Contact restriction time after common nuclear medicine therapies: spreadsheet implementation based on conservative retention function and individual measurements.

The increasing use of new radiopharmaceuticals invites us to reconsider some radiation protection issues, such as the contact restriction time that limits public exposure by nuclear medicine patients. Contact restriction time should be patient specific and conservative, and its assessment made easy for clinicians. Here a method is proposed based on conservative estimation of the whole-body retention function and at least one measurement of the patient's dose rate. Recommended values of the retention function are given for eight therapies:131I (Graves' disease, remnant ablation, patient follow-up, meta-iodobenzylguanidine),177Lu-prostate-specific membrane antigen and177Lu-DOTATATE therapies, and90Y and166Ho microsphere injection of the liver. The patient line source model for scaling dose rate from one distance to another is included in the restriction time calculation. The method is benchmarked against published values and the influence of the dose rate scaling and whole-body retention function illustrated. A spreadsheet is provided, along with the source code, with recommended values for the eight therapies. The recommended values can be changed as well as the dose rate scaling function, and other radiopharmaceuticals can be included in the spreadsheet provided retention functions are defined.

Long term retention and excretion of 201Tl in a patient after myocardial perfusion imaging.

201Tl is widely used in nuclear medicine to carry out myocardial perfusion imaging (MPI). However, very limited data is available on long-term distribution in the body, excretion and corresponding dose. In this study we performed a 2 month follow-up of a patient who underwent MPI, by urine analysis and in vivo measurements. The biological half-life of thallium was consequently estimated to be 11.6-27 d, which is in partial agreement with previous studies. We also estimated excretion and retention of 200Tl, 201Tl and 202Tl isotopes using the biokinetic parameters from ICRP publication 53 and compared the forecast result with actual measurements. The latter demonstrated a higher urinary excretion and a higher body retention than what was expected. Our results therefore suggest that the long-term retention and consequently the effective dose coefficient for 201Tl considered in ICRP publications 53 and 80 may be slightly underestimated.