Lancelot Sophie, Guillet Benjamin, Sigrist Sophie, Bourrelly Marc, Waultier Serge, Mundler Oliver, Pisano Pascale
Unité de Radiopharmacie, CHU Timone, Marseille, France.
Nucl Med Commun. 2008 Apr;29(4):405-10. doi: 10.1097/MNM.0b013e3282f4973a.
Radioisotopes that emit beta radiation are used for the treatment of hepatocellular carcinoma, of arthritic patients (radiosynovectomy) and treatment of bone metastases with, respectively, I-labelled lipiodol, colloidal citrate of Y or and Sm-labelled EDTMP. Radiation energy of these radioisotopes that emit beta or beta and gamma radiation (from 300 to 2000 keV) leads to an increase in radiation dose received by nuclear medicine staff. In this paper we focused on clinical and laboratory staff exposure during these types of metabolic radiation therapies.
Cylindrical LiF thermoluminescence dosimeters were used to measure radiation-related whole-body doses (WBDs) and finger doses of the clinical staff.
Exposure of the two radiopharmacists and three nurses taking part in I-labelled lipiodol, Y-colloid and Sm-EDTMP therapies, for 12 months in succession, were 146 microSv and 750 microSv, respectively, considering WBD, and 14.6 mSv and 6.5 mSv, respectively, considering finger doses. Extrapolated annual exposures (six radiosynovectomies per year) for the rheumatologists were estimated to be 21 microSv (WBD) and 13.2 mSv (finger dose). Extrapolated annual WBDs and finger doses (25 I-labelled lipiodol treatments per year) for radiologists were estimated to 165 microSv and 3.8 microSv, respectively.
Fortunately, these doses were always lower than the limits reported in the European Directive EURATOM 96/29 05/13/1996 (WBD <20 mSv.year; finger dose: 500 mSv.year) but have to be added to those relative to other metabolic radiotherapies such as radioiodine treatments and new metabolic radiotherapies (Y-conjugated peptides or antibodies). Nevertheless, the global exposure of medical staff involved in all these clinical practices justifies dosimetry studies to validate protocols and radiation protection devices for each institution.
发射β射线的放射性同位素分别用于治疗肝细胞癌、关节炎患者（放射性滑膜切除术）以及骨转移，所用的分别是碘标记的碘化油、钇胶体枸橼酸盐或钐标记的依替膦酸二钠。这些发射β射线或β射线与γ射线（能量范围为300至2000 keV）的放射性同位素的辐射能量会导致核医学工作人员所接受的辐射剂量增加。在本文中，我们重点关注了这类代谢性放射治疗期间临床和实验室工作人员的暴露情况。
使用圆柱形氟化锂热释光剂量计测量临床工作人员的辐射相关全身剂量（WBD）和手指剂量。
参与碘标记碘化油、钇胶体和钐-依替膦酸二钠治疗的两名放射药剂师和三名护士连续12个月的暴露情况，就全身剂量而言分别为146微希沃特和750微希沃特，就手指剂量而言分别为14.6毫希沃特和6.5毫希沃特。估计风湿病学家的外推年暴露量（每年6次放射性滑膜切除术）为21微希沃特（全身剂量）和13.2毫希沃特（手指剂量）。估计放射科医生的外推年全身剂量和手指剂量（每年25次碘标记碘化油治疗）分别为165微希沃特和3.8微希沃特。
幸运的是，这些剂量始终低于欧洲指令EURATOM 96/29 05/13/1996中报告的限值（全身剂量<20毫希沃特/年；手指剂量：500毫希沃特/年），但必须将其与其他代谢性放射治疗（如放射性碘治疗和新的代谢性放射治疗（钇偶联肽或抗体））的剂量相加。然而，参与所有这些临床实践的医务人员的总体暴露情况证明有必要进行剂量测定研究，以验证每个机构的方案和辐射防护设备。
