Radiation Safety in Nuclear Medicine

by Lombardi, Max H.

• ISBN13: 9780849318979
• ISBN10: 0849318971
• Format: Hardcover
• Copyright: 1998-11-01
• Publisher: CRC Pr I Llc

Summary

Written in response to new regulations outlined by the NRC, this text addresses the issue of radiation safety in nuclear medicine. This book details reasons for applying safety procedures; the scientific basis of those procedures; and ways to implement procedures, to ensure the safety of staff, patients, and visitors in hospital nuclear medicine departments.Catalog Copy

Table of Contents

Chapter 1 Principles of Radiation Physics	1	(24)
I. Rationale	1	(1)
II. Matter and Energy	1	(2)
A. Nature of Matter	1	(1)
B. Laws of Thermodynamics	1	(1)
1. First Law: Law of Conservation of Mass Energy	2	(1)
2. Second Law: Law of Energy Flow	2	(1)
3. Third Law: Law of Entropy	2	(1)
C. Some Basic Units	2	(1)
1. Mass	2	(1)
2. Distance	2	(1)
3. Time	3	(1)
4. Energy	3	(1)
5. Speed of Light	3	(1)
6. Mass-Energy Equivalence	3	(1)
7. Electrical Charge	3	(1)
III. Atomic Structure and Radioactivity	3	(12)
A. Basic Structure	3	(1)
B. Nuclear Stability	4	(1)
C. Radioactive Decay	5	(2)
D. Modes of Radioactive Decay	7	(1)
1. Alpha Decay	7	(1)
2. Negatron Decay	8	(1)
3. Positron Decay	8	(2)
4. Electron Capture	10	(1)
5. Gamma Decay	10	(1)
6. Isomeric Transition	10	(2)
E. Charts of Nuclides	12	(1)
F. Electromagnetic Radiation	13	(1)
1. The EM Spectrum	14	(1)
IV. Particle Interactions	15	(2)
A. General Considerations	15	(1)
1. Electrical Charge	15	(1)
2. Momentum	15	(1)
3. Impulse	15	(1)
B. Alpha Interactions	15	(1)
1. Trajectory	15	(1)
2. Range	15	(1)
3. Specific Ionization	16	(1)
C. Beta Interactions (Positrons and Negatrons)	16	(1)
1. Trajectory	16	(1)
2. Range	16	(1)
3. Bremsstrahlung (Bracking Radiation)	16	(1)
4. Backscatter	17	(1)
5. Annihilation Radiation	17	(1)
V. Gamma-Ray Interactions	17	(4)
A. General Considerations	17	(1)
B. Photoelectric Effect	17	(1)
C. Compton Effect	18	(1)
D. Pair Production	19	(1)
E. Internal Conversion	19	(2)
VI. Gamma Ray Interactions with Lead and Water	21	(1)
A. Properties of Lead	21	(1)
B. Some Properties of Water	21	(1)
C. Gamma Ray Attenuation	21	(1)
D. In Lead	22	(1)
E. In Water or Soft Tissue	22	(1)
Homework	22	(1)
References	23	(2)
Chapter 2 Units of Radiation Exposure and Dose	25	(10)
I. Rationale	25	(1)
II. Basic Concepts	25	(3)
A. Activity	25	(1)
B. Exposure	26	(1)
C. Absorbed Dose	26	(1)
D. Dose Equivalent	27	(1)
III. Other Concepts	28	(2)
A. Specific Ionization	28	(1)
B. The W Value	28	(1)
C. Linear Energy Transfer	28	(1)
D. Beta Particles Range	29	(1)
E. The f Value (rad/R)	29	(1)
IV. Specific Gamma Constant	30	(2)
Homework	32	(1)
References	32	(3)
Chapter 3 Guidelines for Radiation Protection	35	(14)
I. Rationale	35	(1)
II. National and International Agencies	35	(2)
A. The Big Picture	35	(1)
B. The National Council on Radiation Protection and Measurements	35	(1)
C. The International Commission on Radiation Protection	36	(1)
D. The International Commission on Radiation Units and Measurements	36	(1)
E. The Nuclear Regulatory Commission	37	(1)
F. Other Consulting Organizations	37	(1)
III. Radiation Safety and the Law	37	(5)
A. Objective	37	(1)
B. Philosophy	37	(1)
C. The Concept of Risk	38	(1)
D. The ALARA Policy	38	(1)
E. Method	39	(1)
F. Licensing	39	(1)
1. General Licenses	39	(1)
2. Specific Licenses	39	(1)
G. The Food and Drug Administration	40	(1)
H. The Joint Commission on Accrediation of Health Organizations	40	(1)
I. The Environmental Protection Agency	40	(1)
J. The Department of Transportation	40	(2)
IV. Types of Radiation Effects	42	(1)
A. Point of View	42	(1)
B. Nonstochastic Effects	42	(1)
C. Stochastic Effects	42	(1)
V. Dose Limits	42	(3)
A. Total Effective Dose Equivalent	42	(2)
B. Occupational Dose Limits	44	(1)
C. General-Public Dose Limits	45	(1)
VI. Radiation Safety Practice	45	(1)
VII. Radiation Hormesis	46	(1)
VIII. Radiation Warning Signs	46	(1)
Homework	47	(1)
References	48	(1)
Chapter 4 Radiation Detection and Measurement	49	(18)
I. Rationale	49	(1)
II. Fundamentals	49	(2)
A. Approaches	49	(1)
B. Levels of Radioactive Contamination	49	(1)
C. Detection	49	(1)
D. Measurement	50	(1)
E. Radiation Survey Instruments	50	(1)
1. Gas Detectors	50	(1)
2. Film Badges	50	(1)
3. Thermoluminescent Dosimeters	50	(1)
4. Scintillation Detectors	50	(1)
F. Interpretation	50	(1)
III. Detectors	51	(7)
A. Gas Detectors	51	(1)
1. Design	51	(1)
2. Ions Collected and Voltage	51	(1)
B. GM Survey Meters	52	(2)
C. Wipe-Test Counters	54	(1)
D. Portable Ionization Chambers	54	(1)
E. Dose Calibrators	54	(1)
F. Pocket Dosimeters	55	(1)
G. Summary of Gas Detectors	55	(1)
H. Scintillation Detectors	56	(2)
IV. Statistics of Counting	58	(3)
A. Types of Errors	58	(1)
B. Statistical Distributions	58	(1)
C. Practical Rules	59	(2)
V. Making Decisions	61	(1)
VI. Minimum Detectable Activity	62	(1)
VII. Quality Control of Radiation Counters	63	(2)
A. Reliability	63	(1)
B. QC Tests	63	(1)
1. The Relative Error	63	(1)
2. The Reliability Factor	63	(1)
3. The Chi-Squared Test	63	(2)
Homework	65	(1)
References	65	(2)
Chapter 5 Radiation Safety in the Nuclear Medicine Department	67	(18)
I. Rationale	67	(1)
II. Design of the NM Department	67	(2)
A. Cold Areas	68	(1)
B. Lukewarm Areas	68	(1)
C. Warm Areas	68	(1)
D. Hot Areas	69	(1)
III. Description of Some Areas	69	(3)
A. Waiting Room and Reception	69	(1)
B. Restricted Areas	69	(1)
1. The Radioassay Laboratory	69	(1)
2. Gamma Counters Room	69	(1)
3. Thyroid Uptake Room	69	(1)
4. Control Room	70	(1)
5. Imaging Rooms	70	(1)
6. Radiopharmacy or Hot Lab	70	(1)
IV. The Radiation Safety Program	72	(11)
A. General Considerations	72	(3)
B. Radiation Safety Committee	75	(1)
C. Radiation Safety Officer	75	(1)
D. Radioactive Materials License	76	(1)
E. Quality Management Program	76	(1)
F. Misadministration of Radiopharmaceuticals	76	(1)
G. Recordable Events	77	(1)
H. Reportable Events	77	(1)
I. ALARA Program	77	(1)
J. Authorized Users	77	(1)
K. Training of Personnel	78	(1)
L. Personnel Exposures	78	(1)
M. Recordkeeping	78	(1)
N. Inspections	78	(1)
O. Reception of Radioactive Packages	79	(1)
P. Radiopharmaceuticals	79	(1)
1. Large Patient Load	79	(1)
2. Medium Patient Load	79	(1)
3. Low Patient Load	80	(1)
Q. Dose Calibrators	80	(1)
R. Laboratory Rules	80	(1)
S. Use of Radioactive Materials	80	(2)
T. Radioactive Waste Disposal	82	(1)
U. Laboratory Surveys	82	(1)
V. Sealed Sources	82	(1)
W. Radiation Emergencies	82	(1)
Homework	83	(1)
References	84	(1)
Chapter 6 Safe Handling of Radioactivity	85	(18)
I. Rationale	85	(1)
II. Principles	85	(9)
A. Minimizing External Exposures	85	(1)
1. Quantity of the Radioactivity Used	85	(1)
2. Time of Exposure	86	(1)
3. Effect of Distance	86	(2)
4. Effect of Shielding	88	(3)
B. Preventing Internal Contamination	91	(1)
1. Ingestion	91	(2)
2. Inhalation	93	(1)
3. Percutaneous Absorption	93	(1)
4. Accidental Injection	94	(1)
C. Laboratory Rules	94	(1)
III. Radiation Hazards	94	(4)
A. Alpha Emitters	94	(1)
B. Negatron Emitters	95	(1)
C. Positron Emitters	96	(1)
D. Gamma Emitters	97	(1)
E. Neutrons	97	(1)
IV. Radionuclide Therapy	98	(1)
V. Radioiodine Therapy	98	(1)
A. Imaging of Metastases	98	(1)
B. Hyperthyroidism	99	(1)
C. Thyroid Ablation	99	(1)
VI. Thyroid Ablation	99	(1)
A. Room Preparation	99	(1)
B. Patient Care	99	(1)
C. Release of the Patient	100	(1)
D. Room Decontamination	100	(1)
Homework	100	(1)
References	101	(2)
Chapter 7 Radiation Surveys and Waste Disposal	103	(14)
I. Rationale	103	(1)
II. Radiation Surveys	103	(1)
A. Surveyed Areas	103	(1)
B. Methods	104	(1)
III. Survey Instruments	104	(1)
A. GM Survey Meters	104	(1)
B. Alarm Monitors	104	(1)
C. Ionization Chambers (Cutie Pies)	104	(1)
D. Surface Monitors	104	(1)
IV. Monitoring	105	(3)
A. Department Monitoring	105	(1)
1. Map of the Department	105	(1)
2. Method	105	(2)
3. Hot Lab Housekeeping	107	(1)
B. Wipe Monitoring	107	(1)
C. Leak-Testing of Sealed Sources	108	(1)
V. Accidental Contamination	108	(2)
A. Contamination	108	(1)
B. Decontamination	109	(1)
1. Minor Spills	109	(1)
2. Major Spills	109	(1)
3. Decontamination	109	(1)
VI. Types of Radioactive Wastes	110	(1)
A. Classification of Radioactive Wastes	110	(1)
B. Nuclear-Medicine Wastes	111	(1)
1. Solid Wastes	111	(1)
2. Liquid Wastes	111	(1)
3. Radioactive Gases	111	(1)
VII. Disposal of Radioactive Wastes	111	(3)
A. Disposal of Solid Wastes	111	(1)
1. The Management of Wastes	112	(1)
2. Biohazards	112	(1)
3. Radiopharmaceutical Remnants	112	(1)
4. Nuclide Generators	112	(1)
5. Other Solid Wastes	112	(1)
6. Warning Signs	112	(1)
7. Records	112	(1)
B. Decay in Storage (DIS)	112	(1)
C. Liquid-Wastes Disposal	113	(1)
D. Gases, Acrosols, and Volatile Radioiodine	113	(1)
VIII. Occupational Exposure to Radioactive Material	114	(1)
A. Occupational Exposure to (131)I	114	(1)
B. The Environmental Protection Agency	114	(1)
Homework	115	(1)
References	115	(2)
Chapter 8 Monitoring of Personnel Exposures	117	(12)
I. Rationale	117	(1)
II. Monitoring of Occupational Doses	117	(1)
A. Dose Limits	117	(1)
B. Requirements	117	(1)
III. Occupational Dose Limits	118	(1)
IV. Nonoccupational Areas	118	(1)
V. Monitoring Methods	118	(8)
A. Acceptable Methods	118	(1)
B. Film Badge Dosimetry	119	(1)
1. The Service	119	(1)
2. The Badge Case	119	(1)
3. The Film	119	(1)
4. The Emulsion	119	(1)
5. The Theory	120	(1)
6. Film Processing	120	(1)
7. Density	121	(1)
8. Calibration Curve	122	(1)
9. Advantages	122	(1)
10. Disadvantages	122	(1)
C. Thermoluminescence Dosimetry (TLD)	123	(1)
1. The Principle	123	(1)
2. The Theory	123	(1)
3. Quantification	123	(1)
4. The Service	124	(1)
5. Advantages of TLD	124	(1)
6. Disadvantages of TLD	125	(1)
D. Pocket Dosimeters	125	(1)
1. Description	125	(1)
2. Advantages of Pocket Dosimeters	125	(1)
3. Disadvantages of Pocket Dosimeters	125	(1)
E. Personal Alarm Monitors	126	(1)
1. Description	126	(1)
2. Advantages	126	(1)
3. Disadvantages	126	(1)
VI. Records of Personnel Dosimetry	126	(1)
VII. Reports	126	(1)
A. Lost or Stolen Radioactive Sources	126	(1)
B. Incident Reports	127	(1)
VIII. Reportable Events	127	(1)
Homework	127	(1)
References	128	(1)
Chapter 9 Internal Dosimetry and Bioassays	129	(16)
I. Rationale	129	(1)
II. Internal Dosimetry	129	(8)
A. General Considerations	129	(1)
B. Methods for Calculating Internal Doses	129	(1)
C. ICRP Assumptions	129	(1)
D. Standard Man	130	(1)
E. The Snyder-Fisher Phantom	130	(1)
F. The Marinelli Equations	130	(1)
G. Effective Half-Life	131	(1)
H. The MIRD Method	131	(1)
I. The MIRD Assumptions	132	(1)
J. The MIRD Equation	132	(1)
K. Cumulative Activities	133	(1)
L. Equilibrium Dose Constants	133	(1)
M. Absorbed Fractions	133	(1)
N. Effective Absorbed Energies	133	(1)
O. Mean Absorbed Doses	134	(1)
P. Technetium-99m-RPs	134	(1)
Q. Iodine-131 Iodide	135	(1)
R. Fetal Doses	135	(1)
S. The Highest Diagnostic Internal Doses	135	(1)
T. Internal Dose to the Whole Body	135	(2)
III. Bioassay of Radioactivity	137	(4)
A. Definition	137	(1)
B. Requirements	137	(1)
C. Airborne Medical Radionuclides	137	(1)
D. Bioassays of (131)I	138	(1)
E. Alert and Action Levels for (131)I	138	(1)
F. Biological Models	138	(1)
1. Highly Diffusible Radionuclides	138	(2)
2. High Organ Uptake Radionuclides	140	(1)
IV. Biological Half-Lives	141	(1)
Homework	142	(1)
References	143	(2)
Chapter 10 Introduction to Radiobiology	145	(28)
I. Rationale	145	(1)
II. Basic Concepts in Biology	145	(4)
A. Living Organisms	145	(1)
B. Properties of Living Organisms	145	(1)
C. Flow of Energy	146	(1)
1. Green Plants	146	(1)
2. Animals	146	(1)
3. Bacteria	146	(1)
4. Viruses	146	(1)
D. Cellular Respiration	146	(1)
1. Anaerobic Glycolysis	146	(1)
2. Aerobic Glycolysis	147	(1)
a. Transition Reaction	147	(1)
b. Krebs Cycle	147	(1)
c. Respiratory Chain	147	(1)
E. Cell Division	148	(1)
1. Somatic Cells	148	(1)
2. Germinal Cells	148	(1)
F. Mitosis	148	(1)
1. Prophase	148	(1)
2. Metaphase	148	(1)
3. Anaphase	148	(1)
4. Telophase	148	(1)
G. The Cell Cycle	148	(1)
1. Mitosis	149	(1)
2. Gap 1	149	(1)
3. DNA Synthesis	149	(1)
4. Gap 2	149	(1)
H. Defense Mechanisms	149	(1)
1. Primary Barriers	149	(1)
2. Secondary Barriers	149	(1)
3. Tertiary Barriers	149	(1)
III. The Study of Radiobiology	149	(3)
A. The General Scheme	149	(1)
B. Sources of Radiation	150	(1)
1. Natural Sources	150	(1)
2. Artificial Sources	151	(1)
3. Levels of Radiation	151	(1)
C. The Biological System	151	(1)
1. Systems Studied	151	(1)
2. Experimental Design	151	(1)
3. Conditions	151	(1)
D. The Method of Observation	151	(1)
IV. Types of Exposure	152	(1)
A. Acute Exposure	152	(1)
B. Chronic Exposure	152	(1)
C. Experimental Levels of Exposure	153	(1)
V. Theories of Radiation Injury	153	(2)
A. Introduction	153	(1)
1. Direct Theory	153	(1)
2. Indirect Theory	153	(1)
3. Biological Stage	153	(1)
B. Target Theory	154	(1)
C. Indirect Theory	155	(1)
VI. DNA, the Most Sensitive Target	155	(3)
A. Lesions in DNA	156	(1)
1. The G Value	156	(1)
2. Aberrations	156	(1)
B. Role of DNA	157	(1)
1. Chromosomes	157	(1)
2. Structure	157	(1)
3. Genes	158	(1)
4. Repair of DNA	158	(1)
VII. Quantitative Radiobiology	158	(1)
A. Survival Curves	158	(1)
B. Autoradiography	158	(1)
C. New Techniques	158	(1)
VIII. Survival Curves	158	(2)
A. Definition	158	(1)
B. Equations	159	(1)
C. The Shoulder	160	(1)
IX. Tissue Sensitivities	160	(1)
A. Cells	160	(1)
B. Cell Populations	160	(1)
C. Tissues	160	(1)
X. Types of Damage	160	(1)
A. Sublethal Damage	160	(1)
B. Potentially Lethal Damage	161	(1)
XI. Radiation-Injury Modifiers	161	(2)
A. Physical Modifiers	161	(1)
B. Chemical Modifiers	161	(1)
1. The Oxygen Effect	161	(1)
2. Other Chemical Modifiers	162	(1)
C. Biological Modifiers	162	(1)
D. The Overkill Effect	163	(1)
E. Dose Fractionation	163	(1)
1. Redistribution	163	(1)
2. Reoxygenation	163	(1)
3. Regeneration	163	(1)
4. Repair	163	(1)
XII. The Acute Radiation Syndrome	163	(2)
A. Whole-Body Exposure	163	(1)
B. The Bone Marrow Syndrome	164	(1)
C. The GI Syndrome	164	(1)
D. The CNS Syndrome	165	(1)
XIII. Late Effects of Radiation	165	(3)
A. The Human Experience	165	(1)
B. Hypotheses for Late Effects	166	(1)
1. The Linear Nonthreshold Hypothesis	167	(1)
2. The Linear Quadratic Hypothesis	167	(1)
3. The Threshold-Linear Hypothesis	167	(1)
C. Risks	167	(1)
D. Life-Span Shortening	167	(1)
XIV. Genetic Effects	168	(2)
A. Basic Concepts	168	(1)
B. Background Radiation	169	(1)
C. Mutations in Drosophila	170	(1)
D. The Megamouse Project	170	(1)
XV. Effects of Prenatal Irradiation	170	(1)
A. Experiments with Mice	170	(1)
B. Observations in Humans	170	(1)
C. Recommendations	171	(1)
Homework	171	(1)
References	171	(2)
Appendix A Properties of Medical Radionuclides	173	(2)
Appendix B Dosimetry of Routine NM Procedures	175	(4)
Appendix C Symbols and Abbreviations	179	(6)
Appendix D Answers to Problems	185	(4)
Index	189