Nuclear medicine staff exposure to ionising radiation in 18F-FDG PET/CT practice: a preliminary retrospective study

Arh Hig Rada Toksikol. 2021 Sep 28;72(3):216-224. doi: 10.2478/aiht-2021-72-3517.

Abstract

This retrospective study provides an insight into the levels of radiation exposure of six nuclear medicine (NM) staff (four technologists and two nurses) performing routine diagnostic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) at the University Clinical Centre of the Republic of Srpska, Department of Nuclear Medicine and Thyroid Disorders, Banja Luka, Bosnia and Herzegovina. Data analysis included monthly staff exposure measured with personal thermoluminescent dosimeters (TLD) between June and December 2018, quantified in terms of normalised dose for the whole body [Hp(10)] and dominant hand [Hp(0.07)] and their comparison between each staff member and between the two groups (technologists and nurses). The study goal was to establish how our Department compared with reports from other PET/CT centres worldwide in terms of annual number of procedures and exposure limits and whether there could be room for further improvements in radiation protection. The number of procedures rose considerably from 208 in 2016 to 876 in 2019 and was 423 in the observed seven-month period. Mean individual whole-body exposure dose per GBq of injected 18F-FDG activity, [Hp(10)/A] was 18.55 μSv/GBq for the four technologists and 15.61 μSv/GBq for the two nurses. Mean dominant-hand exposure dose per GBq of injected 18F-FDG activity [Hp(0.07)/A] was 16.99 μSv/GBq and 25.44 μSv/GBq for the two groups, respectively. The average annual cumulative dose for all staff was (1.06±0.29) mSv for Hp(10) and (1.15±0.32) mSv for Hp(0.07). These results are comparable with those of similar studies. Staff doses were well below the annual limits. Nurses received slightly higher extremity doses than technologists. In view of the increasing trends in the number of PET/CT procedures, dose monitoring should be continued to identify exposure hotspots and maintain doses as low as possible.

Ova retrospektivna studija pruža uvid u razinu izloženosti ionizirajućem zračenju za šestero zaposlenih (četiri radiološka tehničara i dvije medicinske sestre) koji izvode rutinska dijagnostička ispitivanja primjenom 18F-FDG na PET/CT-u u Kliničkom zavodu za nuklearnu medicinu i bolesti štitne žlijezde Univerzitetskoga kliničkog centra Republike Srpske (Banja Luka, Bosna i Hercegovina). Analiza podataka obuhvatila je mjesečnu izloženost osoblja, koja je od lipnja do prosinca 2018. mjerena osobnim termoluminiscentnim dozimetrima (TLD-ima), a izražena je normaliziranom dozom za cijelo tijelo [Hp(10)] te dozom za dominantnu ruku [Hp(0,07)]. Također, u obzir je uzeta i usporedba tih veličina između svakoga člana osoblja te između dviju skupina (radiološki tehničari i medicinske sestre). Cilj studije bio je usporediti izvješća našega Zavoda i drugih PET/CT centara u svijetu u pogledu godišnjega broja postupaka, granica izloženosti osoblja te mogućnosti uvođenja dodatnih poboljšanja mjera zaštite od zračenja. Ustanovljeno je da se broj postupaka znatno povećao (s 208 u 2016. na 876 u 2019. godini), a tijekom praćenoga sedmomjesečnog razdoblja iznosio je 423. Srednja vrijednost pojedinačne doze za cijelo tijelo po jedinici aplicirane aktivnosti 18F-FDG [Hp(10)/A] iznosila je 18,55 μSv/GBq za četvero radioloških tehničara i 15,61 μSv/GBq za dvije medicinske sestre. Srednja vrijednost doze za dominantnu ruku po jedinici aplicirane aktivnosti 18F-FDG [Hp(0,07)/A] iznosila je 16,99 μSv/GBq i 25,44 μSv/GBq za te dvije skupine. Srednja vrijednost godišnje kumulativne doze za svih šestero zaposlenih iznosila je (1,06±0,29) mSv za Hp(10) i (1,15±0,32) mSv za Hp(0,07). Ovi su rezultati usporedivi s rezultatima sličnih studija. Doze za osoblje bile su znatno ispod propisanih godišnjih limita. Medicinske sestre imale su nešto više vrijednosti doza za ekstremitete (ruke) nego radiološki tehničari. Imajući u vidu tendenciju povećanja broja PET/CT postupaka, potrebno je nastaviti monitoring doza za osoblje kako bi se identificirale faze radnoga procesa koje dovode do najveće izloženosti osoblja, a zatim smanjile doze za osoblje.

Keywords: 18F-fluorodeoksiglukoza; 18F-fluorodeoxyglucose; ALARA; ALARA principle; TLD; automated dispensing systems; occupational dose; positron emission tomography-computed tomography; pozitronska emisijska tomografija s kompjutoriziranom tomografijom; profesionalna doza; sustav za automatsko ubrizgavanje radiofarmaka; termoluminiscentni dozimetri; thermoluminescent dosimeters.

MeSH terms

  • Fluorodeoxyglucose F18
  • Humans
  • Nuclear Medicine*
  • Occupational Exposure* / analysis
  • Positron Emission Tomography Computed Tomography
  • Radiation Dosage
  • Radiation Exposure*
  • Radiation, Ionizing
  • Retrospective Studies

Substances

  • Fluorodeoxyglucose F18