ABSTRACT
Endovascular brachytherapy using a balloon catheter filled with Re-188 solution is a promising method for the prophylaxis of restenosis in peripheral blood circulation after percutaneous transluminal angioplasty (PTA) treatments. Thereby about 20 GBq Re-188 with a specific activity of about 5 GBq/ml are used. The high ionisation density of the beta radiation with high energy leads to selective irradiation of the blood vessel wall near the catheter, whereas the surrounding tissue remains almost unaffected. However the hospital staff has to carry out some work steps within close range to the high activity during preparation and therapy, causing a high risk of skin exposure, in particular at the hands. Estimations and measurements of the maximal local skin dose were made with thin-layered thermoluminescence dosimeters. It was assessed that the annual dose limit for skin of 500 mSv may be exceeded considerably when using conventional procedures and considering the expected number of 75 treatments per annum. By using the newly developed rhenium-188 application device "FlowMedical Application System" the exposure risk for the staff could be reduced drastically. The maximum skin dose of 76 mSv for the radiologist and of 50 mSv for the physicist was decreased to 2 mSv per treatment for both of them. Consequently, from the radiation protection point of view, the itm Rhenium-PTA is a safe method. Any exceeding of the dose limit can be prevented.
