1. Physician and Nursing Personnel Radiation Exposure Monitoring Experience During the
First Year of Performing I-131 metaiodobenzylguanidine (mIBG) Therapy.
Miguel de la Guardia1, Sophia Mata2, Steven McCammon1, Karen Nielson4, Meaghan Granger3
1 – Cook Children’s Medical Center, Department of Radiology, Fort Worth TX
2 – Cook Children’s Medical Center, Department of Hematology/Oncology Education, Fort Worth TX
3 – Cook Children’s Medical Center, Department of Hematology/Oncology, Fort Worth TX
4 – Texas Oncology, Department of Radiation Oncology, Fort Worth, TX
Methods:
Training consisted of a 4 hour lecture and hands-on training course encompassing
basic radiation safety; principles of ALARA; enhanced universal precautions;
procedures for entering and exiting the radiation isolation room; and basic use of
radiation detectors.
• Remote telemetry is used for routine monitoring of vital signs.
• Work schedules are set to minimize the number of times a nurse takes care of
patients during the first 72 hours immediately after the therapeutic infusion.
• Training is also periodically reinforced with reminders through email, banners,
one-on-one in-service, hands-on demo and debriefing meetings after each patient.
• Radiation exposure is monitored with Landauer® Luxel+® aluminum oxide crystal
dosimeter.
Results:
During the first year; 62 of the 110 trained personnel participated in 21 infusions with
dosage ranging from 10.212 GBq (276 mCi) to 23.088 GBq (624 mCi). The total
Deep Dose (DDE) exposure for nurse and physicians for the monitoring year starting
January 20, 2013 to January 19, 2014 was as follows:
Conclusion:
Working with patients in radiation isolation can be performed in a safe manner if
personnel are educated about the risks and how to manage them using ALARA and
universal precautions.
PUBLICATION NUMBER 1251
SNMMI 2015 - Baltimore, MD
References:
1) Markelewicz RJ, Lorenzen, WA, Shusterman S, et. al; Radiation Exposure to Family Caregivers and Nurses of Pediatric Neuroblastoma Patients Receiving 131I-Metaiodobenzylguanidine (131I-MIBG) Therapy; Clin Nucl Med 2013;38: P 604-607
2) King SH, Singapuri, K; Radiation Safety Training for Nurses Who Provide Care for Brachytherapy or Unsealed Radioisotope Therapy Patients; The Radiation Protection Journal May 1999: P S87 - S90
Contact: Miguel de la Guardia, BS, RT(N) - Miguel.delaguardia@cookchildrens.org
I-131 metaiodobenzylguanidine (mIBG) high-dose therapy treatments present with personnel radiation exposure challenges that require extensive up-front training. In the
initial year of the I-131 mIBG therapy program 110 persons were trained to work with radiation isolation patients and monitored to determine if training and work practices
effectively minimize radiation exposure.
Water Resistant PPE Minimizes
Contamination / Includes
Double Gloves
Automated Urine Discharge System
Eliminates Manual
Exchange/Drainage of Foley Urine Bag
Plastic ties are used to secure all
connections to the urinary catheter
Total Exposure in mSv >0.3 0.2 – 0.3 0.11 – 0.20 0.01- 0.10 <0.01
Persons 0 3 2 23 34
Urine Drips In
Urine to Pump Urine to Drain
Plastic wrap covers all areas
that may become contaminated