Radionuclide therapy for radiation safety

Question 1

What IRR17 radiation protection considerations are required with regards to radionuclide therapy?

Answer 1

• Risk assessment.
• Controlled area.
• Local rules.
• Staff training.
• Contact restrictions.

Question 2

What differences are apparent with preparation and administration between diagnostic and therapy nuclear medicine treatments?

Answer 2

• Radionuclides, activities and energies of emissions.
• Therapy doses often supplied as patient dose so less manipulation required.
• Classified worker designation likely due to skin dose and needlestick injury.
• Therapy shielding will often include perspex to shield from beta emissions.

Question 3

What hazards does a radionuclide therapy patient present? What steps may be taken if hazards are large?

Answer 3

• External radiation.
• Contamination from excretion.
• Patient may be kept as an in patient after treatment (hazards, patient experience and costs must be considered).

Question 4

Which groups of people might a radionuclide therapy risk assessment consider?

Answer 4

• NM staff.
• Ward staff.
• Domestic staff.
• Friends & family.
• General public.
• Carers & comforters.

Question 5

What reasonably foreseeable accidents may require consideration for radionuclide therapy risk assessment?

Answer 5

• Patient requiring emergency care (care takes precedent over radiation risks).
• Death of a patient (autopsy, embalmment, burial etc.).
• Blood samples from patient and risks to staff.
• Other typical NM contingency plans (contamination, fire etc.).

Question 6

What additional measures may be considered for pregnant or breastfeeding staff?

Answer 6

Work restrictions relating to decontamination or entering controlled area after therapy administration.

Question 7

Which staff groups require special training for radionuclide therapy inpatients?

Answer 7

• RPS.
• Ward staff.
• Domestics.
• Doctors.

Question 8

What should be considered in terms of contact restrictions?

Answer 8

• Instructions usually to minimised contact with others post-therapy. This may be based on predetermined restrictions depending on activity administered.
• However, individual needs may need to be considered and bespoke risk assessments are sometimes performed. Models are available to calculate contact restriction times based on treatment, dose rates, contact patterns etc.

Question 9

What visiting restrictions are typically imposed?

Answer 9

Distance and time restrictions to reduce external exposure and risk of contamination.