Are Medical Personnel Safe from Radiation Exposure from Patient Receiving Radioiodine Ablation Therapy?

갑상선 암의 방사성요오드 치료 시 의료진은 방사선 피폭으로부터 안전한가?

  • Kim, Chang-Guhn (Department of Nuclear Medicine, Wonkwang University School of Medicine) ;
  • Kim, Dae-Weung (Department of Nuclear Medicine, Wonkwang University School of Medicine)
  • 김창근 (원광대학교 의과대학병원 핵의학과) ;
  • 김대응 (원광대학교 의과대학병원 핵의학과)
  • Published : 2009.08.30

Abstract

Radioiodine ablation therapy has been considered to be a standard treatment for patient with differentiated thyroid cancer after total thyroidectomy. Patients may need to be hospitalized to reduce radiation exposure of other people and relatives from radioactive patients receiving radioiodine therapy. Medical staffs, nursing staffs and technologists sometimes hesitate to contact patients in radioiodine therapy ward. The purpose of this paper is to introduce radiation dosimetry, estimate radiation dose from patients and emphasize the safety of radiation exposure from patients treated with high dose radioiodine in therapy ward. The major component of radiation dose from patient is external exposure. However external radiation dose from these patients treated with typical therapeutic dose of 4 to 8 GBq have a very low risk of cancer induction compared with other various risks occurring in daily life. The typical annual radiation dose without shielding received by patient is estimated to be 5 to 10 mSv, which is comparable with 100 to 200 times effective dose received by chest PA examination. Therefore, when we should keep in mind the general principle of radiation protection, the risks of radiation exposure from patients are low and the medical personnel are considered to be safe from radiation exposure.

Keywords

References

  1. Cember H. Introduction to Health Physics. 3rd ed. McGraw-Hill; 1996. p. 148
  2. Hubbell JH. Photon mass attenuation and energy-absorption coefficients from 1 keV to 20 MeV. Int J Appl Radiat Isotopes 1982;33:1289-93 https://doi.org/10.1016/0020-708X(82)90248-4
  3. Cherry SR, Sorenson JA, Phelps ME. Physics in Nuclear Medicine. 3rd ed. Philadelphia: Saunders; 2003. p. 434
  4. Edward WW. Radiation protection in nuclear medicine In: Taveras JM, Ferrucci JT. Radiology Diagnosis Imaging Intervention. Philadelphia: J. B. Lippincott Company; 1986. p. 11
  5. Wasserman H, Groenewald W, Air kerma rate constants for radionuclides. Eur J Nucl Med 1988;14:569-71 https://doi.org/10.1007/BF00286779
  6. Groenewald WA, Wasserman HJ. Constants for calculating ambient and directional dose equivalents from radionuclide point sources. Health Physics 1990;58:655-8
  7. International Commission on Radiological Protection. 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP 1991;21:82-7
  8. Stabin MG: MIRDOSE: Personal computer software for internal dose assessment in nuclear medicine. J Nucl Med 1996;37:538-46
  9. Chandra R. Nuclear Medicine Physics the basics, 5th ed. Baltimore: Williams & Wilkins; 1998. p. 64-7
  10. International Commission on Radiological Protection. Dose Coefficients for Intakes of Radionuclides by Workers. ICRP Publication 68. Ann ICRP 1994;24:13-73
  11. Stabin MG, Stubbs JB, Toohey RE: Radiation Dose Estimates for Radiopharmaceuticals (ORNL Report NUREG/CR-6345). Oak Ridge, TN, Oak Ridge Institute for Science and Education; 1996. Also available electronically at http://orise.orau.gov/reacts/dose-estcompendia.htm. Accessed June 12, 2009
  12. International Commission on Radiological Protection. Release of Patients after Therapy with Unsealed Radionuclides. ICRP Publication 94. Ann ICRP 2004;34:13-27
  13. Jacobson AP, Plato PA, Toeroek, D. Contamination of the home environment by patients treated with iodine-131: initial results. Am J Public Health 1978;68:225-30 https://doi.org/10.2105/AJPH.68.3.225
  14. Lubin, E. Definitive improvement in the approach to the treated patient as a radioactive source. J Nucl Med 2002;43:364-5
  15. Siegel JA, Marcus CS, Sparks RB. Calculating the absorbed does from radioactive patients : the line-sourceversus point-source model. J Nucl Med 2002;43:1241-4
  16. Barrington SF, Kettle AG, O'Doherty MJ, Wells CP, Somer EJ, Coakley, AJ. Radiation does rates from patients receiving iodine-131 therapy for carcinoma of the thyroid. Eur J Nucl Med 1996;23:123-30 https://doi.org/10.1007/BF01731834
  17. Hilditch TE, Connell JM, Davies OL, Watson WS, Alexander WD. Radiological protection guidance for radioactive patients-new data for therapeutic 131I. Nucl Med Commun 1991;12:485-95 https://doi.org/10.1097/00006231-199106000-00003
  18. O'Doherty MJ, Kettle AG, Eustance CN, Mountford PJ, Coakley AJ. Radiation does rates from adult patients receiving 131I therapy for thyrotoxicosis. Nucl Med Commun 1993;14:160-8 https://doi.org/10.1097/00006231-199303000-00003
  19. Driver I, Packer S. Radioactive waste discharge quantities for patients undergoing radioactive iodine therapy for thyroid carcinoma. Nucl Med Commun 2001;22:1129-32 https://doi.org/10.1097/00006231-200110000-00012
  20. Culver CM, Dworkin HJ. Radiation safety considerations for post-iodine-131 hyperthyroid therapy. J Nucl Med 1991;32:169-73
  21. National Radiological Protection Board. A national Survey of Doses to- Patients Undergoing a Selection of Routine X-ray Examinations in English Hospitals. NRPB-R200; 1986 and Survey of CT practice in the UK, Part 2: Dosimetric Aspects. NRPBR249;1991. Chilton, Didcot, Oxon
  22. Royal College of Radiologists. Making the Best Use ell Department of Clinical Radiology. 4th ed. Royal College of Radiologists. London. 1998
  23. Hall EJ. Radiobiology for the Radiologist. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 208-9
  24. Little JB. Biologic Effects of Low-Level Radiation Exposure. In: Taveras JM, Ferrucci JT. Radiology Diagnosis Imaging Intervention. Philadelphia: J. B. Lippincott Company; 1986. p. 11
  25. Cohel BL. Catalog of risks extended and updated. Health Phys 1991;61:317-35 https://doi.org/10.1097/00004032-199109000-00002