[Radiation exposure in the environment of patients after application of radiopharmaceuticals. Part 2: Therapeutic procedures].
OBJECTIVE
After therapeutical application of radionuclides the patient has to be regarded as a radioactive source. The radiation exposure differs from diagnostic nuclear medicine due to the amount of radioactivity and due to beta-radiation. Measurements of photon dose rates were carried out and estimates of beta-radiation outside the patient using Monte-Carlo methods. Calculations of maximum beta-ranges in tissue were also performed. Detailed knowledge of the radiation exposure close to the patient is of major importance with respect to radiation protection of the staff.


METHODS
Photon dose rates for 32 patients were determined after treatment with [131I]NaI and [131I]meta-iodobenzylguanidin, [32P]Na2HPO4, [90Y]Zevalin and [153Sm]EDTMP. Readings were taken immediately after application at eight distances.


RESULTS
For therapies with 131I photon dose rates amount to 2 mSv.h(-1).GBq(-1) close to the patient. Taking the typical activities of 3.7 GBq for thyroid carcinoma and up to 11 GBq for mIBG therapies into account this leads to a considerable radiation exposure of approximately 7.5 mSv/h and 20 mSv/h, respectively. At a distance of 2 m the dose rates fall to 1/100 compared to the vicinity. For 153Sm the maximum of 100 microSv.h(-1).GBq(-1) is significantly lower compared to therapies using radioiodine. After application of 32P or 90Y all photon dose rates are lower (<10 microSv.h(-1).GBq(-1)) but in both cases high energy beta-particles associated with high maximum ranges exceeding 1 cm in tissue have to be considered.


CONCLUSIONS
The remarkable difference of the dose rates in the vicinity of the radioactive patient compared to readings at 2 m distance underlines the major importance of the distance for radiation protection. After application of nuclides emitting high energy beta-particles their contribution outside the patient should be considered. For typical procedures in the patient's vicinity the radiation exposure of the personnel remains below the annual limit of 20 mSv.
Sudbrock
F
F
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Kerpener Str. 62, 50937 Köln. Ferdinand.Sudbrock@uni-koeln.de
Boldt
F
F
Kobe
C
C
Hammes
J
J
Eschner
W
W
Schicha
H
H
D000388:Air / Q000032:analysis; D004583:Electrons; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D007297:Inpatients; D007457:Iodine Radioisotopes / Q000032:analysis; D009010:Monte Carlo Method; D017785:Photons / Q000009:adverse effects; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D018570:Risk Assessment
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals