Radiation Safety in Nuclear Medicine: A Practical, Concise Guide

Description

This new edition is a fully updated guide to radiation safety practice for nuclear medicine professionals, and assists the nuclear medicine technologists in taking their board certifying examination. The NRC requires the appointment of a radiation safety officer (RSO) or an associate radiation safety officer (ARSO) for different uses of radioactive material. Board certified nuclear medicine technologists are eligible to be RSO and ARSO in specific uses of radioactive material after successfully completing a 40-hr or 200-hr course on radiation safety depending on the type of RAM use. This book covers all subject materials in these courses on radiation safety.   This guide provides ready-made, handy information on radiation safety as required in the practice of nuclear medicine, presented in a concise form for easy understanding and quick reference related to a given situation and/or incident. The major change in the new edition of the book is the addition of questions at the end of each chapter, to ensure the comprehension of the material by the examinees taking their certifying board examinations. As mentioned in the first edition, the NRC 10CFR20 for Standards for Radiation Protection and the NRC 10CFR35 for Medical Uses of Radioactive Materials are the primary sources of practical information on radiation safety in nuclear medicine. Much of the information is still valid, but many changes and additions have also been made since, which are fully updated here.   This is an ideal reference for nuclear medicine physicians, nuclear medicine technologists, and researchers using radioactive materials. Preface Contents 1: Basic Physics of Radiation Safety 1.1 Atomic and Nuclear Structure 1.2 Radioactive Decay 1.2.1 Spontaneous Fission 1.2.2 Alpha (α) Decay 1.2.3 Beta (β−) Decay 1.2.4 Positron (β+) Decay 1.2.5 Electron Capture 1.2.6 Isomeric Transition 1.3 Radioactive Decay Equation 1.3.1 Successive Decay Equation 1.3.1.1 Transient Equilibrium 1.3.1.2 Secular Equilibrium 1.4 Units of Radioactivity 1.5 Interaction of Radiations with Matter 1.5.1 Interaction of Particulate Radiations 1.5.1.1 Ranges 1.5.1.2 Specific Ionization 1.5.1.3 Annihilation Radiation 1.5.1.4 Bremsstrahlung 1.5.2 Interaction of γ Radiations with Matter 1.5.3 Attenuation of γ Radiation 1.5.4 Linear Energy Transfer 1.6 Counting Statistics 1.6.1 Poisson Distribution 1.6.2 Mean and Standard Deviation 1.6.3 Error, Precision, and Accuracy 1.6.4 Gaussian Distribution 1.6.5 Standard Deviation of Count Rate 1.6.6 Propagation of Errors 1.6.7 Minimum Detectable Activity References and Suggested Reading 2: Essential Equipment in Radiation Safety 2.1 Gas-Filled Detector 2.1.1 Ionization Chamber Survey Meter 2.1.2 Dose Calibrator 2.1.3 Pocket Dosimeter 2.1.4 Proportional Counter 2.1.5 Geiger–Muller Counter 2.2 Scintillation Counter 2.2.1 Well Counter 2.2.2 Thyroid Uptake Probe 2.2.3 Liquid Scintillation Counter 2.3 Neutron Detector 2.4 Personnel Monitoring 2.4.1 Film Badge 2.4.2 Thermoluminescent Dosimeter 2.4.3 Optically Stimulated Luminescence Dosimeter 2.4.4 Electronic Personal Dosimeter Suggested Reading 3: Radiation Units, Exposure, and Absorbed Dose 3.1 Units of Radiation Exposure and Absorbed Dose 3.2 Radiation Exposure 3.2.1 Sources of Radiation 3.2.1.1 Natural Background Radiation 3.2.1.2 Medical Radiation Exposure 3.2.1.3 Industrial, Security, Education, and Research Exposure 3.2.1.4 Occupational Exposure 3.3 Absorbed Dose 3.3.1 External Dosimetry 3.3.1.1 Calculation of External Dose 3.3.1.2 Exposure Rate Constant 3.3.2 External Exposure from a Point Source 3.3.2.1 External Dose from a Line Source 3.3.2.2 External Exposure from a Plane Source 3.3.2.3 External Exposure from a Volume Source 3.3.3 Internal Dosimetry 3.3.4 Dose Limits to Radiation Workers and Others 3.3.5 Planned Special Exposure 3.4 Effective Dose Equivalent and Effective Dose 3.5 Reportable Events 3.6 Notification of Incidents References and Suggested Reading 4: Radiation Protection 4.1 Principles of Radiation Protection 4.1.1 Time 4.1.2 Distance 4.1.3 Shielding 4.1.4 Do’s and Don’ts in Radiation Protection Practice 4.2 NRC Regulations of Radiation Protection 4.2.1 Definition of Specific Terms 4.2.2 Caution Signs 4.2.3 Posting Requirement 4.2.4 Labeling Requirement 4.2.5 ALARA Program 4.3 Security Control of High Radiation Areas 4.4 Use of Individual Respiratory Protection Equipment 4.5 Receiving and Monitoring of Radioactive Packages 4.6 Requirement of Monitoring of Occupational Doses to Radiation Workers 4.7 Wearing Badges 4.8 Bioassay 4.9 Decommissioning of Radiation Laboratory 4.10 Verification Card for Radioactive Patient 4.11 Radiation Phobia References and Suggested Reading 5: Regulatory Framework for Radiation Protection 5.1 Introduction 5.2 Licensing 5.2.1 Agreement State 5.2.2 General Domestic License for In Vitro Testing 5.2.3 Specific Domestic License of Limited Scope 5.2.4 Specific Domestic License of Broad Scope 5.2.5 Application for Specific License 5.3 Food and Drug Administration Regulations for Radiopharmaceuticals 5.3.1 PET Radiopharmaceuticals 5.3.2 Radioactive Drug Research Committee 5.4 Accreditation of Nuclear Medicine Facility 5.4.1 Accreditation by the IAC 5.4.2 Accreditation by the ACR References and Suggested Reading 6: Medical Uses of Radioactive Materials 6.1 Introduction 6.2 Application for License or Renewal 6.3 Where to File 6.4 License Amendment and Notification 6.5 Authorities and Responsibilities for Radiation Protection Program 6.5.1 Radiation Safety Officer 6.5.2 Radiation Safety Committee 6.6 Supervision 6.7 Training, Retraining, and Instructions to Radiation Workers 6.8 Written Directives 6.9 Authorization for Calibration, Transmission, and Reference Sources 6.10 Requirements for Possession of Sealed Sources 6.11 Sterile Preparation of Radioactive Drugs 6.12 Measurement of Dosage of Radiopharmaceutical for Patients 6.13 Permissible Concentration of 99Mo, 82Sr, and 85Sr in Radionuclide Generators 6.14 Use of Unsealed Byproduct Material not Requiring Written Directive 6.15 Minimizing Radiation Exposure from Nuclear Medicine Procedures 6.16 Labeling of Vials and Syringes 6.17 Possession and Calibration of Survey Meter 6.18 Survey of Ambient Exposure Rate 6.19 Survey for Removable Contamination 6.20 Medical Mobile Service 6.21 Medical Uses of Byproduct Materials 6.22 Special Medical Uses of Byproduct Material 6.23 Use of Radioactive Material in Animal Research 6.24 Report and Notification of a Medical Event 6.25 Report and Notification of Dose to Embryo/Fetus or Nursing Child 6.26 Record Keeping 6.26.1 Software for Record Keeping 6.26.2 Duration of Record Keeping References and Suggested Reading 7: Training and Experience of Authorized Personnel 7.1 Introduction 7.2 Radiation Safety Officer and Associate Radiation Safety Officer 7.3 Training for Authorized Medical Physicist 7.4 Training for Authorized Nuclear Pharmacist 7.5 Authorized Users (Physicians, Dentists, and Podiatrists) 7.5.1 7.5.1 Training for Uptake, Dilution, and Excretion Studies 7.5.2 Training for Use of Unsealed Byproduct Material for Imaging and Localization Studies 7.5.3 Training for Use of Unsealed Byproduct Material for which a Written Directive Is Required 7.5.4 Training for Oral Administration of 131I-NaI Requiring a Written Directive in Quantities Less than or Equal to 33 mCi (1.22 GBq) (per 10CFR35.392) and Greater than 33 mCi (1.22 GBq)(per 10CFR35.394) 7.5.5 Training for the Parenteral Administration of Unsealed Byproduct Material Requiring a Written Directive 7.5.6 Training for Use of Manual Brachytherapy Sources 7.5.7 Training for Use of Sealed Sources for Diagnosis 7.6 Exemptions for Experienced RSO, AMP, AU, and ANP 7.7 Recentness of Training References and Suggested Reading 8: Radiation Emergency Procedures 8.1 Introduction 8.2 Basic Procedures for Containment of a Spill 8.3 Radiation Incidents and Accidents 8.3.1 Management of Major Accidents 8.4 Radiological Dispersal Device 8.4.1 Measures to Take Following Explosion of Radiological Dispersal Device 8.4.1.1 Get Inside 8.4.1.2 Stay Inside 8.4.1.3 Stay Tuned 8.4.1.4 Other Protection Steps 8.4.2 Effects of RDD Dispersion 8.4.3 Measures to Prevent RDD References and Suggested Reading 9: Management and Release of Patients Administered with Radioactivity 9.1 Diagnostic Patients 9.2 Therapeutic Patients 9.2.1 Therapy with Sealed Sources 9.2.2 Therapy with Unsealed Sources 9.3 Release of Patients Treated with 131I-NaI and Other Radionuclides 9.3.1 Calculation of Administered Activity to Release a Patient 9.3.2 Measured Dose Rates from a Patient Administered with Radioactivity to Release 9.4 Release of Patients Treated with 131I-NaI Based on Patient-Specific Factors 9.5 Written Instructions to the Patient to Follow after Release 9.6 Internal Dose 9.7 Record Keeping References and Suggested Reading 10: Transportation of Radioactive Material 10.1 Introduction 10.2 Definition 10.3 Packaging 10.3.1 Stability Tests for Packages 10.3.2 Labeling of Packages 10.4 Exemption for Limited Quantity of Radioactive Material 10.5 Empty Packaging 10.6 Vehicles for Transportation of Radioactive Material 10.7 Exemption for Licensed Physician 10.8 Employee Training 10.9 Transportation of Radioactive Materials Within Hospital 10.10 Record Keeping References and Suggested Reading 11: Disposal of Radioactive Waste 11.1 Rationale for Radioactive Waste Disposal 11.2 Management and Storage of Radioactive Waste 11.2.1 Storage of Dry Solid Waste 11.2.2 Storage of Liquid Waste 11.2.3 Infectious or Biohazard Radioactive Waste 11.2.4 Sharps and Glass Container 11.2.5 Radioactive Animal 11.3 Radioactive Waste Disposal 11.3.1 Decay-in-Storage 11.3.2 Disposal by Incineration 11.3.3 Disposal of Radioactive Material into Sewerage 11.3.4 Transfer to Authorized Recipients 11.3.5 Other Disposal Methods 11.4 Special Situations for Disposal of Radioactive Waste 11.4.1 Disposal of Gaseous Waste 11.4.2 Disposal of Sealed Sources 11.4.3 Management of Cadavers Containing Radioactive Materials 11.4.4 Disposal of Radioactive Animals 11.5 Record Keeping References and Suggested Reading 12: Biological Effects of Radiation on Humans 12.1 Cell Structure and its Function 12.2 Apoptosis 12.3 Radiation Damage in Human Cells 12.4 Factors Affecting Radiation Damage in Genes and Chromosomes 12.4.1 Dose and Dose Rate 12.4.2 Linear Energy Transfer 12.4.3 Radiosensitizer and Radioprotector 12.4.4 Stage in the Cell Cycle 12.5 Acute Effects of Total-Body Irradiation 12.5.1 Hematopoietic Syndromes 12.5.2 Gastrointestinal Syndromes 12.5.3 Cerebrovascular Syndromes 12.6 Long-Term Effects of Radiation 12.6.1 Carcinogenesis 12.6.2 Dose–Response Relationship 12.6.3 Specific Cancers 12.6.4 Skin Damage 12.6.5 Cataractogenesis 12.7 Radiation Damage to Embryo and Fetus 12.7.1 Preimplantation Period 12.7.2 Major Organogenesis 12.7.3 Fetal Stage 12.8 Genetic Effects 12.9 Risk Versus Benefit in Diagnostic Radiology and Nuclear Medicine Procedures References and Suggested Reading Appendix A: Characteristics of Common Radionuclides Appendix B: Units and Constants Energy Charge Mass and Energy Length Activity Constants Appendix C: Answers to Questions Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Appendix D: Terms Used in the Text Appendix E: Abbreviation Used in Text Appendix F: Typical NRC Notification and Reporting Requirements for Different Situations Appendix G: Radioactive Decay of 99mTc Appendix H: Radioactive Decay of 131I Appendix I: Radioactive Decay of 18F Appendix J: Frequency of Essential Chores in Nuclear Medicine Index