear Medicine Professionals

Description

The book covers all the radiation safety aspects while working with unsealed radionuclides. Radiation safety plays a significant role in routine nuclear medicine practices and is necessary to protect occupational workers, patients, members of the general public and the environment. A fair knowledge of radiation safety is expected from all nuclear medicine professionals. Chapters include basics of radiation physics, biological bases of radiation protection, planning and design of nuclear medicine facilities, cyclotron and high dose therapy facilities, radiation safety considerations in nuclear medicine, cyclotron while preparing radiopharmaceuticals. It also includes the working mechanism of radiation detectors, quality assurance of positron emission tomography (PET) and gamma camera, including single photon emission computed tomography (SPECT), emergency preparedness plan, nuclear medicine and CT dosimetry, transport regulations, the role of national regulatory authorities and radioactive waste management. The last chapter provides probable model questions asked in the radiological safety officer certification examination and includes 250 multiple-choice questions (MCQs), 100 true or false, 60 fill in the blanks, and 40 match the following questions. The book is written in a simple language for a better understanding of the occupational workers of any grade. It serves as reference material for nuclear medicine professionals on radiation safety, related to planning, quality assurance, dosimetry and various regulations pertaining to nuclear medicine. It is a ready reckoner for the students pursuing a degree/diploma in nuclear medicine and preparing for certification courses in radiation safety to understand the subject matter along with options to attempt practice questions. Preface Acknowledgements Contents 1: Basics of Radiation Physics 1.1 Introduction 1.2 Chronological Events of Radiation Interaction 1.2.1 Physical Interaction of Radiation 1.2.2 Chemical Steps of Interactions 1.2.3 Biological Interactions 1.3 Atomic Structure 1.3.1 The Electrons 1.3.2 The Nucleus 1.4 Properties of Radioactive Materials and Radiation Sources 1.4.1 Stability of a Radionuclide 1.4.2 Binding Energy 1.4.3 Radioactive Decay Scheme 1.5 Radioactive Decay and Decay Series 1.5.1 Basic Concepts of Radioactivity 1.5.2 Positron Emission 1.5.3 Electron Capture 1.5.4 Alpha Emission 1.6 Concept of Half-Life 1.7 Specific Activity 1.8 Average (Mean) Life 1.9 Successive Radioactive Transformation: Radioactive Decay Chains 1.10 Artificial Sources of Radiation 1.10.1 X-Rays References 2: Radiation Quantities and Units 2.1 Activity, ‘A’ 2.2 Kerma, ‘K’ (Kinetic Energy Released per Unit Mass) 2.3 Exposure, ‘X’ 2.4 Dose, ‘D’ 2.5 Equivalent Dose, ‘HT’ 2.6 Effective Dose, ‘E’ 2.7 Collective Effective Doses, ‘S’ 2.8 Annual Limit on Intake (ALI) 2.9 Derived Air Concentration (DAC) Reference 3: Interaction of Ionizing Radiation with Matter 3.1 Section 1: Interaction of Radiation with Matter 3.1.1 Interaction of Charged Particles 3.1.1.1 Radiative Collision 3.1.1.2 Range of Charged Particles in Matter 3.1.2 Electromagnetic Radiations 3.1.2.1 Photoelectric Absorption (Effect) 3.1.2.2 Compton Scattering 3.1.2.3 Pair Production 3.1.3 Attenuation of Gamma Radiation in Matter 3.1.4 Interaction of Neutrons 3.1.5 Nuclear Cross-Section (σ) 3.2 Section 2: Production of Radionuclides Used in Nuclear Medicine 3.2.1 Reactor Based 3.2.1.1 Nuclear Reaction (n,γ) 3.2.1.2 Standard β Emitters for Internal Radiotherapy 32P (T½ = 14.3 days) 89Sr (T½ = 50.5 days) 90Y (T½ = 2.7 days) 131I (T½ = 8.02 days) 153Sm (T½ = 1.93 days) 177Lu (T½ = 6.65 days) 188Re (T½ = 17.0 h) 3.2.1.3 Standard α Particle Emitters for Targeted Therapy 211At (T½ = 7.2 h). 213Bi (T½ = 45.6 min) 223Ra (T½ = 11.4 days) 225Ac (T½ = 10.0 days) 3.2.2 Cyclotron Based 3.2.3 Generator Based 3.2.3.1 Generator for 99Mo/99mTc Type of Wet Column Dry Column Type 3.2.4 Generator-Produced Standard Positron Emitters 3.2.4.1 68Ge/68Ga Generator System 3.2.4.2 82Sr/82Rb Generator System References 4: Radiation Protection Standards in Relation to ICRP Recommendations 4.1 Introduction 4.2 Radiation Effects 4.2.1 Deterministic Effects 4.2.2 Prenatal Effects 4.2.3 Stochastic Effects 4.2.3.1 Radiation Carcinogenesis 4.2.3.2 Genetic Effects 4.3 Weighing Factors Used in Radiation Protection 4.3.1 Radiation Weighting Factor 4.3.2 Tissue Weighting Factor 4.4 Risk Projection Models 4.4.1 Nominal Fatality Probability Coefficients 4.4.2 Dose and Dose Rate Effectiveness Factor 4.5 Detriments 4.6 Dose Limits 4.7 Principle of Implementation of Radiation Protection 4.8 Summary References 5: Radiation Hazard Evaluation and Control in Nuclear Medicine 5.1 Introduction 5.2 External Radiation Hazard 5.2.1 The Term ‘Exposure’ 5.2.2 Exposure Rate 5.2.3 Exposure Rate Constant 5.3 Control of External Radiation Hazards 5.3.1 Strength of the Source 5.3.2 Shielding 5.3.2.1 Half-Value Thickness (HVT) and Tenth-Value Thickness (TVT) 5.3.2.2 Relationship Between HVL and TVL 5.3.2.3 The Buildup Factor 5.3.3 Distance 5.3.4 Time 5.4 Internal Radiation Hazard 5.4.1 Effective Half-Life 5.4.2 ALI and DAC 5.4.3 Surface Contamination References 6: Occupational and Public Exposure to Nuclear Medicine 6.1 Introduction 6.2 Type of Exposures 6.2.1 Planned Exposures 6.2.2 Emergency Exposures 6.2.3 Existing Exposure Situations 6.3 Categories of Exposures 6.3.1 Occupational Exposure 6.3.2 Public Exposure 6.3.3 Medical Exposure 6.4 Identification of Exposed Individuals 6.4.1 Workers 6.4.2 Members of the Public 6.4.3 Patients and Comforters 6.5 Death of Patient-Administered with Radiopharmaceutical 6.6 Possibilities of Exposure in Nuclear Medicine 6.7 Elimination of Radionuclides from Internal Routes 6.8 Effective Half-Life 6.8.1 Estimation of Effective Dose 6.8.2 Dose to Extremities and Individual Organs 6.8.3 Occupational Exposure of Women 6.8.4 Apprentices and Students 6.9 Methods to Prevent or Reduce the Dose to Occupational Workers 6.9.1 Storage of Source 6.9.2 Essential Points in Planning Work 6.9.3 Handling of Sources 6.10 Overexposure Investigations and Follow-Up 6.11 Occupational Exposures and Dose Records 6.12 Roll of Personnel Monitoring 6.13 Comparison of Occupational Nuclear Medicine Laboratories Compared to Other Medical Practices References 7: Biological Bases of Radiation Protection 7.1 Introduction 7.2 Radiation Effects at Cellular Level 7.2.1 Mechanism of Damage 7.2.2 Nature of Damage 7.2.3 Effects at Cellular Level 7.2.4 Factors Modifying the Damage 7.3 Relative Biological Effectiveness (RBE) 7.4 Law of Bergonie and Tribondeau 7.5 Deterministic and Stochastic Effects 7.6 Acute Radiation Syndrome 7.6.1 Radiation Sickness 7.6.2 Haematopoietic Tissue Damage 7.6.3 Gastrointestinal Tract Damage 7.6.4 CNS Syndrome 7.7 Damage to Individual Organs 7.7.1 Skin 7.7.1.1 Early Effects 7.7.1.2 Skin Late Effects 7.7.2 Gonads 7.7.2.1 Males 7.7.2.2 Female 7.7.3 Eye Lens 7.7.4 Lungs 7.7.5 Endocrine System 7.7.6 Chronic Radiation Sickness 7.8 Stochastic Effects 7.8.1 Carcinogenesis in Human Beings 7.8.2 Genetic Effects 7.9 Summary References 8: Planning and Design of Nuclear Medicine Imaging Facilities 8.1 Diagnostic Nuclear Medicine Facility 8.1.1 Site Selection 8.1.2 Layout and Area Requirement 8.1.3 Equipment and Accessories 8.1.4 Staff 8.1.5 General 8.2 Shielding Requirement in a Diagnostic Nuclear Medicine Facility 8.3 Shielding Calculation for SPECT-CT and PET-CT Facilities 8.3.1 Shielding Calculation for Uptake Room in the NM Facility (Fig. 8.4) 8.3.2 Shielding Calculation for Imaging Room in the NM Facility 8.3.3 Calculation of the Thickness of the Ceiling above the PET-CT Facility Reference 9: Planning and Design of High-Dose Therapy Facility 9.1 Therapeutic Nuclear Medicine 9.1.1 Site Selection 9.1.2 Layout and Area Requirement 9.1.3 Equipment and Accessories 9.1.4 Staff 9.1.5 General 9.2 Isolation Ward for Hospitalization of Patients 9.3 Shielding Requirement in an Isolation Ward 9.4 Delay-Decay Tank for Storage of Radioactive Waste Reference 10: Planning and Design of Medical Cyclotron Facility 10.1 Selection of Site 10.2 Approval of Layout Plan of Medical Cyclotron 10.3 Staff Requirement in Medical Cyclotron 10.4 Personnel Monitoring of Staff Members 10.5 Supply of Cyclotron-Produced Radionuclides to Users and Transportation 10.6 Radiation Monitoring Devices 10.7 Radiation Safety Devices 10.8 Transport of Individual Dosages 10.9 Typical Model for the Medical Cyclotron 10.10 Shielding Calculation for Medical Cyclotron 10.10.1 Shielding Calculations for Unshielded Medical Cyclotron 10.10.2 Shielding Calculations for Self-Shielded Medical Cyclotron Reference 11: Personnel Monitoring and Radiation Protection Survey in Nuclear Medicine 11.1 Introduction 11.2 Objectives of Personnel Monitoring 11.3 Benefits of Personnel Monitoring 11.4 Devices 11.5 Dose Limits in Planned Exposure Situations for Radiation Workers 11.6 Dose Limits in Emergency Exposure Situations for Radiation Workers 11.7 Dose Limit for Medical Exposures 11.8 Dose Record of Occupational Exposures 11.9 Personal Monitoring During Pregnancy 11.9.1 Radiation-Induced Malformations 11.10 Overexposure Investigation and Follow-Up 11.11 Situations Not Warranting Personnel Monitoring 11.12 Survey of Nuclear Medicine Facility 11.13 Area and Environmental Monitoring 11.14 External Contamination Monitoring 11.14.1 Surface Monitoring 11.14.2 Air Monitoring 11.15 Monitoring and Surveillance Procedures in Nuclear Medicine 11.16 Conclusion References 12: Radiation Safety Considerations in Nuclear Medicine 12.1 99mTc Products 12.2 Cyclotron Products 12.2.1 SPECT Product 12.2.2 PET Products 12.3 Radionuclide Therapy (RNT) 12.3.1 131I-MIBG 12.3.2 Products for Radiation Synovectomy 12.3.3 Product of Radio­immunotherapy (RIT) and Radio-Peptide Therapy (RPT) 12.3.4 Products for Loco-Regional Delivery for RNT 12.3.5 Products for Endovascular Radionuclide Therapy (EVRT) 12.4 Other Products and Techniques 12.5 131I Administration 12.6 Radiation Safety Precaution During Pre- and Post-therapy 12.7 Radiation Protection for the Nursing Staff 12.8 Radiation Protection for the Visitors 12.9 Patient Monitoring and Discharge Criteria for Isolation Ward Patients 12.10 Optimisation of Radiation Dose to Non-target Tissues 12.11 Handling Emergency Situations 12.12 Conclusions 13: Radiation Safety Consideration in Medical Cyclotron 13.1 Radiation Surveillance Programme in Medical Cyclotron Facility 13.2 Pregnant Occupational Worker 13.3 Management of Radioactive Waste 13.4 Radiological Surveillance 13.4.1 Area Monitoring 13.4.2 Personnel Monitoring 13.4.3 Contamination Monitoring 13.5 Log Book Keeping 13.6 Decommissioning Further Reading 14: Radiation Safety Considerations During Radiopharmaceutical Preparation 14.1 Introduction 14.2 The Dose Calibrators 14.2.1 Various Names of Dose Calibrators 14.2.2 Physical Characteristics of Dose Calibrator 14.2.3 Working Mechanism of Dose Calibrators 14.2.4 Choice of Gas in Dose Calibrators 14.2.5 Current Conversion 14.2.5.1 Calibration Factors 14.2.6 Energy-Response Curve 14.2.6.1 Theoretical Dependence on Energy of Photons for Competitive Photoelectric Effect and Compton Scattering 14.2.6.2 Photoelectric Effect Probability Dependence on Energy of a Photon in Argon Gas 14.2.6.3 Compton Scattering Probability 14.2.7 Major Sources of Error in Measurements [4] 14.2.7.1 Calibration Factor 14.2.7.2 Electronics 14.2.7.3 Statistical Variations 14.2.7.4 Ion Recombination 14.2.7.5 Effects of Background 14.2.7.6 Size and Shape of Source Container and Effects of Volume 14.2.7.7 Effects on the Source Position 14.2.7.8 Source Adsorption on the Container Surface 14.2.8 Measuring Pure Beta Emitters 14.2.9 Effects of Contaminants 14.2.10 Dose Calibrators Acceptance and Routine Testing 14.2.10.1 Accuracy and Constancy 14.2.10.2 Linearity 14.2.10.3 Geometry Response 14.2.11 Materials Needed for Quality Control of Dose Calibrators 14.2.12 Test of Accuracy and Constancy 14.2.12.1 Procedure 14.2.13 Measurement of Linearity of Dose Calibration 14.3 Radiopharmaceutical Dispensing to Patients 14.3.1 Dosage Calculation for Heavyweight Patients 14.3.2 Paediatric Dosage Calculations 14.4 Medical Events (Formerly Misadministration) 14.4.1 Medical Event Reporting 14.5 Control of Radiation Hazards in Radiopharmacy 14.5.1 Safety Aspects 14.5.2 Essential Points in Planning Work 14.5.3 Handling of Sources 14.5.4 Storage of Source 14.5.5 Monitoring 14.5.5.1 Wipe Tests and Daily Surveys 14.6 Decontamination of Working Area and Equipment 14.6.1 Personnel Decontamination 14.6.1.1 Internal Contamination 14.6.2 External Contamination 14.6.3 Surface Decontamination 14.7 Radioactive Waste Disposal 14.8 Record-Keeping in Radiopharmacy [4] 14.8.1 Quality Control Records 14.8.2 Records of Radioactive Materials (RAM) Received 14.8.3 Radiopharmaceutical Preparation and Dispensing Records 14.8.4 Radioactive Waste Disposal Records References 15: Working Mechanism of Radiation Detectors Used in Nuclear Medicine 15.1 Introduction 15.2 Interaction of Radiation with Matter 15.3 Definition of Radiation Detector 15.4 Characteristics of Good Radiation Detection System 15.5 Types of Detectors 15.6 Radiation Detection Mechanism 15.6.1 Gas-Filled Detectors 15.6.1.1 Voltage-Response Curve Ionization Chamber Region Proportionality Region Region of Limited Proportionality Geiger-Muller (GM) Region Region of Continuous Discharge 15.6.2 Ionization Chamber Detectors 15.6.2.1 Pocket Dosimeters 15.6.2.2 Digital Pocket Dosimeter 15.6.2.3 Gun Monitor 15.6.2.4 Dose Calibrators 15.6.3 Proportional Counters 15.6.4 Geiger–Müller (GM) Counters 15.6.5 Scintillation Detectors 15.6.6 Computed Tomography (CT) Detectors 15.6.7 Semiconductor Detectors 15.6.7.1 Mechanism of Detection 15.6.7.2 Properties of CZT (Cd1-xZnxTe) Detectors 15.6.8 Thermoluminescent Dosimeters (TLDs) 15.6.8.1 CaSO4:Dy TLDs Mechanism of Detection 15.6.8.2 Disadvantages of CaSO4:Dy TLDs References 16: Quality Control of Planar Gamma Camera and Single-Photon Emission Computed Tomography 16.1 Introduction 16.2 Acceptance and Reference Tests 16.3 Routine Quality Control 16.4 Action Thresholds, Follow-Up, Record Keeping, Review, and Monitoring 16.5 Daily Operating Care and Maintenance for a Scintillation Camera 16.6 Preparatory Steps 16.7 Preventive Maintenance and Calibrations 16.8 Radionuclides for Testing 16.9 Test Equipment and Manuals 16.10 Physical Inspection 16.10.1 Physical Condition 16.10.2 Safety Interlocks 16.10.3 Camera Detector Shielding 16.11 Computer Monitor Inspection: Monitors Used for Image Processing and Image Interpretation 16.12 Acceptance Reference Tests 16.13 Routine Tests 16.14 Periodical Tests 16.15 Gamma Camera Planar Tests 16.15.1 Flood Field Uniformity 16.15.1.1 Gamma Camera Detector Setup and Source Placement Energy Window Width and Peak 16.15.1.2 Test of Intrinsic Flood Field Uniformity Purpose of Test Materials Procedure Analysis Image Analysis Report Performance Specifications 16.15.1.3 Test of System Flood Field Uniformity Purpose of Test Materials Procedure 16.15.1.4 Data Analysis Report Performance Specifications 16.15.1.5 Intrinsic Off-Peak Flood Field Uniformity Frequency Image Acquisition Image Analysis Report Performance Specifications 16.15.2 Spatial Linearity 16.15.3 Spatial Resolution 16.15.4 Intrinsic Tests of Spatial Resolution and Spatial Linearity 16.15.4.1 Frequency 16.15.4.2 Testing Procedure Slit Phantom Measurement Image Acquisition Analysis for Spatial Resolution Analysis for Spatial Linearity 16.15.5 Intrinsic Resolution Using Bar Phantom 16.15.5.1 Quantification of Spatial Resolution 16.15.6 Extrinsic Spatial Resolution Using Bar Phantom 16.15.6.1 Frequency 16.15.6.2 Procedure for Checking Image Acquisition Spatial Resolution Analysis Spatial Linearity Analysis Report 16.15.7 Energy Resolution 16.15.7.1 Procedure for Checking Image Acquisition 16.15.8 Extrinsic Planar Sensitivity 16.15.8.1 Frequency 16.15.8.2 Procedure of Checking Image Acquisition Image Analysis Report Performance Specifications 16.15.9 Performance of Intrinsic Count Rate 16.15.9.1 Two-Source Method Frequency Testing Procedure 16.15.9.2 Two-Source Method Maximum Peak Count Rate Calculation 16.15.9.3 Report 16.15.9.4 Performance Specifications 16.15.10 Pixel Calibration 16.15.10.1 Purpose 16.15.10.2 Frequency 16.15.10.3 Testing Procedure 16.15.10.4 Image Analysis Performance Specifications 16.15.11 Multiple Window Spatial Registration (MWSR) 16.15.11.1 Frequency 16.15.11.2 Testing Procedure Test Source Image Acquisition Image Analysis Report Requirements for Performance 16.15.11.3 Test of Collimator Hole Angulation Purpose Image Acquisition Image Analysis 16.15.12 Test of Collimator Quantitation Hole Angulation 16.16 Quality Control of SPECT System 16.16.1 Flood Uniformity 16.16.2 Centre of Rotation (COR), Multiple-Head Registration and Head Tilt 16.16.2.1 Preparing a Point Source 16.16.2.2 Procedure for Checking Point Source Placement SPECT Acquisition Projection Image Processing and Analysis Report and Frequency 16.16.3 Resolution of Tomographic Image 16.16.3.1 Frequency 16.16.3.2 Procedure for Checking Line Source Placement SPECT Acquisition SPECT Image Reconstruction Planar Image Acquisition Image Processing and Analysis for Spatial Resolution MHR, COR and Head Tilt Error Analysis Report Performance Specifications 16.16.4 Tomographic Uniformity and Contrast 16.16.4.1 Frequency 16.16.4.2 The Procedure of the Test How to Prepare the Phantom Phantom Positioning Image Acquisition Reconstruction of Image Image Analysis Spatial Resolution Contrast Delectability Uniformity Analysis of Tomography Uniformity Report Performance Specifications 16.16.5 SPECT/CT Spatial Registration 16.16.5.1 Frequency 16.16.5.2 Procedure for Checking Assessment of Spatial Registration Report Performance Criteria Slice Thickness 16.16.5.3 Procedure for Checking Data Analysis Report Performance Criteria References 17: Quality Assurance in Positron Emission Tomography-Computed Tomography (PET-CT) 17.1 Quality Assurance (QA) Program 17.2 Routine Quality Assurance 17.3 Performance Assessment 17.4 Responsibilities for Quality Control Tests 17.5 Important Points 17.6 Quality Control Records 17.7 Preventive Maintenance 17.8 Acceptance Test Procedures 17.9 Spatial Resolution 17.9.1 Purpose 17.9.2 Material Requirements (Table 17.1) 17.9.3 Activity Requirements 17.9.4 Activity in Point Source at the Start of Data Acquisition 17.9.5 Source Distribution (Fig. 17.1) 17.9.6 The Positioning of the Source (Figs. 17.2, 17.3 and 17.4) 17.9.7 Data Processing 17.9.8 Analysis 17.9.9 Report 17.9.10 Suggested Tolerances 17.9.11 Corrective Action 17.10 Sensitivity 17.10.1 Purpose 17.10.2 Frequency 17.10.3 Material (Table 17.4) 17.10.4 Activity Requirements 17.10.5 Phantom Positioning 17.10.6 Activity Preparation 17.10.7 Line Source Preparation 17.10.8 Data Acquisition (for all Five Sleeves), Processing, and Analysis 17.10.9 Calculations and Analysis 17.10.9.1 System Sensitivity 17.10.9.2 Axial Sensitivity Profile 17.10.10 Tolerances Suggestions 17.10.11 Corrective Measures 17.11 Scatter Fraction, Count Losses, and Randoms Measurement 17.11.1 Purpose 17.11.2 Frequency 17.11.3 Material Requirements 17.11.4 Activity 17.11.4.1 Requirements 17.11.5 Phantom Positioning 17.11.6 Activity Preparation 17.11.7 Line Source Preparation as Shown in Fig. 17.16 17.11.8 Data Acquisition 17.11.9 Data Processing 17.11.10 Symbols 17.11.11 Analysis 17.11.12 Analysis with Randoms Estimate 17.11.12.1 Scatter Fraction 17.11.12.2 Count Rates and NECR 17.11.13 Alternative Analysis with no Random Estimate 17.11.14 Count Rates and NECR 17.11.15 Results 17.11.15.1 Plot of Count Rate 17.11.15.2 Values for Peak Count 17.11.15.3 System Scatter Fraction 17.11.16 Tolerances Suggested 17.11.17 Taking Corrective Action 17.12 Energy Resolution 17.12.1 Purpose 17.12.2 Frequency 17.12.3 Materials 17.12.4 Data Gathering 17.12.5 Analysis 17.12.6 Tolerances Suggested 17.12.7 Taking Corrective Action 17.13 Image Quality, the Accuracy of Attenuation, and Scatter Corrections 17.13.1 Purpose 17.13.2 Frequency 17.13.3 Material Requirements 17.13.3.1 Activity Requirements 17.13.4 Phantom Positioning 17.13.5 Activity Preparation 17.13.6 Preparation of Phantoms (8:1 Activity Concentration Ratio) 17.13.6.1 Prepare Line Source Such as Stated Below 17.13.6.2 Data Acquisition (8:1 Activity Concentration Ratio) 17.13.7 Preparation of Phantoms (4:1 Activity Concentration Ratio) 17.13.7.1 Data Acquisition #2 (4:1 Activity Concentration Ratio) 17.13.8 Processing of Data 17.13.9 Analysis 17.13.9.1 Image Quality 17.13.9.2 Accuracy of Attenuation and Scatter Corrections 17.13.9.3 Accuracy of Radioactivity Quantitation 17.13.9.4 Tolerances Suggested 17.13.9.5 Taking Corrective Action 17.13.10 Resolution of Coincidence Timing in TOF Positron Emission Tomography 17.13.10.1 Purpose 17.13.10.2 Frequency 17.13.10.3 Materials 17.13.10.4 Data Acquisition 17.13.10.5 Analysis 17.13.10.6 Tolerances Suggested 17.13.10.7 Taking Corrective Action 17.14 Well Counter Correction 17.14.1 Purpose 17.14.2 Frequency 17.14.3 Material 17.14.4 Data Acquisition: In Phantom, Fill it with Activity 17.14.5 Result 17.14.6 Tolerance 17.15 Calibration of Activity Concentration in 2D OR 3D17.15.1. Purpose 17.15.1 Test Purpose & Frequency 17.15.2 Material 17.15.3 Data Acquisition 17.15.4 Analysis of Data 17.15.4.1 Result 17.15.5 Tolerance References Further Reading 18: Radiation Emergencies in Nuclear Medicine and Preparedness 18.1 Introduction 18.2 Prevention of Radiological Emergencies 18.3 Design and Layout of Nuclear Medicine Department 18.4 Emergency Management Plan 18.5 Emergency Management Kit 18.6 Various Emergency Situations and Their Management 18.6.1 Spill Management and Decontamination Procedure 18.6.1.1 Minor Spill Management 18.6.1.2 Major Spill Management 18.6.1.3 Decontamination 18.6.1.4 Decontamination Monitoring 18.6.1.5 Surface Decontamination 18.6.1.6 Personal Decontamination 18.6.2 Incidental Release of Radioactive Fume, Dust and Gases 18.6.3 Loss or Theft of Radioactive Sources 18.6.4 Damage to 99mTc Generators 18.6.5 Medical Emergencies Involving Radioactivity Administered to Patients 18.6.6 Receipt of Broken FDG Vial 18.6.7 Fire 18.6.8 Unauthorized Access to Radiation Area 18.6.9 Medical Events (Formerly Mis-Administration) 18.6.10 Death of Patient Administered with Radiopharmaceuticals 18.6.11 Emergencies During Transport of Radioactive Material References 19: Nuclear Medicine Internal Dose Assessment 19.1 The Term ‘Dosimetry’ 19.2 The Need 19.3 ALARA and AHASA Concepts in RNTs 19.4 The Term ‘Absorbed Dose’ 19.5 Dose Rate 19.6 Absorbed Dose Calculation and its Components 19.7 Assigning Numerical Values 19.8 Organ Mass 19.9 Specific Absorbed Fraction (SAF) 19.10 Various Systems of Dose Assessment Calculations 19.10.1 Medical Internal Radiation Dosimetry (MIRD) Formalism 19.10.1.1 Strengths and Inherent Limitations in the Formalism 19.10.2 The International Commission on Radiation Protection (ICRP) 19.10.2.1 Equivalent Dose 19.10.2.2 Effective Dose 19.10.2.3 Determination of Tissue Weighing Factors and Effective Dose 19.10.2.4 Use of Effective Dose 19.10.2.5 Limitations of Effective Dose 19.10.3 Radiation Dose Assessment Resource (RADAR) Task Force Method 19.11 Free Websites for Diagnostic Dose Estimation 19.12 Dose Assessment in Therapeutic Nuclear Medicine 19.12.1 Time-Integrated Activity Estimation 19.12.2 Obtaining System Sensitivity 19.12.3 Image Quantification 19.12.4 Scatter Corrections 19.12.5 Corrections for Background Activity 19.12.6 Tomographic Imaging 19.13 Conclusion References Untitled 20: Computed Tomography Dose Assessment 20.1 Introduction 20.2 Design and Working Principle of CT Scan Machines 20.2.1 PET-CT Scanners 20.3 CTDI 20.4 CTDI100 20.5 CTDIw 20.6 CTDIvol 20.7 DLP 20.8 CT Dosimetry Phantoms 20.9 Size-Specific Dose Estimate (SSDE) 20.10 CT Doses 20.11 Estimating Effective Doses 20.11.1 Calculation of Effective Dose Using Dose Reports 20.12 Diagnostic Reference Levels (DRL) and Achievable Dose (AD) References Untitled 21: Transport of Radioactive Material 21.1 Regulatory Aspects 21.2 Definitions of the Terms Used 21.2.1 Radioactive Material 21.2.2 Special Form Radioactive Material 21.2.3 A1 and A2 Values 21.2.4 Contamination 21.2.5 Exclusive Use 21.2.6 Surface Contaminated Object 21.2.7 Package 21.2.7.1 Excepted Package 21.2.7.2 Excepted Limit of Activity of a Radioisotope 21.2.7.3 Industrial Packages (Type IP-1, Type IP-2, Type IP-3) 21.2.7.4 Type A Package Requirements of Type-A Package 21.2.7.5 Type B(U)/(M) Package 21.2.7.6 Type C Package 21.3 Contamination Level for Packages 21.4 Categories of Packages 21.5 Marking, Labelling, and Placarding 21.5.1 Marking 21.5.2 Labelling 21.5.3 Placarding 21.6 Transport Documents References 22: Legislation and Role of National Regulatory Authority in Nuclear Medicine 22.1 Introduction 22.2 The Atomic Energy Act 22.2.1 Rules Issued Under the Act 22.2.2 Surveillance Procedures Issued Under the Rules [2] 22.3 Safety Code for Nuclear Medicine Facilities 22.3.1 The Employer 22.3.2 Licensee 22.3.3 The Radiological Safety Officer 22.3.3.1 In Addition to the Above, R.S.O. of High Dose Therapy Shall 22.3.4 Nuclear Medicine Physician 22.3.5 Nuclear Medicine Technologist 22.4 Conclusion References 23: Radioactive Waste Disposal and Safe Management of Disused Sealed Radioactive Sources 23.1 Fundamental Radioactive Waste Management (RWM) Principles 23.2 Classification of Wastes 23.3 Radioactive Waste Collection 23.4 Radioactive Waste Disposal 23.4.1 Solid Waste 23.4.2 Liquid Waste 23.4.3 Incineration of Wastes 23.5 Record Keeping 23.6 Management of Cadavers Containing Radionuclides 23.7 Disposal of Disused Sealed Radioactive Sources (DSRS) 24: Model Questions for Radiological Safety Certification Examination in Nuclear Medicine 24.1 Questions for RSO Exams 24.1.1 Section A 24.1.1.1 Multiple Choice Questions 24.2 Section B 24.2.1 State True or False 24.3 Section C 24.3.1 Fill in the blanks 24.4 Section D 24.4.1 Match the following: 24.4.2 Indicate whether the following effects are Stochastic (S) or Deterministic (D). 24.4.3 Match the following 24.4.4 Match the following: 24.5 Keys 24.5.1 Section A: Multiple Choice Questions 24.5.2 Section B: True/False 24.5.3 Section C: Fill in the Blanks 24.5.4 Section D: Match the Following