Radiation Safety in nuclear medicine

imaging facilities.
Ahmed Zahw , Course report for physics of
Diagnostic radiation (2) PHY- 664 course.
Contents
1.Diagnostic Nuclear Medicine Facility ................................................................................... 3
1.1.Site election .................................................................................................................. 3
1.2.Layout and Area Requirement........................................................................................ 3
1.3. Equipment and Accessories .......................................................................................... 5
1.4.Staff .............................................................................................................................. 5
1.5.General ......................................................................................................................... 5
2.Shielding Requirement in a Diagnostic Nuclear Medicine Facility .......................................... 5
3.Shielding Calculation for SPECT-CT and PET-CT Facilities ..................................................... 6
3.1.Shielding Calculation for Uptake Room in the NM Facility ................................................ 6
3.2.Shielding Calculation for Imaging Room in the NM Facility .............................................. 7
1.Diagnostic Nuclear Medicine Facility
1.1.Site election
In case the nuclear medicine facility is located inside a hospital, its location should be away from other
equipment/departments where ionizing radiations are being used, such as diagnostic X-ray equipment and
radiotherapy department.

The radiation from other sources will create interference with nuclear medicine imaging equipment, thereby
distorting the image quality.

Preferably, nuclear medicine facility should be located at the end of the hospital where movement of the general
public can be restricted. As the nuclear medicine facility caters the diagnostic need of other clinical departments,
the same should be well connected with other departments.

1.2.Layout and Area Requirement

The understanding of a diagnostic nuclear medicine facility, in general, applies to a facility having
a gamma camera (planar or with SPECT/ SPECT-CT installation) or PET-CT installations for imaging purposes,
an in-house radiopharmacy, facilities for decontamination, storage and safe disposal of radioactive waste, dose
administration room, pre- and post-administration waiting area for patients and general areas for reception and
records, staff sitting place, toilets, etc.

The typical layout plans are shown in Figs.1,2 and 3. The total area required for such a facility is about 200 sq.
metres. The gamma camera room should have an area of about 30–40 sq. metres, depending upon the size of the
equipment. For comfortable working, the radiopharmacy room should be at least 12 sq. metres. It will be
advantageous to have separate rooms for extraction of 99mTc and other radiopharmacy works such as dispensing
of PET radiopharmaceuticals or preparation of 68Gallium or 177Lutetium radiopharmaceuticals. As injectable

compounds are prepared in the in-house radiopharmacy, this room must be maintained dust free and very clean.
Fig. 1 Typical layout of SPECT-CT facility
Fig. 2 Typical layout of PET-CT facility

Fig.3 Typical layout of SPECT-CT and PET-CT facility

A laminar airflow (LAF) system is preferred to be installed in this room for the preparation of injectable
compounds.
Area requirements for other rooms, such as for nuclear medicine physician, nuclear medicine
physicists/technologists, in vivo counting, dose administration, patient waiting, etc., may be flexible. About 10–
15 sq. metres for each of these purposes is considered as reasonable for comfortable working. Nuclear medicine
facility performing low-dose therapeutic procedures, such as treatment of thyrotoxicosis using 131I, palliative
treatment of painful bone metastasis using 32P or 89Sr, 177Lutetium therapies and alpha therapy, which do not
warrant hospitalization of patients after administration of radioactivity, may be carried out by providing additional
facilities for the respective procedure such as a room where the patient after administration of activity can wait
for observation. However, for handling and administration of therapeutic quantities of 131I,
including low-dose therapeutic procedures, a separate fume hood with charcoal filter is essential. For handling 32P
or 89Sr for low-dose therapeutic procedures, a fume hood may not be essential, but a beta shielding device, made
of Perspex sheets of about 12 mm thickness, must be provided. For 177Lutetium therapies, a separate
room with a drainage system directly connected to the main sewerage line is sufficient and does not require a
delay and decay tank.
1.3. Equipment and Accessories
For measurement of activity before administration to patients, a calibrated isotope calibrator (dose calibrator as it
is often called) and a portable contamination monitor for monitoring of work surfaces, body parts, etc. should be
procured and maintained in the department. For a nuclear medicine facility, a properly ventilated
fume hood for iodination work is an additional requirement. As the iodination work leads to a considerable amount
of radioactive waste, appropriate containers for storage of liquid and solid radioactive waste must be provided in
the laboratory.

1.4.Staff
In the nuclear medicine facility, administration of radiopharmaceuticals in humans has to be done by trained
nuclear medicine physicians. Hence, in this facility, at least one nuclear medicine physician having an appropriate
qualification as prescribed by the regulatory authority (RA) should be available. For the preparation of
radiopharmaceuticals, administration to patients, quality assurance, dosimetry, etc., an adequate number of
qualified physicists/technologists as per the qualification prescribed by RA should be appointed. It is needless to
mention that an adequate number of supporting staff for helping in scintigraphy work, nursing, reception and
recordkeeping, etc. should also be employed. Apart from the above mandatory staff, a RSO (Radiological Safety
Officer), approved by the competent Authority, should be appointed to take care of radiation safety aspects in the
nuclear medicine facility.

1.5.General
The drainage system for the nuclear medicine facility should be a separate one, without passing through other
departments in the building and connected to the main sewage line. The walls and doors in the facility should be
painted with hard, washable paint to enable easy decontamination whenever the need arises. All the work
surfaces should have a smooth, non-absorbent finish, such as Sunmica. All the sinks in the facility should be
of smooth finish, such as stainless steel, and should have elbow-operated taps. The floor should be covered with
linoleum or similar material, which is non-absorbent and has a smooth surface. The ventilation system in the
facility should be such that the direction of airflow should be from the area having low activity to the area
having high activity and then be driven out of the facility through a properly laid exhaust system, such as a fume
hood or any other type of exhaust system.

2.Shielding Requirement in a Diagnostic Nuclear Medicine Facility

Since most of the diagnostic procedures in conventional nuclear medicine facility (gamma camera or SPECT-CT/
SPECT-CT) are carried out using 99mTc, which emits 140 keV gamma rays, normally, there is no necessity for
additional structural shielding. However, in places where large activities are stored or radioactive waste containers,
such as carboys containing large activities of spent 99Mo, are stored, additional shielding using interlocking lead
bricks should be provided. Similarly, where the 99mTc generator is kept, a barrier of lead bricks should be provided
to bring down the radiation level in the working area (controlled area) to within the maximum permissible level
(0.01 mGy/h, for 40 working hours in a week). The principle of ALARA (as low as reasonably achievable, taking
the socio-economic factors into account) should be employed while planning the laboratory. The shielding data
for some of the important radionuclides used in nuclear medicine in Tables 1 and 2.
 Table.1. HVL and TVL of lead for
common radionuclides.

Table.2. HVL and TVL for 18F in tungsten ,concrete and brick.

3.Shielding Calculation for SPECT-CT and PET-CT Facilities

The SPECT-CT facility requires the normal structural shielding, i.e. 15 cm concrete or 23 cm brick, which is good
enough for performing procedures using Tc-99 m-labelled radiopharmaceuticals. However, for the PET-CT
facility, where F-18 (511 keV gamma)-labelled radiopharmaceuticals are commonly used, additional shielding is
required based on the size of the room and occupancy all around the room.

The dose rate constant of F-18 is 5.3 R/h-mCi at 1 cm; however, due to absorption of activity in the patient’s body,
the dose rate constant to be considered for calculation is 3.4 R/h-mCi at 1 cm, which leads to an absorption factor
of 0.36. Further, in an uptake and imaging room, where the patient with large activity spends most of its time and
requires appropriate shielding, thus as an example, we have shown here the shielding calculation for these two
rooms specifically.

3.1.Shielding Calculation for Uptake Room in the NM Facility

The transmission factor, ‘B’, is defined as the ratio of the radiation flux ‘ϕ’
passing through the medium to the flux ‘ϕ0’ incident upon the surface
of the medium ‘B’ = ϕ/ϕ0. The transmission factor in any area depends
upon the activity of the radioactive source, distance from the source, the
occupancy and the permissible dose limit. The equations used for the
calculation of transmission factors for uncontrolled and controlled areas as
per AAPM Task Group-108 are given below.

(a) For uncontrolled areas:

(b) For controlled areas at ALARA levels:

where Fig.3Uptake room

B = Transmission factor. tu= Uptake time (h).
RtU = Dose reduction factor over uptake time.
d = Distance from source to barrier (m).
T = Occupancy factor. Nw = Number of patients per week. A0 = Administered activity (mCi).
3.2.Shielding Calculation for Imaging Room in the NM Facility

Usually, the calculation carried out for the imaging room is the same as that used for the uptake room until the
tomograph provides any shielding.
However, as there is a delay after the administration of activity till the patient is taken for imaging procedure,
the patient activity decreased by a factor ‘FU’, which is calculated as follows:

Before imaging, the patient will void in most of the cases; thus about 15% of the activity administered will be
removed, which will decrease the dose rate by 0.85.

(a) For uncontrolled areas:

(b) For controlled areas:

where.
B = Transmission factor.
d = Distance from source to barrier (m).
T = Occupancy factor.
Nw = Number of patients per week.
A0 = Administered activity (mCi).
Fu = Uptake time decay factor
tI = Imaging time (h).
RtI = Dose reduction factor over imaging time.

The decay factor for ‘FU’ for F-18 for 45 min is equal to exp (-0.693 × 45/110) = 0.75.