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Vol. 35. Issue 3.
Pages 175-185 (May - June 2016)
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Vol. 35. Issue 3.
Pages 175-185 (May - June 2016)
Original Article
Radiation dose produced by patients during radiopharmaceutical incorporation in nuclear medicine diagnostic procedures
Dosis de radiación producida por los pacientes durante la incorporación del radiofármaco en las pruebas diagnósticas de medicina nuclear
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V. Morána, E. Prietoa,b, B. García-Garcíac, B. Barbésa,b, M.J. Ribellesc, J.Á. Richterb,c, J.M. Martí-Climenta,b,
Corresponding author
jmmartic@unav.es

Corresponding author.
a Servicio de Radiofísica y Protección Radiológica, Clínica Universidad de Navarra, Pamplona, Spain
b Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain
c Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Spain
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Tables (4)
Table 1. Dose rate (H*(10)) and dose rate normalized to the radioactivity administered and measured at several distances for different measurement time points (95th percentile for bone scintigraphies and maximum value for the remaining tests).
Table 2. Maximum doses produced by the patient at different distances considering different contact times. Bone scintigraphy values are expressed as the 95th percentile.
Table 3. Doses calculated based on the conditions established when the contact between the patient and a third party is produced immediately and 1h after the administration of the radiopharmaceutical. Bone scintigraphy values are expressed as the 95th percentile and maximum values are used for the remaining studies.
Table 4. Doses calculated based on the conditions established when the contact between the patient and a third party was produced on completion of the diagnostic study when the contact was produce immediately after leaving the Department of Nuclear Medicine and with different delays. Bone scintigraphy values are expressed as the 95h percentile and maximum values are used for the remaining studies.
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Abstract
Objectives

The aim of this study was to assess the dose received by members of the public due to close contact with patients undergoing nuclear medicine procedures during radiopharmaceutical incorporation, and comparing it with the emitted radiation dose when the test was complete, in order to establish recommendations.

Material and methods

A prospective study was conducted on 194 patients. H*(10) dose rates were measured at 0.1, 0.5, and 1.0m after the radiopharmaceutical administration, before the image acquisition, and at the end of the nuclear medicine procedure. Effective dose for different close contact scenarios were calculated, according to 95th percentile value (bone scans) and the maximum value (remaining tests).

Results

During the radiopharmaceutical incorporation, a person who stays with another injected patient in the same waiting room may receive up to 0.59mSv. If the patient had a medical appointment, or went to a restaurant or a coffee shop, members of the public could receive 23, 43, and 22μSv, respectively. After finishing the procedure, these doses are reduced by a factor 3. In most of the studies, the use of private instead of public transport may reduce the dose by more than a factor 6.

Conclusion

It is recommended to increase the distance between the patients during the radiopharmaceutical incorporation and to distribute them according to the diagnostic procedure. Patients should be encouraged to use private instead of public transport. Depending on the number of nuclear medicine outpatients per year attended by a physician, it could be necessary to apply restrictions.

Keywords:
Nuclear medicine
Radiation protection
Dose to members of the public
Diagnostic procedure
Radiopharmaceutical incorporation
Resumen
Objetivos

Evaluar la dosis que pueden recibir los miembros del público debido al contacto con pacientes de medicina nuclear durante la incorporación del radiofármaco y compararla con la dosis impartida una vez finalizado el estudio, con el fin de establecer recomendaciones.

Material y métodos

Se estudiaron 194 pacientes de forma prospectiva. Se midió la tasa de dosis H*(10) a 0,1; 0,5 y 1m tras la administración del radiofármaco, antes de la imagen y finalizada la prueba diagnóstica. Se calcularon las dosis efectivas para diferentes circunstancias de contacto, mediante el percentil-95 (gammagrafías óseas) y el valor máximo (resto de los estudios).

Resultados

La dosis máxima que recibe el paciente por compartir sala de espera con otro paciente, durante la incorporación del radiofármaco, es 0,59mSv. Si acudiese a una consulta médica, a un restaurante o a una cafetería las dosis a terceros alcanzarían los 23, 43 y 22μSv. Estas dosis se reducen en un factor 3 cuando dicha actividad tiene lugar una vez finalizada la prueba. En la mayoría de los estudios, el uso del transporte privado, frente al público, reduce la dosis en un factor superior a 6.

Conclusiones

Durante la incorporación del radiofármaco se recomienda maximizar la distancia entre pacientes y hacer una distribución de los mismos en función del tipo de estudio. Debe fomentarse que los pacientes hagan uso del transporte privado frente al público. Dependiendo del número de pacientes de medicina nuclear por año que reciba un médico en su consulta, puede ser necesario aplicar restricciones.

Palabras clave:
Medicina nuclear
Protección radiológica
Dosis al público
Procedimiento diagnóstico
Incorporación del radiofármaco

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