Less-restrictive, patient-specific radiation safety precautions can be safely prescribed after permanent seed implantation.
OBJECTIVE
To use radiation exposure rate measurements to determine patient-specific radiation safety instructions with the aim of reducing unnecessary precaution times and to evaluate potential doses to members of the public.


METHODS
Radiation exposure rate measurements were obtained from 1279 patients with Stage T1-2 prostate cancer who underwent transperineal (125)I or (103)Pd seed implantation from January 1995 through July 2008. An algorithm was developed from these measurements to determine the required precaution times to maintain public effective doses below 50% of the limits for specific exposure situations.


RESULTS
The median air kerma rates at 30 cm from the anterior skin surface were 4.9 microGy/h (range: 0.1-31.5) for (125)I and 1.5 microGy/h (range: 0.02-14.9) for (103)Pd. The derived algorithms depended primarily on the half-life T(p), the measured exposure rate at 30 cm, and specific exposure situation factors. For the typical (103)Pd patient, no radiation safety precautions are required. For the typical (125)I patient, no precautions are required for coworkers, nonpregnant adults who do not sleep with the patient, or nonpregnant adults who sleep with the patient. Typical (125)I patients should only avoid sleeping in the "spoon" position (i.e., in contact) with pregnant adults and avoid holding a child for long periods of time in the lap for about 2 months.


CONCLUSIONS
The large number of cases available for this study permitted the development of an algorithm to simply determine patient-specific radiation safety instructions. The resulting precaution times are significantly less restrictive than those generally prescribed currently.
Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. dauerl@mskcc.org
Lawrence T
LT
Dauer
Marisa A
MA
Kollmeier
Matthew J
MJ
Williamson
Jean
J
St Germain
Joaquin
J
Altamirano
Yoshiya
Y
Yamada
Michael J
MJ
Zelefsky
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001822:Body Burden; D001918:Brachytherapy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods / Q000706:statistics & numerical data*; D011868:Radioisotopes / Q000032:analysis*; D011874:Radiometry / Q000379:methods* / Q000706:statistics & numerical data; D011879:Radiotherapy Dosage; D012062:Relative Biological Effectiveness
D011868:Radioisotopes