[ RadSafe ] Traveling After Nuclear Medicine Procedure Ma

Mccormick, Luke I luke.mccormick at dhs.gov
Fri Jul 22 13:11:56 CDT 2005

The Nuc. Med ID card for travelling patients is a great idea! We are forced
to pull hundreds of passengers off of their returning Cruise ships and
planes to resolve the radiation detections. Many have no idea they had a
radioactive procedure. However lawyers got involved and now many hospitals
will not issue them because of privacy concerns.
Luke McCormick

____________________Reply Separator____________________
Subject:    [ RadSafe ] Traveling After Nuclear Medicine Procedure Ma...
Author:     radsafe-bounces at radlab.nl
Date:       7/22/2005 1:25 PM

       [ RadSafe ] Traveling After Nuclear Medicine Procedure May Not

       Traveling After Nuclear Medicine Procedure May Not Fly

       By Michael Smith , MedPage Today Staff Writer
       Reviewed by Zalman S. Agus, MD; Emeritus Professor at the
       University of
       Pennsylvania School of Medicine.

       LONDON, July 21-The threat of terrorism has made it tougher for
       who have undergone radioisotope procedures to slip quietly past
       radiation detectors deployed in airports and many other public

       A 55-year-old commercial pilot learned that the hard way, when
       he was
       detained for questioning at Moscow's airport two days after
       having a
       thallium-201 myocardial perfusion scintigram.

       After "extensive interrogation," the pilot was released, only
       to trip
       radiation detectors again four days later while leaving Moscow,
       according to a case report in the July 23 issue of The Lancet.

       The case and others like it suggest "it is important to warn
       having had a thallium scan that they may trigger radiation
       detectors for
       up to 30 days," wrote Richard Underwood, M.D., and colleagues
       London's Royal Brompton Hospital.

       In fact, the authors suggested, it should be standard practice
       to give
       patients an information card after they've had diagnostic or
       procedures involving radioisotopes.

       The card would give:

           * The date and place of the procedure.
           * The radioisotope used and its half-life.
           * The potential duration of radioactive emissions.
           * Who to call for verification.

       More than 18 million such procedures are carried out every year
       and more
       and more radiation detectors are in place in what the U.S.
       Regulatory Commission calls "critical infrastructure,"
       airports, banks, railway stations, and highway tunnels.

       In 2003, the commission urged that nuclear medicine specialists
       make a
       point of emphasizing that patients should follow the written
       instructions they get after a procedure, which usually suggest
       not using
       public transport within two days.

       The recommendation came after a New York State police pulled
       over a bus
       traveling from New York to Atlantic City after it tripped a
       detector in a highway tunnel leading out of the city.

       It turned out that one of the passengers had received a dose of
       iodine-131 earlier the same day, but had ignored her doctor's
       suggestion to avoid public transit for at least two days.

       To "avoid unnecessary concern by law enforcement authorities,"
       commission suggested nuclear medicine specialists should
       giving patients their business card and written information
       about the

       A spokesman for the commission said there's no legal
       requirement to
       report such events, so the commission doesn't know how common
       they are.

       But reports date back to at least 1986, when a letter to the
       New England
       Journal of Medicine noted two incidents in which Secret Service
       seized patients who set off radiation detectors at the White
       House after
       thallium stress tests.

       The half-life of thallium-201 is 73 hours; the usual
       intravenous dose is
       80 mega Becquerel. That means, wrote Dr. Underwood, that
       patients may
       trigger radiation detectors for at least two weeks.

       In fact, highly sensitive modern detectors -- like those issued
       police and other security personnel -- may detect the traces of
       thallium-210 for as much as a month, according to a report at
       the 2004
       meeting of the Radiological Society of North America.

       The least durable radioisotope was fluorine-18, which lasted
       about a
       day; the most durable was iodine-131, which in some cases could
       trigger detectors 95 days after it was administered.

       The pilot -- who had never complained of chest pain or
       shortness of
       breath -- was shown to have a dilated and hypertrophied left
       with no evidence of inducible ischemia, the authors noted.

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