Medical radiation safety officers (RSOs) need to understand the risk of extravasations associated with radiopharmaceutical infusion therapies, and this case study can help RSOs be prepared to respond to an extravasation at their facility.

Importance 177 Lu therapy as part of theranostic treatment for cancer is expanding but it can be a challenge for sites with limited radiation protection staff to implement the radiation safety program required for therapeutic nuclear medicine. Objective To increase the adoption of 177 Lu therapy, especially in smaller centers and clinics, by providing a collection of radiation safety best practices and operational experience. To provide a resource for radiation safety officers supporting the implementation of a 177 Lu therapy program. Methods A panel of 11 radiation safety professionals representing sites across Canada and the United States with experience delivering 177 Lu therapy was assembled and discussed their responses to a list of questions focused on the following radiation safety topics: facility layout and design; radiation safety program; and drug management and patient care. Results A comprehensive set of best practice guidelines for clinical radiation safety during 177 Lu therapy has been developed based on the collective operational experience of a group of radiation safety professionals. Significant findings included that 177 Lu therapy is often safely administered in unshielded rooms, that staff radiation exposure associated with 177 Lu therapy is minimal relative to other nuclear medicine programs, and that some relatively simple preparation in advance including papering of common surfaces and planning for incontinence can effectively control contamination during therapy. Conclusion The guidance contained in this paper will assist radiation safety professionals in the implementation of safe, effective 177 Lu therapy programs, even at smaller sites with limited to no experience in therapeutic nuclear medicine.

Not all healthcare providers can afford to purchase commercially available programs that can quickly and easily provide peak skin dose estimations for patients undergoing diagnostic and international fluoroscopic procedures. The air kerma reference point exposure, Ka,r, available on all equipment manufactured after 2006, may over or under estimate the patient's peak skin dose. The total air kerma reference point exposure provided at the end of a case might be on the order of 20 Gy for a patient, indicating that a Joint Commission 'sentinel event' may have occurred. An investigation to determine whether a sentinel event has occurred becomes necessary. This article will introduce information available to the investigating health physicist for data mining, how to process that information, and then how best to interpret the results. I have used this system of data mining and analysis to effectively influence how physicians performing diagnostic and interventional fluoroscopic procedures use fluoroscopic equipment. Arriving at an answer is not simple; it is time consuming, and the methodologies are imperfect. Your effort can result in improved utilization of fluoroscopic equipment at your institution which in turn will lower patient and staff doses.

The field of medicine has been rapidly changing recently for providers and patients. This article considers how such changes have impacted the roles and responsibilities of the medical facility radiation safety officer. To supplement the personal experiences of the authors, a questionnaire soliciting voluntary feedback was submitted to a group of medical radiation safety officers. Several common themes emerged in the responses received, confirming that the role of the medical radiation safety officer has indeed changed concurrent with the changes occurring in medicine, frequently due to changing regulations and accreditation requirements in response to new and novel imaging and treatment modalities. Today’s medical radiation safety officer faces some daunting challenges, including limited staffing, incorporation of numerous accreditation standards, and maintenance of effective communication with administrators and other personnel. Nonetheless, respondents indicate that they have tremendous job satisfaction and embrace the changing landscape. Shared challenges and changes are discussed herein to provide readers with a perspective on the life of a medical center radiation safety officer.

Calcium ions are key signaling molecules in dendritic spines, the small neurotransmitter-receiving protrusions along dendrites. Their dynamics have been shown to regulate many downstream phenomena including synaptic plasticity and learning. Previously we and others have shown that the subcellular morphology of spines can affect signaling dynamics of Ca 2þ and cAMP. In this work we construct a reaction-diffusion Partial Differential Equation (PDE) model of the dynamics of calcium in response to varied electrical stimuli. On realistic mesh geometries of dendritic spines generated from 3D electron micrographs via our open-source workflow including softwares IMOD, GAMer 2, and Blender, the PDEs are solved using FEniCS, an open-source finite element solver. The resulting simulations across many dendritic spines are analyzed for correlations between calcium signals and spine geometries. We posit that these robust ultrastructure-signaling relationships represent possible mechanisms of how dendritic spines can learn and process information.