Recommendations to reduce hand exposure for standard nuclear medicine procedures

The optimization of the extremity dosimetry of medical staff in nuclear medicine was the aim of the Work Package 4 (WP4) of the ORAMED project, a Collaborative Project (2008–2011) supported by the European Commission within its 7th Framework Programme. Hand doses and dose distributions across the hands of medical staff working in nuclear medicine departments were evaluated through an extensive measurement program involving 32 hospitals in Europe and 139 monitored workers. The study included the most frequently used radionuclides, 99mTc- and 18F-labelled radiopharmaceuticals for diagnostic and 90Y-labelled Zevalin® and DOTATOC for therapy. Furthermore, Monte Carlo simulations were performed in different predefined scenarios to evaluate separately the efficacy of different radiation protection measures by comparing hand dose distributions according to various parameters. The present work gives recommendations based on results obtained with both measurements and simulations. This results in nine practical recommendations regarding the positioning of the dosemeters for an appropriate skin dose monitoring and the best protection means to reduce the personnel exposure.

► Measurements and simulations were done to optimize hand dosimetry in nuclear medicine.
► Results lead to nine recommendations to reduce hand exposure.
► The recommended position is the base of the index finger of the non-dominant hand.
► Dosemeter placed at recommended position underestimates maximum dose by a factor of 6.
► Adequate shielding, tools and training are important parameters for dose reduction.