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Nuclear - Radiation Safety, Radiopharmaceuticals Flashcards

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1
Q

What is the uniformity standard performance parameter for detectors in SPECT?

A
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2
Q

Describe the findings

A

Uniformity test

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3
Q

Describe the findings

A

Cracked crystal

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4
Q

Describe how to measure change in sensitivity?

A

record the time taken to acquire a preset number of counts using a set dose

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5
Q

What is the cause of “ring artifact” on SPECT imaing?

A

non-uniformity on SPECT

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6
Q

How frequently should these QC measures be performed:

  • COR
  • Plexiglas phantom
  • Uniformity correction
A
  • COR –> weekly or monthly
  • Plexiglas phantom –> quarterly or annually
  • Uniformity correction –> manufacturer recommendation
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7
Q

What are examples of COR artifacts?

A
  • Doughnut artifact (360 degrees)
  • Tuning fork artifact (180 degrees)
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8
Q

What is a survery meter (Geiger counter, Geiger-Mueller counter, GM counter)?

A

used daily to detect radioactive contamination in labs

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9
Q

What are QC checks that should be done on survey counters daily?

A
  • Battery check
  • Source check
    • ensure meter responds to radiation
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10
Q

How often should survey counter calibration be performed?

A

annually

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11
Q

What are the standard testing done on dose calibrators?

A
  • Background
  • Voltage
  • Accuracy
  • Constancy
  • Linearity
  • Geometry
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12
Q

What are common isotopes used for annual dose calibrator accuracy testing?

A
  • Co-57
  • Cs-137

*** Results must be within 5%

****sources must be traceable to the National Institute of Standards and Technology (NIST)

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13
Q

What does a geometry test measure?

A

ability of the dose calibrator to measure accurately with consistent activity at different volumes

  • performed at installation, recalibration, “plug-in”
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14
Q

What is a constancy test?

A
  • designed to show that a long half-life source yields reproducible readings
    • within 5% of decay corrected accuracy readings
    • check each setting (isotope) button
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15
Q

What is a linearity test?

A

assesses ability to read both high and low activity (range)

  • performed quarterly
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16
Q

What is a Rad?

A
  • radiation absorbed dose
  • energy absorbed in material
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17
Q

What is a Gray?

A

100 Rad = 1 Gray

SI unit for Radiation Absorbed Dose

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18
Q

Define Relative Biological Effectivenss (RBE)

A
  • ratio of biological effectiveness of one type of ionizing radiation relative to another, given the same amount of absorbed energy
  • different types of radiation have diffierent biologic burdens
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19
Q

How can you calculate a Roentgen Equivalent Man (Rem)?

A

Rem = Rad x QF

  • 1 Rad gamma rays = 1 Rem
  • 1 Rad alpha particles = 20 Rem
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20
Q

What is the international unit for Rem

A

Sievert (Sv)

  • 100 Rem = 1 Sv
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21
Q

Describe the radiological units summary

  • Roentgen (R)
  • Rad
  • Rem
  • SI units
    • Gray (Gy)
    • Sievert (Sv)
A
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22
Q

What are the Quality Factors (QF):

  • XR, Gamma rays
  • Beta particles
  • Neutrons and Protons
  • Alpha particles
A
  • XR, Gamma rays –> 1.0
  • Beta particles –> 1.0
  • Neutrons and Protons –> 10
  • Alpha particles –> 20
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23
Q

What is the international unit to express dose equivalent?

A

Sievert (Sv)

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24
Q

What are the assumptions and limitations of the Medical Internal Radiation Dose (MIRD) method?

A
  • radioactivity is uniformly distributed in the organ
  • organ size assumed for the standard person
  • cellular level micro-dosimetry is not modeled
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25
What is the effective radiation dose per examination: * Tc99m Sestamibi * Tl201 * Cardiac cath * CT angio * CXR
26
What is the dose limit: * non-occupational dose limits from occupational sources (shielding of rooms, breastfeeding)
1 mSv (100 mRem)
27
What is the dose limit: * infrequent exposure from other's medical procedures (family member, release to public)
5 mSv (500 mRem)
28
What is the dose limit: * occupational dose limits
* models determining the equivalent chance of developing major cancer = as that of a major work related event
29
What are the Quarterly ALARA Investigational Levels?
30
What steps should be taken if you reach a Quarterly ALARA investigational level?
* Level I --\> Notify and action taken at RSO discretion * Level II --\> Investigate and take action
31
What is the natural background received by a person living the US each year?
**300 mRem/year**
32
What is the annual whole-body dose limit for an occupational worker?
**5 Rem or 0.05 Sv**
33
What is the dose limit: * Pregnant workers
**500 mRem (5 mSv) over gestation period** * \< 50 mRem / month * fetus is a non-occupational worker
34
What are the regulations for breastfeeding?
reduce the dose to a newborn infant to **\< 1 mSv (actual regulation is \< 5 mSv)**
35
What is the unit equivalent: * 1 Rem --\> mSv
1 Rem --\> **10 mSv**
36
What are the requirements for personnel monitoring?
* any occupational woker likely to exceed 500 mRem/year and/or * those who handle millicurie amounts of radioactive material (license requirement)
37
What are the main types of devices used for personnel monitoring?
* Film badges * Thermo Luminscent Devices (TLD) * Optically Stimulated Luminescence (OSL) * Pocket Ion Chamber
38
What is ALARA?
As Low as Reasonably Achievable * 10% of occupational dose limits * 10% of limit (5 Rem/yr) = 500 mRem/year
39
What are the components of ALARA?
* Time * Distance * Shielding
40
Define Inverse Square Law
maintain a distance from a known radiation source * Intensity = 1 / d2 * increase distance --\> reduce by a squared factor
41
What is the unit equivalent: * 1 mRem --\> μSv
1 mRem --\> **10 μSv**
42
What is the unit equivalent: * 100 Rem --\> Sv
100 Rem --\> **1 Sv**
43
What are the principles of shielding: * Alpha particles * Beta particles * Gamma rays
44
Define Half-Value Layer
amount of material needed to reduce the intensity by half * synonymous with half-life
45
What are the HVL's (in Pb): * Tc99m * F18 * Cs137
46
Describe deterministic effects
* **Threshold dose** below which no effect is observed * Severity increases with dose (commonly from cell death) * Examples: skin erythema, dermatitis, cataracts, sterility, hematopoietic syndrome
47
Describe Stochastic Effects
* Incidence (**_probability)_** increases with dose - not severity * No dose threshold * Basis for ALARA principle of radiation protection * Example: Late induced malignant neoplasm * "Linear No-threshold" theory
48
What are the ways to handle waste management?
* Decay in storage * Transfer to authorized recipient * Sewage * Atmosphere
49
What are the rules for Decay In Storage?
* Waste with half-life of \< 120 days * Store in shielded container * Label with date and longest lived isotope * Survey to ensure indistinguishable from background * Remove all radioactive labels prior to final disposal * Maintain record of disposal for a minimum of 3 years
50
What are the rules for receiving radioactive material?
* Package must be monitored within _3 hours (start of buisness, if before hours)_ * Wear gloves * Visually inspect for problems * Measure 1 meter exposure (report if problem; \> 10 mR/hr report to DOH) * Wipe test if contamination is suspected
51
Describe the meaning of the package:
**Type III - Yellow** * Surface exposure \< 200 mRem/hr * 1 meter exposure \< 10 mRem/hr * Surface wipe test \< 6600 dpm/300 cm2
52
Describe the meaning of the package:
* Surface exposure \< 50 mRem/hr * 1 meter exposure \< 1 mRem/hr * Surface wipe test \< 6600 dpm / 300 cm2
53
Describe the meaning of the package:
* Surface exposure \< 0.5 mRem/hr * 1 meter exposure - not detectable * Surface wipe test \< 6600 dpm / 300 cm2
54
What is the package label required for limited quantities of radioactive material?
Excepted Package, Limited Quantity
55
What are the Excepted Package, Limited Quantities of the following: * Tc99m * Co57 * Tl201 * F18
* Tc99m --\> 11 mCi * Co57 --\> 27 mCi * Tl201 --\> 11 mCi * F18 --\> 1.6 mCi
56
What if a package has more than one isotope, how is the amount quantified?
max quantity defaults to the lower limit
57
When are medical misadministrations reportable to NRC?
* \> 5 Rem (0.05 Sv) to the whole body * \> 50 Rem (0.5 Sv) to any individual organ
58
Describe the meaning of the sign
Radioactive material * areas where material are used / stored
59
Describe the meaning of the sign
Radiation area * Individuals could exceed a dose of \> 5 mRem in an hour * 30 cm from a source or any surface where radiation penetrates
60
Describe the meaning of the sign
High Radiation Area * Individuals could exceed a dose of \> 100 mRem in an hour * 30 cm from a source or any surface where radiation penetrates
61
What are the half-lives of the following radionuclides? * F18 * Tc99m * Tl201 * Co57
* F18 --\> 110 minutes * Tc99m --\> 6 hours * Tl201 --\> 73 hours / 3 days * Co57 --\> 271.7 days
62
Describe the relationship between: * physical half-life * biologic half-life
(1/Te) = (1/Tp) + (1/Tb) * Tp = physical half life * Tb = biologic half life * Te = effective half-life
63
What is an example of a radionuclide useful for quality assurance and calibration of PET scanners?
**Germanium-68**
64
What are required regulations under the Nuclear Regulatory Commission (NRC) for the possession of radiaoctive material?
* Limits of radioactive material possessed at any given time * Disposal of radioactive material * Use of radioactive material **\*\*\* Cost of radioactive material not required**
65
What is the radiation cut-off that does not require posting of a sign?
areas where a person receives \< 2 mrem / hr
66
Caution: Very High Radiation Area sign should be posted in an area where radiation exceeds this amount?
**500 rads / hr at 1m from the source**
67
What does the transportation index found on a radioactive shipment package measure?
**Exposure measurement at 1m from the surface of the package** ## Footnote ​
68
What instrument is used to measure removable contamination on a radioactive package?
**well counter** * most sensitive and practical for measuring the swipes that are used to test packages delivered to a nuclear laboratory
69
A 65 year old male presents with A-fib. He was started on a Heparin drip. A multigated (MUGA) acquisition scan was ordered to evaluate the LVEF. What is the most appropriate choice for labeling the RBC for this patient?
**Ultratag** * composed of stannous citrate along with acid citrate dextrose and sodium hypochlorite * labeling RBCs by this pharmaceutical is by in **"in vitro"** method * labeling efficiency \> 97%
70
What RBC labeling agent is contraindicated with Heparin use?
**Sn-Pyrophate** * heparin is one of the drugs that inhibit the diffusion of stannous ion to the RBC with the use of Sn-Pyrophate * labeling is compromised --\> some of Tc99m-pertechnetate is reduced
71
Why should BB and nitrates be held prior to stress testing? How long should they be held prior to testing?
* they may decrease the detection of ischemia * should be held 12-24 hours prior to testing
72
What is the most appropriate monitoring device for measurement of occupational dose for a radiation worker?
**Photographic film badge**
73
How long should one abstain from breastfeeding following a stress Tl201 study?
**at least 2 weeks following the study** * T 1/2 = 73 hours
74
What is the NRC annual body radiation exposure limit for radiation?
* **1.25 Rem/quarter year** * **5 Rem / year**
75
What survey frequency is mandated by the NRC for radioactive materials areas?
**Daily** * in accordance with ALARA principles, the NRC requires that daily surveys be performed with a survey instrument at the end of each day
76
What is the appropriate DOT label for package shipping: * Surface radiation exposure - 5 mR/h * 1 m from surface - 0.2 mR/h
**Yellow II**
77
For a Tc99m, 1 day, rest/stress sequence, How long after the resting injection should the acquisition be performed?
**30 minutes (ideally 30-60 minutes)** * time delay after injection is to allow clearance from the liver and maximize the myocardial uptake * at 15 minutes --\> too much liver activity --\> contaminates inferior wall * \> 2 hours --\> liver clearance but increased probability of bowel loop uptake
78
What is the optimum "rest" dose range for a 1-day rest/stress Tc99m SPECT MPI study?
**8-12 mCi** * rest dose should be approximately **1/3 of the stress dose** * with some variation introduced by the length of time between the 2 studies
79
Describe 1-day rest/stress Tc99m SPECT MPI study rest/stress doses * Why? * What are the effect on intervals?
* 1:3 ratio (rest/stress) * stress dose overcomes the smaller rest dose so that the stress images have less residual activity form the rest study * Interval between studies * Short --\> higher stress dose * Longer --\> lower stress dose (1:3 may not be needed)
80
1-day rest/stress Tc99m SPECT MPI study * What is the effect if a lower stress dose is used without enough time between injections?
* there will be residual activity from the rest study * this can underestimate the amount of ischemia present
81
When can rest/stress imaging be started in a 1-day rest/stress Tc99m SPECT MPI study: * Rest images * Stress images
* Rest images --\> **30-60 minutes** post-injection * Stress images --\> * **10-20 minutes** after exercise * **30-60 minutes** after pharmacologic
82
Tc99m labeled perfusion tracers have improved SPECT perfusion imaging relative to Tl201 due to this characteristic?
**Higher photon energy resulting in less tissue attenuation** * also has shorter half-life allowing administration of a much higher dose but less total body radiation
83
Describe the interaction between Quantitative analysis and AC in SPECT imaging? * gender differences * normalcy * specificity
* AC gender maps are not different between males and females * AC improves normalcy \> Quantitative analysis * Specificity of a positive finding is higher in images interprested with AC
84
What is the maximum permissible activity concentration of molybdenum-99 to Tc99m as stipulated by NRC?
**0.15 μCi / mCi at the time of administration to the patient**
85
What are regulations related to Aluminum ion concentrations? Who regulates these concentrations?
* **Limts are 10 μg/mL of eluate** * **US Pharmacopeia (USP-XXIII)**
86
What is the average ionizing radiation received annually?
**620 mRem (6.2 mSv) per year**
87
How should Tc99m radioactive waste generated in a nuclear medicine department be disposed?
**Store in-house for decay to _background radiation level_ before disposal**

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