Physician and Nurse Radiation Exposure During the First Year of Performing I-131 mIBG Therapy

1251 Objectives I-131 metaiodobenzylguanidine (mIBG) high-dose therapy treatments present with personnel radiation exposure challenges that require extensive up-front training. In the initial year of the I-131 mIBG therapy program 110 persons were trained to work with radiation isolation patients and monitored to determine if training and work practices effectively minimize radiation exposure. Methods Training consisted of a 4 hour lecture and hands-on training course encompasing basic radiation safety; principles of ALARA; enhanced universal precautions; procedures for entering and exiting the radiation isolation room; and basic use of radiation detectors. Remote telemetry is used for routine monitoring of vital signs. Additionally, work schedules are set to minimize the number of times a nurse take care of patients during the first 72 hours immediately after the therapeutic infusion. Radiation exposure is monitored with Landauer® Luxel+® aluminum oxide crystal dosimeter. Training is also periodically reinforced with reminders through email, banners, one-on-one in-service, hands-on demo and debriefing meetings after each patient. Results During the first year; 62 of the 110 trained personnel participated in 21 infusions with dosage ranging from 10.212 GBq (276 mCi) to 23.088 GBq (624 mCi). The total Deep Dose (DDE) exposure for nurse and physicians for the monitoring year starting January 20, 2013 to January 19, 2014 was: 3 persons between 0.21 mSv - 0.3 mSv (21 to 30 mrem); 2 persons between 0.11 - 0.2 mSv (11 to 20 mrem); 23 persons between 0.01 - 0.1 mSv (1 - 10 mrem). There were none over 0.3 mSv (30 mrem) and the rest were less than 0.01 mSv (1 mrem). Conclusions Working with patients in radiation isolation can be performed in a safe manner if personnel are educated about the risks and how to manage them using ALARA and universal precautions. Research Support No commercial, private or government assistance was used to support this work.