Nuclear Medicine Procedures Can Trigger Radiation Alarms in Public Places

Twenty million nuclear medicine procedures that detect and evaluate heart disease, brain disorders, and cancer, which use radiopharmaceuticals to treat overactive thyroids and some cancers, are performed each year in the United States. While healthcare providers in many facilities do provide patients with adequate information about nuclear medicine procedures, there is room for improvement, according to a recent study.

"Patients undergoing diagnostic procedures are less likely than patients undergoing therapeutic procedures to be informed that they could activate radiation alarms in public places,” said Dr. Armin Ansari, a health physicist in the radiation studies branch of the Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA).

The study, done in collaboration with the Nuclear Regulatory Commission (NRC; Washington DC, USA), examined the range of patient release procedures and practices among 66 health care facilities in 12 U.S. states. Participating facilities performed a range of diagnostic and therapeutic procedures including cardiac stress tests; positron emission tomography (PET), bone, lung and renal scans; thyroid uptake studies; whole body scans; I-131 hyperthyroid treatments; I-131 Bexxar cancer treatments; and brachytherapy. For the study, 89 health care professionals (including doctors, nuclear medicine technologists, radiation safety officers, and physicists) were interviewed at large and small hospitals and outpatient-only clinics.

The study indicated that healthcare professionals, particularly in outpatient facilities and those performing only diagnostic procedures, could benefit from an outreach program, detailing the need to inform and counsel all released patients. "Some standardization of basic instructions and documentation given to released patients would also be helpful,” said Dr. Ansari.

Federal regulations and guidelines describe when and how licensed healthcare facilities can release patients following a nuclear medicine procedure and address the safety instructions that facilities must provide to patients or to their parents or guardians to ensure that doses to other individuals remain "as low as is reasonably achievable.” Since 2003, NRC supplemented these guidelines with a notice reminding health care professionals that released patients need to know the importance of following instructions so that a dose to other individuals can be maintained low and that the likelihood of triggering radiation alarms is reduced. The NRC suggests voluntary actions that healthcare professionals can take with every released patient whose body contains detectable amounts of radiation after receiving diagnostic or therapeutic quantities of radiopharmaceuticals or brachytherapy implants. These actions should include explaining to patients the potential to trigger radiation monitoring alarms and providing them with written information for law enforcement use.

Drs. Ansari and Luba Katz, from Abt Associates (Cambridge, MA, USA), reported their results in the December 2007 issue of the Journal of Nuclear Medicine.


Related Links:
Centers for Disease Control and Prevention
Nuclear Regulatory Commission