Exposure of medical personnel to radiation during radionuclide therapy practices

Lancelot, Sophie; Guillet, Benjamin; Sigrist, Sophie; Bourrelly, Marc; Waultier, S; Mundler, O.; Pisano, Pascale

doi:10.1097/mnm.0b013e3282f4973a

Cited by 15 publications

(11 citation statements)

References 15 publications

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“…A France group calculated for six treatment using 90 Y whole body dose of 21 μSV for the therapist. [ 19 ] However, the highest radiation exposure appears at the finger pulp, especially at the left thumb and forefinger, which the injection needle is fixed. A treatment using 185 MBq of 90 Y leads to a radiation absorbed does to finger pulp of thumbs of 4 mSv (22.1 μSv/MBq).…”

Section: Radiation Exposurementioning

confidence: 99%

Radiosynovectomy in the Therapeutic Management of Arthritis

Liepe

2015

World J Nucl Med

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Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000–60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy. The special focus in these countries is maintaining of mobility and work ability. Often only the knee and medium joints (ankle, elbow and shoulder) are treated using yttrium-90, rhenium-186 or phosphorus-32. However, in rheumatoid arthritis most common affected joints are the fingers. For the treatment in these small joints, erbium-169 is necessary. Unfortunately, erbium-169 is only available in Europe. Further indications for radiosynovectomy are osteoarthritis and the articular effusion after joint replacement. The reported response rates in rheumatoid and poly-arthritis range from 60% to 80% depends from the stage of previous arthrosis. The best effectiveness of therapy was observed in hemophilic arthritis with response rate of 90% and significant reducing of bleeding frequency. The therapy is well-tolerated with low rate of side effects. In respect of the specific uptake of particles in the synovia and short range of beta radiation, the radiation exposure outside the joint is very low. The radiosynovectomy has efforts in comparison to surgical synovectomy: it's a minor intervention with low costs; and simultaneous treatments of multiple joints or treatment in short intervals are possible. The presented paper summarized the published papers and reports our own experiences in >15,000 treated joints.

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Section: Radiation Exposurementioning

confidence: 99%

Radiosynovectomy in the Therapeutic Management of Arthritis

Liepe

2015

World J Nucl Med

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“…As Lancelot et al [18] These values can be compared with the typical finger doses measured in our centre before introducing 90 Y treatments (the skin equivalent dose resulted in about 10 mSv for both chemists and physicians by a ring dosimeter worn at the base of a finger), which imply more than doubling the finger doses for people involved in these procedures and justify the higher attention paid to radioprotection techniques.…”

Section: Resultsmentioning

confidence: 95%

Radiation protection in 90Y-labelled DOTA-D-Phe1-Tyr3-octreotide preparations

Grassi¹,

Sghedoni²,

Asti

et al. 2009

Nuclear Medicine Communications

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“…In fact, a comparison of the data in the literature shows that beta-emitter handling can involve potentially higher finger doses than similar practices in nuclear medicine (Saether et al 2005;Cremonesi et al 2006;Covens et al 2007). This justifies greater attention in choosing individual protection devices and radiation monitoring systems (Lancelot et al 2008;Grassi et al 2009). For this reason, the dose to the skin is evaluated for each radiolabeling by using specific fingertip dosimeters.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two Different Types of Lif:mg,cu,p Thermoluminescent Dosimeters for Detection of Beta Rays (Beta-Tlds) From 90sr/90y, 85kr and 147pm Sources

et al. 2011

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Targeted radionuclide therapies in nuclear medicine departments increasingly depend on using unsealed beta radiation sources in the labeling of peptides and antibodies. Monitoring doses received by the fingers and hands during these procedures is best accomplished with TLD dosimeters that can be located at the fingertips. The present study examines the response of two TLD dosimeters (MCP-Ns and GR200A) to 90Sr/90Y, 85Kr, and 147Pm. The dosimeters were supplied by two different services, and all irradiations were performed at the PTB Institute in Germany. Each dosimetry service evaluated the dosimeters without knowledge that they had been purposefully irradiated. The accuracy and precision of the dosimeters were evaluated as a function of delivered dose, energy of beta particles and angular incidence. The results are compared to performance measures recommended by the IEC. Both dosimeter types displayed significant energy dependence. Angular dependence was moderate. Accuracy and precision as a function of dose (linearity) differed between the two systems, with the MCP-Ns being noticeably better than the GR200A. The superior precision makes the MCP-Ns much more useful for extremity dose measurements. The differences between these two dosimeter systems reinforce the need to evaluate a dosimeter carefully before using it in the daily work routine.

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Exposure of medical personnel to radiation during radionuclide therapy practices

Cited by 15 publications

References 15 publications

Radiosynovectomy in the Therapeutic Management of Arthritis

Radiosynovectomy in the Therapeutic Management of Arthritis

Radiation protection in 90Y-labelled DOTA-D-Phe1-Tyr3-octreotide preparations

Comparison of Two Different Types of Lif:mg,cu,p Thermoluminescent Dosimeters for Detection of Beta Rays (Beta-Tlds) From 90sr/90y, 85kr and 147pm Sources

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