Special Radiation Protection Precautions in Therapeutic Nuclear Medicine

Therapeutic Nuclear Medicine concerns the administration of appropriate amounts of radioactivity of certain isotopes, in order to achieve internal localized irradiation of neoplasmatic cells. Due to the increased level and the specific isotope characteristics of administered radioactivity, special Radiation Protection precautions must be taken. This study addresses such issues, based on national as well as international legislation and guidelines. Application of the principle of optimization is of outmost importance and is based on individual dose planning. The decision about the release of Nuclear Medicine patients after therapy is determined on an individual basis, taking into account patients' pattern of contact with other people, their age and that of persons in the home environment, in addition to other factors. Estimation of the absorbed dose given to the treated organ is based on uptake measurements and other biokinetic data, as well as on the mass of the treated tissue or organ. Concerning pregnant women, the rule of thumb is that they should not be treated, unless the radionuclide therapy is required to save their lives. In that case, the potential absorbed dose and risk to the foetus should be estimated and conveyed to the patient. After radionuclide therapy, a female should be advised to avoid pregnancy for the period of time depending on the specific radionuclide. This is to ensure that the dose to a conceptus/foetus would probably not exceed 1 mGy (the member of the public dose limit). The radiation risk for relatives and caregivers is small and unlikely to exceed the legal dose constraints during the period of the patient's treatment. Solid waste from the patient's stay in hospital is a different matter, and is normally incinerated or held for a period until radioactive decay brings the activity to an acceptable level.