title: Exposure of treating physician to radiation during prostate brachytherapy using iodine-125 seeds: dose measurements on both hands with thermoluminescence dosimeters.
abstract: OBJECTIVE
  Only sparse reports have been made about radiation exposure of the treating physician during prostate seed implantation. Therefore, thermoluminescence dosimeter (TLD) measurements on the index fingers and the backs of both hands were conducted.
  
  
  METHODS
  Stranded iodine-125 seeds with a mean apparent activity of 27.4 MBq per seed were used. During application, the treating physician manipulated the loaded needle with the index fingers, partially under fluoroscopic control. Four physicians with varying experience treated 24 patients. The radiation exposure was determined with TLD-100 chips attached to the index fingertips and the backs of hands. Radiation exposure was correlated with the physician's experience.
  
  
  RESULTS
  The average brachytherapy duration by the most experienced physician was 19.2 min (standard deviation sigma = 1.2 min; novices: 34.8 min [sigma = 10.2 min]). The mean activity was 1,703 MBq (sigma = 123 MBq), applied with 16.3 needles (sigma = 2.5 needles; novices: 1,469 MBq [sigma = 229 MBq]; 16.8 needles [sigma = 2.3 needles]). The exposure of the finger of the "active hand" and the back of the hand amounted to 1.31 mSv (sigma = 0.54 mSv) and 0.61 mSv (sigma = 0.23 mSv), respectively (novices: 2.07 mSv [sigma = 0.86 mSv] and 1.05 mSv [sigma = 0.53 mSv]).
  
  
  CONCLUSIONS
  If no other radiation exposure needs to be considered, an experienced physician can perform about 400 applications per year without exceeding the limit of 500 mSv/year; for novices, the corresponding figure is about 200.
authors.affiliation: Department of Radiooncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. Johann.Schiefer@KSSG.ch
authors.forename: Hans
authors.initials: H
authors.lastname: Schiefer
authors.forename: Friedrich
authors.initials: F
authors.lastname: von Toggenburg
authors.forename: Wolf
authors.initials: W
authors.lastname: Seelentag
authors.forename: Ludwig
authors.initials: L
authors.lastname: Plasswilm
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ries
authors.forename: Cornelius
authors.initials: C
authors.lastname: Lenggenhager
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Schmid
authors.forename: Thomas
authors.initials: T
authors.lastname: Leippold
authors.forename: Ladislav
authors.initials: L
authors.lastname: Prikler
authors.forename: Bernd
authors.initials: B
authors.lastname: Krusche
authors.forename: Jakob
authors.initials: J
authors.lastname: Roth
authors.forename: Daniel
authors.initials: D
authors.lastname: Engeler
mesh_terms: D001822:Body Burden; D001918:Brachytherapy; D005385:Fingers / Q000528:radiation effects*; D006225:Hand / Q000528:radiation effects*; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009367:Neoplasm Staging; D009784:Occupational Diseases / Q000517:prevention & control; D016273:Occupational Exposure; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control; D011835:Radiation Protection; D013819:Thermoluminescent Dosimetry
chemical_list: D007457:Iodine Radioisotopes