Radiation Safety in Nuclear Medicine : A Practical, Concise Guide

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 of Counts
		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	 Ion 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	 Liquid Scintillation Counter
	2.3	 Film Badge
	2.4	 Optically Stimulated Luminescence Dosimeter
	2.5	 Thermoluminescent Dosimeter
	2.6	 Electronic Digital Dosimeter
	2.7	 Neutron Detector
	References and Suggested Reading
3: Radiation Units, Radiation Exposure, and Absorbed Dose
	3.1	 Radiation Units
	3.2	 Radiation Exposure
		3.2.1	 Sources of Radiation
		3.2.2	 Planned Special Exposure
	3.3	 Absorbed Dose
		3.3.1	 External Dosimetry
		3.3.2	 Internal Dosimetry
		3.3.3	 Dose Limits to Radiation Workers and Others
	3.4	 Effective Dose Equivalent and Effective Dose
	3.5	 Reporting
	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	 Dos 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 Package
	4.6	 Requirement of Monitoring of Occupational Doses to Radiation Workers
	4.7	 Bioassay
	4.8	 Decommissioning of Radiation Laboratory
		4.8.1	 At Least 4 Weeks Ahead
		4.8.2	 2 Weeks Ahead
		4.8.3	 Closure
	4.9	 Verification Card for Radioactive Patient
	4.10	 Radiation Phobia
	4.11	 Reportable Events
	4.12	 Notification of Incidents
	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	 PET Radiopharmaceuticals
	5.4	 Radioactive Drug Research Committee
	5.5	 Accreditation of Nuclear Medicine Facility
		5.5.1	 Accreditation by IACNL
		5.5.2	 Accreditation by ACR
	References and Suggested Reading
6: Medical Uses of Radioactive Materials
	6.1	 Introduction
	6.2	 Application for License or Renewal
	6.3	 License, Amendment and Notification
	6.4	 Authorities and Responsibilities for Radiation Protection Program
		6.4.1	 Radiation Safety Officer
		6.4.2	 Radiation Safety Committee
	6.5	 Supervision
	6.6	 Training, Retraining, and Instructions to Workers
	6.7	 Written Directives
	6.8	 Authorization for Calibration, Transmission, and Reference Sources
	6.9	 Requirements for Possession of Sealed Sources
	6.10	 Sterile Preparation of Radioactive Drugs
	6.11	 Measurement of Dosage of Radiopharmaceutical for Patients
	6.12	 Permissible Concentration of 99Mo, 82Sr, and 85Sr in Radionuclide Generators
	6.13	 Use of Unsealed Byproduct Material Not Requiring Written Directive
	6.14	 Labeling of Vials and Syringes
	6.15	 Possession and Calibration of Survey Meter
	6.16	 Survey of Ambient Exposure Rate
	6.17	 Survey for Removable Contamination
	6.18	 Medical Mobile Service
	6.19	 Medical Uses of Byproduct Materials
	6.20	 Report and Notification of a Medical Event
	6.21	 Report and Notification of Dose to Embryo/Fetus or Nursing Child
	6.22	 Record Keeping
	References and Suggested Reading
7: Training and Experience of Authorized Personnel
	7.1	 Preamble
	7.2	 Training for Radiation Safety Officer and  Associate Radiation Safety Officer
	7.3	 Training for Authorized Medical Physicist
	7.4	 Training for Authorized Nuclear Pharmacist
	7.5	 Training for Authorized Users (Physicians)
		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: Emergency Procedures
	8.1	 Introduction
	8.2	 Basic Procedures for Containment of Spill
	8.3	 Personnel Contamination with Serious Injury
	8.4	 Radiological Dispersal Device
		8.4.1	 Measures Following Explosion of Radiological Dispersal Device
		8.4.2	 Get Inside
		8.4.3	 Stay Inside
		8.4.4	 Stay Tuned
		8.4.5	 Other Protection Steps
		8.4.6	 Effect of RDD Dispersion
		8.4.7	 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
	References and Suggested Reading
10: Disposal of Radioactive Waste
	10.1	 Rationale for Radioactive Waste Disposal
		10.1.1	 Decay-in-Storage
		10.1.2	 Disposal by Incineration
		10.1.3	 Disposal of Radioactive Material into Sewerage
		10.1.4	 Transfer to Authorized Recipients
		10.1.5	 Other Disposal Methods
	10.2	 Special Situations for Disposal of Radioactive Waste
		10.2.1	 Disposal of Gaseous Waste
		10.2.2	 Disposal of Sealed Sources
		10.2.3	 Management of Cadavers Containing Radioactive Materials
	10.3	 Record Keeping
	Reference and Suggested Reading
11: Transportation of Radioactive Material
	11.1	 Introduction
	11.2	 Definition
	11.3	 Packaging
		11.3.1	 Stability Tests for Packages
		11.3.2	 Labeling of Packages
	11.4	 Exemption for Limited Quantity of Radioactive Material
	11.5	 Empty Packaging
	11.6	 Vehicles for Transportation of Radioactive Material
	11.7	 Exemption for Licensed Physician
	11.8	 Employee Training
	11.9	 Record Keeping
	References and Suggested Reading
12: Biological Effects of Radiation in Humans
	12.1	 Radiation Damage in Genes and Chromosomes
	12.2	 Factors Affecting Radiation Damage in Genes and Chromosomes
		12.2.1	 Dose and Dose Rate
		12.2.2	 Linear Energy Transfer
		12.2.3	 Radiosensitizer and Radioprotector
		12.2.4	 Cell Cycle
	12.3	 Acute Effects of Total-Body Irradiation
		12.3.1	 Hematopoietic Syndromes
		12.3.2	 Gastrointestinal Syndromes
		12.3.3	 Cerebrovascular Syndromes
	12.4	 Long-Term Effects of Radiation
		12.4.1	 Carcinogenesis
		12.4.2	 Dose-Response Relationship
		12.4.3	 Specific Cancers
	12.5	 Radiation Damage to Embryo and Fetus
		12.5.1	 Preimplantation Period
		12.5.2	 Major Organogenesis
		12.5.3	 Fetal Stage
	12.6	 Genetic Effects
	12.7	 Risk Versus Benefit in Diagnostic Radiology and Nuclear Medicine Procedures
	References and Suggested Reading
Appendix A: Units and Constants
	Energy
	Charge
	Mass and Energy
	Length
	Activity
	Constants
Appendix B: Terms Used in the Text
Appendix C: Abbreviations Used in Text
Appendix D: Typical NRC Notification and Reporting Requirements for Different Situations
Appendix E: Radioactive Decay of 99mTc
Appendix F: Radioactive Decay of 131I
Appendix G: Radioactive Decay of 18F
Appendix H: Frequency of Essential Chores in Nuclear Medicine
Index