The exponential rise in nuclear medicine procedures performed around the world benefits an increasing number of patients, but it also intensifies the need to avoid any related accidental radiation exposure. Participants in an IAEA meeting last week discussed how to ensure the safety of patients, health workers and the public in nuclear medicine.
There are over 30 million nuclear medicine procedures performed annually. In these a patient receives a radioactive tracer orally or by intravenous injection, for diagnosis, staging of disease, therapy or monitoring. That means a new procedure starting every second somewhere in the world.
“Our role is to ensure that on balance, the benefits outweigh the risks associated with the use of radioactive substances,” said Peter Johnston, Director of Radiation Transport and Waste Safety at the IAEA, speaking at the opening of the first IAEA Technical Meeting on Preventing Unintended and Accidental Exposures in Nuclear Medicine last week.
The meeting attracted 45 nuclear medicine physicians, medical physicists, radiopharmacists, radiation technologists and regulators from over 30 countries and nine international organizations, including the World Health Organization (WHO), the International Commission on Radiological Protection (ICRP) and several professional societies.
The goal of the three-day meeting, held from 16 to 18 May, was to share experience, learn from past incidents and prepare guidelines on how to avoid accidents in the future, said Jenia Vassileva, a radiation protection specialist at the IAEA. “Incidents, including near-misses, happen more frequently than accidents, and by looking at them and learning from them, we can improve safety.”
Incidents can happen during the preparation of radiopharmaceuticals, during the management of radioactive materials and during the procedure on the patient.
Patients are not the only individuals affected by these incidents, but so could be the people they are in contact with: if a patient leaves the hospital too soon after a therapeutic nuclear medicine procedure, he or she may expose others in transport or at home. Medical staff working with radiopharmaceuticals also need to be protected: while the exposure from a syringe filled with radiopharmaceuticals is relatively small, for a professional handling thousands of these a year, the exposure can add up.
Describing and categorizing the incidents is the first step towards identifying procedures for their prevention. “It is very important to evaluate and discuss what systems need to be in place for each different type of potential incident, because the causes vary, so it is important to include preventions for each type,” said Colin Martin, a medical physicist from the United Kingdom and the Chair of the meeting.
