Radiation Safety in Nuclear Medicine PDF

Preface to the Second Edition

The main objectives of this book remain unchanged in this second edition. They are to teach the students of nuclear medicine (NM) technology: (1) the principles of radiation physics, (2) the units of radioactivity, radiation exposure, and radiation dosimetry, (3) the principles of instrumentation needed for radiation detection and measurement, (4) the basis of NM imaging, (5) the scientific basis of radiation safety, (6) the rules and regulations of radiation safety, (7) the practice of radiation safety in hospitals and clinics in the United States, and (8) the fundamentals of radiobiology.

The field of NM has made many advances in the few years since this book was first published in 1999. Thanks to the efforts of the global biomedical community, those advances are making the diagnosis, the management, and the treatment of illnesses more sensitive, more specific, more accurate, and safer for patients of all ages. In this second edition, those advances are introduced keeping in mind that the final scope is the teaching of the radiological safety of the patients, the NM personnel, and all visitors to the NM department of hospitals and clinics. Some examples of those advancements follow.

1. The progress made in positron emission tomography (PET), its related radiopharmaceuticals, instrumentation, and procedures has been remarkable. This has been possible for two reasons: (1) the expansion of Medicare coverage and other insurance plans for PET imaging procedures and (2) the subsequent multiplication of medical cyclotron facilities (PET centers) in metropolitan areas. These facilities produce the necessary positronemitting radionuclides and the labeled compounds using robotic radiochemical synthesizers.

2. The merging of two imaging modalities: (1) the metabolic images of PET using ¹⁸ F-labeled deoxyglucose (FDG) and (2) the exquisite anatomical images of computerized tomography (CT), in one scanning procedure lasting less than eight minutes. This combination is, without a doubt, of utmost importance to the patient.

3. Many new imaging and therapeutic radiopharmaceuticals that use "molecular targeting" as a method of localization are being tested now and soon shall become routine in NM. This should not surprise us since for years radiolabeled antibodies have been used to target specific antigens within tissues both for imaging and for treatment. The "magic bullets" and the age of molecular medicine are here to stay.

Recent revisions in the U.S. Code of Federal Regulations, Title 10, (10CFR), parts 19, 20, 30, and 35, which apply to the use of radiopharmaceuticals in medicine, are also introduced in this second edition of the book. The CFR is the document enforced by the Nuclear Regulatory Commission (NRC) in 18 states and the designated agencies in the remaining 32 "agreement states" within the U.S.

The role played by nuclear medicine technologists (NMTs) in the everyday practice of NM must be recognized. As their responsibilities become more and more complex with the arrival of new methodologies, they must participate in "on-site" training programs and in continuing education plans to earn and maintain accreditation. The efforts of the Society of Nuclear Medicine, Technology Section (SNMTS), in this regard must be recognized and appreciated, also. Its "Performance and Responsibility Guidelines for NMTs," approved at the SNM annual meeting of June 2003, is contributing to the update and upgrade of educational programs for NMTs.

The author wishes to express his gratitude to the many persons who directly or indirectly participated in making this second edition a reality. Special recognition and appreciation is given to Martin Sabarsky, vice president of corporate development, Diversa Corporation, San Diego, for his invaluable assistance in the editing of the original manuscript and in the remaking of six illustrations. My gratitude is extended also to Pete Shackett, B.A., C.N.M.T., A.R.R.T.(N), of Palmetto, Florida, and to Beverly Ammidown, C.N.M.T., of Gainesville, Florida, for their assistance in the literature research. My love goes to all the members of my family for their constant encouragement in the pursuit of this worthwhile project.