RE: Radioisotopes in Medical Cardiac Testing

["North, David" <DNorth@Lifespan.org>]

In answer to the medical questions:

1) I am not aware of any clear cut advantage. Each has its drawbacks. Both
are widely in use.

2) The patients are always informed that they are receiving small quantities
of radioactive material as radiopharmaceuticals. The nuclear medicine
technologist who administers the radiopharmaceutical will generally not be
aware of the patient's occupation.

3) The whole body dose will be roughly 0.5 rad regardless of the
radionuclide used since longer lived radionuclides will be given in smaller
amounts of activity. Some doses to single organs/tissues, e.g. bladder wall,
small intestine, will be higher depending on the specific
radiopharmaceutical and its metabolic pathways.

David L. North, Sc.M. DABR
Associate Physicist
Department of Medical Physics
Rhode Island Hospital
593 Eddy St.
Providence, RI 02903
ph: (401)444-5961
fax: (401)444-4446
dnorth@lifespan.org


> ----------
> From: 	Pollan, Paul B.
> Reply To: 	radsafe@romulus.ehs.uiuc.edu
> Sent: 	Thursday, January 4, 2001 13:04
> To: 	Multiple recipients of list
> Subject: 	Radioisotopes in Medical Cardiac Testing
> 
> Greetings colleagues.   I would like to ask the medical and Nuclear Plant
> people out there about workers that have cardiac testing with
> radioisotopes;
> specifically, Tl-201 or Tc-99m.  Several people in the plant recently had
> cardiac testing performed with Tl-201.  This essentially eliminates them
> for
> any work inside the Radiation Controlled Area for approximately 21 days
> before the personnel contamination monitors will allow them to clear.
> 
> We try to make it clear in our Radiation Worker Training to notify Health
> Physics or Dosimetry if a cardiac test involving radioisotopes is to be
> performed, and to turn in their dosimetry prior to the testing.  Many
> times,
> those performing the testing will not admit they injected the individual
> with a radioisotope.  One Sr. Health Physics Technician was with Tl-201
> after he/she was told that they were going to be given "Cardio-lite"
> (Tc-99m).  This individual raised enough of a fuss to get the hospital to
> place a sign that stated "IF YOU WORK AT XXX Nuclear Plant, PLEASE INFORM
> THE RECEPTIONIST PRIOR TO REGISTERING".  I wish more medical facilities
> that
> use in-vitro radioisotopes in their diagnostic procedures would post a
> similar sign if there are laboratories/plants, etc. in the area that
> handle
> or work around radioactive material as an occupation.
> 
> I wish to ask the medical people out there:
> 
> 1) Is there a distinct advantage of one isotope over the other with
> respect
> to picture quality, and
>  2) Do physicians or the Radiopharmeceutical Technicians let the patients
> know what they are being given if the patient works with radioactive
> materials?  
> 3) What is the average TEDE for a cardiac test involving the above
> mentioned
> radioisotopes (naturally given age/weight factors, there cannot be any
> consistent numbers).
> 
> I wish to ask the Nuclear Power plant people as well as others that work
> with radioactive materials:
> 
> 1) How do you handle personnel that have had a medical procedure involving
> radioisotopes and need access to the radiation controlled area?
> 2) Are your people asked to ask if radioisotopes are involved in a
> procedure?
> 3) Does Management have any control regarding medical procedures involving
> radioisotopes?
> 
>   I ask this since a frisker (Eberline RM-20) upscaled into alarm (200cpm)
> from a worker from approximately 10 feet away from the frisker. The
> individual had entered the Radiation Controlled Area and was unaware that
> he/she had been injected with a diagnostic radioisotope.  He/she had been
> given the injection during a cardiac test 3 days earlier.  Co-workers were
> not particularly pleased since they worked with the person in the "clean"
> shop.
> 
> Thank you in advance for your assistance.
> 
> Paul B Pollan, RRPT
> Southern Nuclear Operating Co.
> pbpollan@southernco.com
> 
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