Radiation exposure awareness from patients undergoing nuclear medicine diagnostic 99mTc-MDP bone scans and 2-deoxy-2-(18F) fluoro-D-glucose PET/computed tomography scans

Assessment of Radiation Exposure in a Nuclear Medicine Department during 99mTc-MDP Bone Scintigraphy

This study measured 99mTc-MDP bone scintigraphy radiation risks, as low-dose radiation exposure is a growing concern. Dosimeter measurements were taken at four positions (left lateral, right lateral, anterior, and posterior) around the patients at 30, 60, 100, and 200 cm at 0, 1.5, and 3 h. The highest dose rates were recorded from 51% of the patients, who emitted ≥ 25 µSv/h up to 49.00 µSv/h at the posterior location at a distance of 30 cm. Additionally, at the anterior location at a distance of 30 cm, 42% of patients emitted ≥ 25 µSv/h up to 38.00 µSv/h. Furthermore, at 1.5 h after the tracer injection, 7% of the dose rates exceeded 25 µSv/h. There was a significant reduction in mean dose rates for all positions as distance and time increased (p-value < 0.05). As a result, radiation levels decreased with increased distance and time as a result of radiation decay, biological clearance, and distance from the source. In addition, increasing the distance from the patient for all positions reduced the radiation dose, as was substantiated via exponential regression analysis. Additionally, after completing the bone scintigraphy, the patients' dose rates on discharge were within the current guidelines, and the mean radiation doses from 99mTc-MDP were below occupational limits. Thus, medical staff received less radiation than the recommended 25 μSv/h. On discharge and release to public areas, the patients' mean dose rates were as follows: 1.13 µSv/h for the left lateral position, 1.04 µSv/h for the right lateral, 1.39 µSv/h for the anterior, and 1.46 µSv/h for the posterior. This confirms that if an individual was continuously present in an unrestricted area, the dose from external sources would not exceed 20 µSv/h. Furthermore, the patients' radiation doses were below the public exposure limit on discharge.

The suitability of smartphone camera sensors for detecting radiation

The advanced image sensors installed on now-ubiquitous smartphones can be used to detect ionising radiation in addition to visible light. Radiation incidents on a smartphone camera's Complementary Metal Oxide Semiconductor (CMOS) sensor creates a signal which can be isolated from a visible light signal to turn the smartphone into a radiation detector. This work aims to report a detailed investigation of a well-reviewed smartphone application for radiation dosimetry that is available for popular smartphone devices under a calibration protocol that is typically used for the commercial calibration of radiation detectors. The iPhone 6s smartphone, which has a CMOS camera sensor, was used in this study. Black tape was utilized to block visible light. The Radioactivity counter app developed by Rolf-Dieter Klein and available on Apple's App Store was installed on the device and tested using a calibrated radioactive source, calibration concrete pads with a range of known concentrations of radioactive elements, and in direct sunlight. The smartphone CMOS sensor is sensitive to radiation doses as low as 10 µGy/h, with a linear dose response and an angular dependence. The RadioactivityCounter app is limited in that it requires 4-10 min to offer a stable measurement. The precision of the measurement is also affected by heat and a smartphone's battery level. Although the smartphone is not as accurate as a conventional detector, it is useful enough to detect radiation before the radiation reaches hazardous levels. It can also be used for personal dose assessments and as an alarm for the presence of high radiation levels.

Imaging in clinical trials: a patient-led questionnaire study to assess impact of imaging regimes on patient participation

BACKGROUND

Cancer trials often incorporate intensive imaging with Magnetic Resonance Imaging (MRI) and Positron Emission Tomography with Computerised Tomography (PET/CT), which can be physically and mentally exhausting for patients. This questionnaire study aimed to determine the aspects of imaging that affect a patient's decision to participate in clinical trials in order to inform the design of future trials that utilise imaging. This should achieve greater patient compliance and improve the patient experience.

METHOD

A detailed questionnaire assessing patient expectation and acceptability of imaging within clinical trials was developed in collaboration with two patient representatives. The questionnaire addressed the influence of scan type, length, frequency, scheduling, invasiveness and staff support on acceptability of imaging. It was applied to three patient groups. Group 1 consisted of patients newly recruited to studies with imaging, Group 2 consisted of previous participants in studies with imaging and Group 3 consisted of patients having imaging for clinical care.

RESULTS

One hundred ninety six patients completed the questionnaires (Group 1:47; Group 2: 50 and Group 3: 99). The use of ionising radiation and number of scans required were identified as negative influences on decision to participate by 25% of Group 3 but only by 6% of Groups 1 and 2. Scan duration >30mins was perceived as a negative factor for decision to participate by all Groups (12-22%). Good communication provided by researchers in terms of discussing the study before and after reading study materials was a key factor in influencing decision to participate (> 50% in Groups 1 and 2 and > 20% in Group 3).

CONCLUSION

Factors relating to imaging procedures within clinical trials that affect participation have been identified with communication around study materials as the key determinant. These data will be used to influence the development of future research protocols. Modification of imaging requirements within clinical trials will improve patient tolerance and acceptability and is likely to raise recruitment.