Radiation Safety in Nuclear Medicine, Second Edition

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ISBN: 9780849381683 | 0849381681
Cover: Hardcover
Copyright: 10/20/2006

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Recent advances in the field of nuclear medicine (NM) are expanding the role and responsibilities of the nuclear medicine technologist (NMT) to include more complex and detailed tasks. New technologies are making the diagnosis, management, and treatment of illnesses more sensitive, more specific, more accurate, and ultimately safer for both the patient and the technologist.Radiation Safety in Nuclear Medicine, Second Edition provides the latest technological advances and expanded responsibilities of today's NMT while laying a solid foundation for understanding the basic physics behind the technology. As with the original, this edition teaches the units of radioactivity, exposure, and dosimetry, along with the principles of instrumentation needed for detection and measurement. Focusing on the issues of safety, this volume devotes considerable attention to the science and practice of safety techniques and includes information on rules and regulations.In keeping with the expanding nature of the field, the second edition incorporates many updates and additions such as,· Recent modifications to the U.S. Code of Federal Regulations specific to the use of radiopharmaceuticals in medicine· The growing popularity of metabolic imaging with positron emissions tomography (PET)· The benefits of merging two modalities, namely, the images of PET and computerized tomography (CT) into one short scanning procedure· The new role of therapeutic radiopharmaceuticals that use molecular targeting as a method of localizationProviding a basic understanding of nuclear medicine, its scientific basis, diagnostic and therapeutic applications, safety practices and regulations, and future directions, Radiation Safety in Nuclear Medicine, Second Edition is the comprehensive reference for technologists, students, researchers, and other professionals in the Nuclear Medicine.

Chapter 1 Principles of Radiation Physics

(28)

I. Rationale

(1)

II. Brief History of Radiation Science

(3)

A. The Nature of Matter

(1)

B. Atoms and Molecules

(1)

C. X-Rays and Natural Radioactivity

(1)

D. Relativity

(1)

E. Quantum Physics

(1)

F. Radiation Physics

(1)

III. Matter and Energy

(2)

A. Nature of Matter

(1)

B. Laws of Thermodynamics

(1)

C. Some Basic Units

(1)

1. Mass

(1)

2. Distance

(1)

3. Time

(1)

4. Energy

(1)

5. Speed of Light (c)

(1)

6. Mass–Energy Equivalence (E = mc²)

(1)

7. Electrical Charge

(1)

IV. Atomic Structure and Radioactivity

(13)

A. Basic Structure

(1)

B. Nuclear Stability

(1)

C. Radioactive Decay

(2)

D. Modes of Radioactive Decay

(6)

1. Alpha Decay

(1)

2. Negatron Decay

(2)

3. Positron Decay

(1)

4. Electron Capture

(1)

5. Gamma Decay

(1)

6. Isomeric Transition (IT)

(1)

E. Electromagnetic (EM) Radiations

(3)

1. The EM Spectrum

(1)

V. Particle Interactions

(2)

A. General Considerations

(1)

1. Electrical Charge

(1)

2. Momentum

(1)

3. Impulse

(1)

B. Alpha Interactions

(1)

1. Trajectory

(1)

2. Range

(1)

3. Specific Ionization (S)

(1)

C. Beta Interactions (Positrons and Negatrons)

(1)

1. Trajectory

(1)

2. Range

(1)

3. Bremsstrahlung (Braking Radiation)

(1)

4. Backscatter

(1)

5. Annihilation Radiation

(1)

VI. Gamma Ray Interactions

(3)

A. General Considerations

(1)

B. Photoelectric Effect (τ)

(1)

C. Compton Effect (σ)

(1)

D. Pair Production (kappa)

(1)

E. Internal Conversion (IC)

(1)

VII. Gamma Ray Interactions with Lead and Water

(2)

A. Some Properties of Lead

(1)

B. Some Properties of Water

(1)

C. Gamma Ray Attenuation

(1)

D. In Lead

(1)

E. In Water or Soft Tissue

(1)

Problems

(1)

References

(3)

Chapter 2 Units of Radiation Exposure and Dose

(12)

I. Rationale

(1)

II. Basic Concepts

(5)

A. Activity (A)

(1)

1. Relative Standardization

(1)

2. Absolute Standardization

(1)

B. Exposure (X)

(1)

C. Absorbed Dose (D)

(1)

D. Equivalent Dose (HT,R)

(1)

E. Effective Dose (E)

(1)

F. Relative Biological Effectiveness (RBE)

(1)

III. Other Concepts

(3)

A. Specific Ionization

(1)

B. The W Value

(1)

C. Linear Energy Transfer (LET)

(1)

D. Range of Beta Particles

(1)

E. The f Value (rad/R)

(2)

IV. Specific Gamma Constant (F)

(1)

V. About S.I. Units

(1)

Problems

(1)

References

(2)

Chapter 3 Guidelines for Radiation Protection

(16)

I. Rationale

(1)

II. National and International Agencies

(5)

A. The Big Picture

(1)

B. National Council on Radiation Protection and Measurement

(1)

C. International Commission on Radiation Protection (ICRP)

(1)

D. International Commission on Radiation Units and Measurements

(1)

E. Nuclear Regulatory Commission (NRC)

(1)

F. Environmental Protection Agency (EPA)

(1)

G. Food and Drug Administration (FDA)

(1)

H. Department of Transportation (DOT)

(1)

I. Joint Commission on Accreditation of Health Organizations

(1)

J. Other Consulting Organizations

(1)

III. Radiation Safety and the Law

(2)

A. Objective

(1)

B. Philosophy

(1)

C. The Concept of Risk

(1)

D. The ALARA Policy

(1)

E. Method

(1)

F. Licensing (10CFR19.3)

(1)

1. General Licenses

(1)

2. Specific Licenses

(1)

IV. Types of Radiation Effects

(1)

A. Acute and Chronic Exposures

(1)

B. Deterministic Effects

(1)

C. Stochastic Effects

(1)

V. Other Concepts in Dosimetry

(2)

A. Committed Equivalent Dose, HT(τ)

(1)

B. Committed Effective Dose, E(τ)

(1)

C. Annual Limit on Intake (ALI)

(1)

D. Derived Air Concentrations (DACs)

(1)

E. Deep Dose (Hd)

(1)

F. Shallow Dose (Hs)

(1)

G. Lens Dose (LD)

(1)

VI. Recommended Dose Limits

(1)

A. Occupational Dose Limits (10CFR20.1201)

(1)

B. General Public Dose Limits (10CFR20.1301)

(1)

C. Comments

(1)

VII. Radiation Safety Practice

(2)

A. Radiation Safety Officer (RSO)

(1)

B. Radiation Safety Committee (RSC)

(1)

C. Radiation Safety Program (RSP)

(1)

D. Quality Management Program (QMP)

(1)

E. The ALARA Program

(1)

F. Radiation Warning Signs

(1)

Problems

(1)

References

(3)

Chapter 4 Radiation Detection and Measurement

(24)

I. Rationale

(1)

II. Fundamentals

(2)

A. Principles

(1)

B. Detection

(1)

C. Radioactive Contamination

(1)

D. Measurement

(1)

E. Radiation Survey Instruments

(1)

1. Gas Detectors

(1)

2. Personal Exposure Monitors

(1)

3. Scintillation Detectors

(1)

F. Interpretation

(1)

III. Gas Detectors

(6)

A. Basic Design

(2)

1. Components

(1)

2. Ions Collected and Voltage

(2)

B. GM Survey Meters

(1)

1. Design

(1)

2. Scales

(1)

3. Wall Thickness

(1)

4. Gases

(1)

5. Error of Detection

(1)

6. Time Constant

(1)

7. Disadvantage

(1)

C. Calibration of GM Survey Meters

(1)

1. Sealed Source

(1)

2. Regulation

(1)

3. Correction Factor

(1)

D. Wipe-Test Counters

(1)

1. Design

(1)

2. Positive Wipes

(1)

E. Portable Ionization Chambers

(1)

1. Properties

(1)

2. Accuracy

(1)

3. Scales

(1)

F. Dose Calibrators

(1)

1. Accurate Assays

(1)

2. Safety

(1)

G. Pocket Dosimeters

(1)

1. Design

(1)

2. Operation

(1)

3. Applications

(1)

4. Advantage

(1)

H. Summary of Gas Detectors

(1)

IV. Scintillation Detectors

(2)

A. Basic Design

(1)

1. The Na(Tl) Detector

(1)

2. Principle

(1)

B. Associated Electronics

(1)

1. Single-Channel Analyzer (SCA)

(1)

2. The Window

(1)

3. Applications

(1)

4. Other Scintillation Detectors

(1)

V. Imaging Instrumentation

(3)

A. Conventional Imaging

(1)

1. Planar Imaging

(1)

2. SPECT

(1)

B. Pet Imaging

(1)

1. Metabolic Tracers

(1)

2. The PET Scanner

(1)

C. The Merging of PET and CT

(1)

1. Computerized Tomography (CT)

(1)

2. Coverage

(1)

3. The PET/CT Scanner

(1)

4. Applications

(1)

VI. Statistics of Counting

(4)

A. Types of Errors

(1)

1. Systematic Errors

(1)

2. Random Errors

(1)

3. Blunders

(1)

B. Statistical Distributions

(1)

1. Poisson Distribution

(1)

2. Gaussian Distribution

(1)

C. The Normal Distribution

(3)

1. Sample

(1)

2. Ranges of Confidence

(1)

3. The Meaning of σs

(1)

4. Practical Rules

(1)

5. Background Radiation

(1)

6. Coefficient of Variation (CV)

(1)

7. Standard Deviation of the Mean, σx

(1)

8. Total Counts Collected (N)

(1)

9. Reliability

(1)

10. Rejection of Data

(1)

VII. Making Decisions

(1)

A. Relative Error (τ)

(2)

1. Detector Performance

(1)

2. Is There Contamination?

(1)

VIII. Minimum Detectable Activity (MDA)

(1)

IX. Quality Assurance of Radiation Counters

(2)

A. Reliability

(1)

B. QA Tests

(6)

1. The Relative Error (τ)

(1)

2. The Reliability Factor (RF)

(1)

3. The Chi-Squared Test (χ²)

(1)

Problems

(1)

References

(3)

Chapter 5 Radiation Safety in the Nuclear Medicine Department

(22)

I. Rationale

(1)

II. Design of the NM Department

(1)

A. Cold Areas

(1)

B. Lukewarm Areas

(1)

C. Warm Areas

(1)

D. Hot Areas

(1)

III. Description of Some Areas

(3)

A. Waiting Room and Reception

(1)

B. Nonimaging Procedures Room

(1)

1. Radioimmunoassays (RIAs)

(1)

2. Thyroid Uptake of Radioiodide

(1)

3. Schilling Test

(1)

4. Blood Volume Test

(1)

C. Control Room

(1)

D. Imaging Rooms

(1)

E. Radiopharmacy (Hot Lab)

(1)

IV. Molecular Medicine

(3)

V. The Radiation Safety Program (RSP)

(1)

A. General Considerations

(1)

B. Contents

(1)

VI. Radiation Safety Committee (RSC)

(1)

VII. Radiation Safety Officer (RSO)

(1)

VIII. Radioactive Materials License

(1)

IX. Quality Management Program (QMP)

(1)

A. Definition

(1)

B. Misadministrations

(1)

C. Recordable Events

(1)

D. Reportable Events

(1)

X. The ALARA Program

(1)

A. Objective

(1)

1. Inclusion

(1)

XI. The Practice of Radiation Safety

(6)

A. Authorized Users

(1)

B. Training of Personnel

(1)

C. Personnel Exposures

(1)

D. Record Keeping

(1)

E. Inspections (10CFR19.14, 10CFR30.52)

(1)

F. Reception of Radioactive Packages

(1)

G. Radiopharmaceuticals

(1)

H. Dose Calibrators

(1)

I. Laboratory Rules

(1)

J. Use of Radioactive Materials

(1)

K. Radioactive Waste Disposal

(2)

L. Laboratory Surveys

(1)

M. Sealed Sources

(1)

N. Radionuclide Therapy

(1)

O. Radiation Emergencies

(1)

Problems

(1)

References

100

(3)

Chapter 6 Safe Handling of Radioactivity

103

(20)

I. Rationale

103

(1)

II. Minimizing External Exposures

103

(7)

A. Principles

103

(7)

1. Quantity of Radioactivity Used

103

(1)

2. Time of Exposure

104

(1)

3. Effect of Distance

105

(1)

4. Effect of Shielding

106

(4)

III. Preventing Internal Contamination

110

(2)

A. Ingestion

110

(1)

B. Inhalation

110

(1)

C. Percutaneous Absorption

111

(1)

D. Accidental Injection

112

(1)

IV. Laboratory Rules

112

(1)

V. Radiation Hazards

113

(4)

A. Alpha Emitters

113

(1)

B. Negatron Emitters

114

(1)

C. Positron Emitters

115

(1)

D. Gamma Emitters

116

(1)

E. Neutrons

116

(1)

VI. Radionuclide Therapy

117

(2)

A. Radioiodine Therapy

117

(1)

1. Imaging of Metastases

117

(1)

2. Hyperthyroidism

117

(1)

3. Thyroid Ablation

117

(1)

B. Thyroid Ablation

118

(1)

C. Release of Patients

119

(1)

D. Room Decontamination

119

(1)

VII. Other Radionuclide Therapies

119

(2)

A. Phosphorus-32

119

(1)

B. Strontium-89 Chloride and 153Sm-EDTMP

120

(1)

C. Yttrium-90

120

(1)

D. Iodine-125

120

(1)

E. Iodine-131

120

(1)

Problems

121

(1)

References

121

(2)

Chapter 7 Radiation Surveys and Waste Disposal

123

(16)

I. Rationale

123

(1)

II. Radiation Surveys

123

(3)

A. Preparation

123

(1)

B. Survey Practices

124

(1)

C. Selection of a Survey Instrument

124

(1)

D. Proper Operation

124

(1)

E. Surveying of Working Areas

125

(1)

F. Methods

125

(1)

III. Survey Instruments

126

(2)

A. GM Survey Meters

126

(1)

B. Alarm Monitors

126

(1)

C. Ionization Chambers

126

(1)

D. Surface Monitors

127

(1)

IV. Monitoring

128

(2)

A. Map of the Department

128

(1)

B. Method

128

(1)

C. Hot-Lab Housekeeping

129

(1)

D. Wipe-Test Monitoring

129

(1)

V. Accidental Contamination

130

(2)

A. Radioactive Spills

130

(1)

B. Decontamination

130

(2)

1. Minor Spills

130

(1)

2. Major Spills

130

(1)

3. Procedure

131

(1)

C. Release of ¹³³Xe

132

(1)

VI. Radioactive Wastes

132

(2)

A. Classes of Radioactive Wastes

132

(1)

B. Nuclear Medicine Wastes

133

(1)

1. Solid Wastes

133

(1)

2. Liquid Wastes

133

(1)

3. Radioactive Gases

133

(1)

C. Radiotoxicity

133

(1)

VII. Disposal of Radioactive Wastes

134

(2)

A. Disposal of Solid Wastes

134

(1)

1. Management of Wastes (10CFR20.2001)

134

(1)

2. Segregation by Half-Life

134

(1)

3. Biohazards

134

(1)

4. Radiopharmaceutical Remnants

134

(1)

5. Nuclide Generators

134

(1)

6. Labeling

135

(1)

7. Records

135

(1)

B. Liquid Wastes Disposal

135

(1)

C. Gases, Aerosols, and Volatile Radioiodine

135

(1)

D. Transportation of Wastes

136

(1)

VIII. Occupational Exposures

136

(1)

A. Occupational Exposure to ¹³¹I

136

(1)

B. Occupational Exposure to ¹³³Xe

136

(1)

IX. The Environmental Protection Agency (EPA)

136

(1)

Problems

137

(1)

References

137

(2)

Chapter 8 Monitoring of Personnel Exposures

139

(14)

I. Rationale

139

(1)

II. Monitoring of Occupational Exposures

140

(1)

A. Dose Limits

140

(1)

B. Requirements

140

(1)

III. Reminder of Dose Limits

140

(1)

A. Occupational Dose Limits (10CFR20.1201)

140

(1)

B. Nonoccupational Dose Limits (10CFR20.1301)

140

(1)

IV. Monitoring Methods

141

(8)

A. Acceptable Methods

141

(1)

B. Film Badge Dosimetry

141

(4)

1. The Service

141

(1)

2. The Badge Case

141

(1)

3. The Film

142

(1)

4. The Emulsion

142

(1)

5. The Theory

143

(1)

6. Film Processing

143

(1)

7. Density

143

(1)

8. Calibration Curve

144

(1)

9. Advantages

145

(1)

10. Disadvantages

145

(1)

C. Thermoluminescence Dosimetry (TLD)

145

(1)

1. The Principle

145

(1)

2. The Theory

145

(1)

3. Quantification

145

(1)

4. The Service

146

(1)

5. Advantages of TLD

146

(1)

6. Disadvantages of TLD

146

(1)

D. Pocket Dosimeters

146

(2)

1. Description

146

(2)

2. Advantages

148

(1)

3. Disadvantages

148

(1)

E. Personal Alarm Monitors (Bleepers)

148

(1)

1. Description

148

(1)

2. Advantages

148

(1)

3. Disadvantages

148

(1)

F. OSL Dosimetry

148

(1)

1. Advantages

149

(1)

2. Disadvantages

149

(1)

V. Records of Personnel Dosimetry

149

(1)

A. Personnel Doses

149

(1)

B. Previous Records

149

(1)

C. Committed Dose

149

(1)

D. Other Records

149

(1)

VI. Reports

149

(1)

A. Lost or Stolen Radioactive Sources

149

(1)

B. Incident Reports (10CFR20.2202)

150

(1)

1. Immediate Notification

150

(1)

2. Twenty-Four-Hour Notification

150

(1)

VII. Reportable Events

150

(1)

A. Incidents

150

(1)

B. The EPA

150

(1)

C. Reports to Individuals

150

(1)

D. Files

150

(1)

Problems

151

(1)

References

151

(2)

Chapter 9 Internal Dosimetry and Bioassays

153

(18)

I. Rationale

153

(1)

II. Historical Review

153

(7)

A. General Considerations

153

(1)

B. Methods

154

(1)

C. The ICRP Method

154

(2)

1. Assumptions

154

(1)

2. "Standard Man"

154

(1)

3. The Snyder–Fisher Phantom

154

(1)

4. The Marinelli Equations

155

(1)

5. Effective Half-Life (Te)

155

(1)

D. The MIRD Method

156

(3)

1. MIRD Assumptions

156

(1)

2. The MIRD Equations

157

(1)

3. Cumulative Activities (Ã)

157

(1)

4. Equilibrium Dose Constants (Δi)

157

(1)

5. Absorbed Fraction (φ)

157

(1)

6. Effective Absorbed Energies (EAE)

158

(1)

7. Mean Absorbed Doses (S)

158

(1)

8. Internal Doses According to MIRD

159

(1)

E. The Radar Web Site

159

(1)

III. Internal Doses from Radiopharmaceuticals

160

(2)

A. Package Inserts

160

(1)

1. Requirement

160

(1)

B. Diagnostic RPs

160

(2)

1. Conventional Imaging Procedures

160

(1)

2. Dosimetry of '8F-FDG

160

(1)

3. Dosimetry of Radionuclide Therapy

160

(2)

4. Diagnostic Whole-Body and Fetal Doses

162

(1)

IV. Bioassay of Radioactivity

162

(4)

A. Definitions

162

(1)

B. Requirements

163

(1)

C. Airborne Medical Radionuclides

163

(1)

D. Bioassays of Iodine-131

163

(1)

1. Alert and Action Levels for ¹³¹I

163

(1)

2. Action Levels

164

(1)

E. Biological Models

164

(2)

1. Highly Diffusible Radionuclides

164

(1)

2. High-Organ-Uptake Radionuclides

165

(1)

V. Biological Half-Times

166

(1)

A. Exponential Removal

166

(1)

Problems

167

(1)

References

168

(3)

Chapter 10 Introduction to Radiobiology

171

(32)

I. Rationale

171

(1)

II. Review of Basic Concepts

171

(5)

A. Living Organisms

171

(1)

B. Properties of Living Organisms

171

(1)

C. Energy Flow

172

(1)

D. Cellular Respiration

173

(1)

E. Cell Division

174

(1)

F. Mitosis

174

(1)

G. The Cell Cycle

175

(1)

H. Defense Mechanisms

175

(1)

III. The Study of Radiobiology

176

(2)

A. The General Scheme

176

(1)

B. Sources of Radiation

176

(1)

C. The Biological System

177

(1)

IV. Types of Exposure

178

(1)

A. Acute Exposure

178

(1)

B. Chronic Exposure

179

(1)

C. Experimental Levels of Exposure

179

(1)

V. Theories of Radiation Injury

179

(3)

A. Introduction

179

(1)

B. Target Theory

180

(1)

C. Indirect Theory

181

(1)

VI. DNA: The Most Sensitive Target

182

(2)

A. Lesions in DNA

182

(1)

B. Role of DNA

183

(1)

VII. Quantitative Radiobiology

184

(1)

A. Survival Curves

184

(1)

B. Microscopic Autoradiography

184

(1)

C. Other Methods

184

(1)

VIII. Survival Curves

184

(2)

A. Definition

184

(1)

B. Equations

185

(1)

C. The Shoulder

185

(1)

IX. Tissue Sensitivities

186

(1)

A. Cells

186

(1)

B. Cell Populations

186

(1)

C. The Law of Bergonie and Tribondeau

186

(1)

X. Types of Damage

186

(1)

A. Sublethal Damage (SLD)

186

(1)

B. Potentially Lethal Damage (PLD)

187

(1)

XI. Radiation Injury Modifiers

187

(2)

A. Physical Modifiers

187

(1)

B. Chemical Modifiers

187

(1)

C. Biological Modifiers

188

(1)

D. The Overkill Effect

188

(1)

E. Dose Fractionation

189

(1)

XII. Acute Radiation Syndrome (ARS)

189

(3)

A. Whole-Body Exposure

189

(1)

B. The Bone Marrow Syndrome

190

(1)

C. GI Syndrome

190

(1)

D. CNS Syndrome

191

(1)

E. Radiation Dispersion Device (RDD)

191

(1)

XIII. Late Effects of Radiation

192

(5)

A. Types of Late Effects

192

(1)

B. The Human Experience

192

(1)

C. Hypotheses for Late Effects

193

(1)

D. Radiation Hormesis

194

(1)

E. The Concept of Risk

194

(2)

F. Life-Span Shortening

196

(1)

G. Other Late Effects

196

(1)

XIV. Genetic Effects

197

(1)

A. Basic Concepts

197

(1)

B. Background Radiation

198

(1)

C. Mutations in Drosophila

198

(1)

D. The Megamouse Project

198

(1)

XV. Effects of Prenatal Irradiation

198

(1)

A. Experiments with Mice

198

(1)

B. Observations in Humans

199

(1)

C. Recommendations

199

(1)

Problems

199

(1)

References

200

(3)

Appendix A Properties of Medical Radionuclides

203

(2)

A. Negatron Emitters

203

(1)

B. Gamma (X-Rays) Emitters

203

(1)

C. Positron Emitters (Annihilation Radiation)

204

(1)

Appendix B Symbols and Abbreviations

205

(6)

Appendix C Interconversion of Units

211

(2)

Appendix D Answers to Problems

213

(6)

Chapter 1

213

(1)

Chapter 2

213

(1)

Chapter 3

214

(1)

Chapter 4

215

(1)

Chapter 5

215

(1)

Chapter 6

216

(1)

Chapter 7

216

(1)

Chapter 8

217

(1)

Chapter 9

217

(1)

Chapter 10

218

(1)

Index

219

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Radiation Safety in Nuclear Medicine, Second Edition

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Table of Contents

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Radiation Safety in Nuclear Medicine, Second Edition

Summary

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