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ZEMEDI-10638; No.

of Pages 7 ARTICLE IN PRESS


ORIGINALARBEIT

Dose rate constants for the quantity Hp(3) for frequently used
radionuclides in nuclear medicine
Bastian Szermerski 1,∗ , Iris Bruchmann 1 , Rolf Behrens 2 , Lilli Geworski 1
1
Department for Radiation Protection and Medical Physics, Medical School Hannover
2
Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, 38116 Braunschweig

Received 1 June 2015; accepted 23 November 2015

Abstract Dosisleistungskonstanten für die Messgröße


Hp (3) für häufig eingesetzte Nuklide in der
According to recent studies, the human eye lens is more Nuklearmedizin
sensitive to ionising radiation than previously assumed.
Therefore, the dose limit for personnel occupationally
exposed to ionising radiation will be lowered from cur- Zusammenfassung
rently 150 mSv to 20 mSv per year. Currently, no data
base for a reliable estimation of the dose to the lens of the Die Augenlinse ist nach aktuellem Stand der Wissenschaft
eye is available for nuclear medicine. Furthermore, the strahlensensibler als bislang angenommen. Der Grenzwert
dose is usually not monitored. The aim of this work was to für beruflich strahlenexponierte Personen wird künftig von
determine dose rate constants for the quantity Hp (3), which 150 mSv/a auf 20 mSv/a abgesenkt. In der Nuklearmedi-
is supposed to estimate the dose to the lens of the eye. For zin ist weder eine hinreichende Datenlage verfügbar, aus
this, Hp (3)-dosemeters were fixed to an Alderson Phan- welcher sich belastbare Dosiswerte abschätzen lassen,
tom at different positions. The dosemeters were exposed to noch wird die Organdosis in der Regel messtechnisch
radiation from nuclides typically used in nuclear medicine erfasst. Das Ziel dieser Arbeit war die messtechnische Be-
in their geometries analog to their application in nuclear stimmung von Dosisleistungskonstanten für die Messgröße
medicine, e.g. syringe or vial. The results show that the Hp (3), mit welchen eine Abschätzung der Augen-
handling of high-energy beta (i.e. electron or positron) linsendosis ermöglicht werden soll. Hierzu wurden
emitters may lead to a relevant dose to the lens of the Hp (3)-Dosimeter an einem Aldersonphantom an ver-
eye. For low-energy beta emitters and gamma emitters, an schiedenen Trageorten befestigt. Als Strahlenquellen
exceeding of the lowered dose limit seems to be unlikely. wurden Spritzen oder Vials verwendet, wie sie in der
Nuklearmedizin verwendet werden. Die Messergebnisse
zeigen, dass speziell beim Umgang mit hochenergetis-
cher Betastrahlung (d. h. Elektronen oder Positro-
nen) relevante Dosisbeiträge entstehen können, und
dass für niederenergetische Betastrahler und Gammas-
trahler kaum mit einer Überschreitung des zukünf-
tig herabgesetzten Grenzwertes zu rechnen ist.

Keywords: Ocular lens, nuclear medicine, cataract, Schlüsselwörter: Augenlinse, Nuklearmedizin, Katarakt,
dose rate constant Dosisleistungskonstante

∗ Corresponding author: Bastian Szermerski, Department for Radiation Protection and Medical Physics, Medical School Hannover, Carl-Neuberg-Str. 1,

30625 Hannover. Tel.: +05115324028; Fax: +05115322676.


E-mail: szermerski.bastian@mh-hannover.de (B. Szermerski).

Z. Med. Phys. xxx (2015) xxx–xxx


http://dx.doi.org/10.1016/j.zemedi.2015.11.003
www.elsevier.com/locate/zemedi
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1 Introduction spectrum. In case only positrons are meant this is explicitly


outlined.
The aim of radiation protection for the eye lens is to avoid The aim of this study is to determine dose rate constants for
cataract formation caused by ionising radiation. Currently, a nuclides often used in nuclear medicine utilising dosemeters
dose limit of 150 mSv/a applies for occupationally exposed which allow the estimation of the dose to the lens of the eye
persons [1,2]. According to studies within the last decade (see per activity and time interval at different working distances.
references in [3]), the human eye lens is more sensitive to
ionising radiation than previously assumed. A re-evaluation of 2 Methods
epidemiological studies supports the assumption that possibly
a threshold dose of about 0.5 Gy cumulative dose is required For simulating exposure conditions in nuclear medicine
for the induction of a cataract; however, it is unclear, whether facilities, measurements were performed with syringes
such a threshold exists at all [3]. containing radiopharmaceuticals with the commonly used
Hence, the International Commission on Radiological Pro- radionuclides Tc-99m, Y-90, F-18 and Ga-68, and with an
tection (ICRP) has recommended a reduction of the dose limit I-131 capsule in an applicator. For simulating realistic geome-
[4] to 100 mSv cumulative dose in five years. In addition, tries and associated scattering effects on the skull and body, the
a dose of 50 mSv/a shall not be exceeded in a single year. sources were positioned in front of an Alderson phantom [9],
Following this recommendation, the Council of the European which consists of tissue-equivalent material, at usual working
Union has laid down these new limits in the Directive 2013/59 / distances from 20 cm up to 50 cm. The phantom was placed
EURATOM as of 05.12.2013 [5] which has to be implemented more than 1 m away from all room walls and other objects in
into national law within a period of four years in member states order to minimize scattering effects.
of the EURATOM treaty. Dosemeters were attached to the phantom at possible wear-
The impending reduction of the dose limit for the eye lens ing positions, see figure 1. The exposure times and nuclide
requires a reassessment of individual exposure conditions for activities were chosen such that the resulting dose is well
occupationally exposed personnel. As the eye lens is located above the background level, which has also been determined
behind the cornea and anterior chamber in a total depth of by the dosemeters. The radioactive sources were obtained
about 3 mm, the quantities Hp (10) (usually used as a measure from the laboratory of the department of nuclear medicine and
of the effective dose) and Hp (0.07) (usually used as a mea- the activities were comparable to typical activities applied to
sure of the local skin dose) do not seem to be appropriate patients, ranging from 3 MBq up to 3.7 GBq. The irradiation
for estimating the dose to the lens of the eye. Instead, Hp (3) times (between about 1 h and 90 h) were chosen to produce
should be used, at least in beta radiation fields. Hp (3) is the a minimum dose of about 1 mSv (based on preliminary dose
dose at 3 mm depth in the human body below the point where estimates). The measured doses range between about 0.6 mSv
an eye dosemeter is worn (preferably as close as possible to and 140 mSv (depending on the dosemeter’s distance and
the eye). Thus, only radiation being able to penetrate 3 mm wearing position).
of tissue (with an average density of 1 g/cm3 assumed) con- For the measurements, Eye-D dosemeters with thermolu-
tributes to Hp (3). Accordingly, Hp (0.07) and Hp (10) are the minescence detectors (TLD, Typ MCP-N, LiF:Mg,Cu,P) [10]
dose in 0.07 and 10 mm tissue depth, respectively. However,
at present only few dosemeters for Hp (3) are available and,
at least in Germany, none is approved by regulation bodies.
Finally, in Germany the need for a special dosemeter is still
under discussion.
In nuclear medicine, a variety of different nuclides is in
use for the treatment of patients and for research purposes.
The lens of the eye of the medical staff is exposed to mixed
fields of photons, electrons and positrons over a broad energy
range. In most nuclear medicine departments and institutions,
the individual exposure of the eye lens is neither measured nor
calculated [6]. The estimation of doses to the lens of the eye has
been facilitated with the recent publication of tabulated dose
rate per activity values [7] (these are currently implemented in
a revision of reference [8]). This is, however, only applicable
to ␤− emitting radionuclides but not to ␤+ -emitters.
In this work the term “beta radiation” is used for both elec-
trons and positrons. Depending on the context, the term refers
to the whole spectrum emitted from a radionuclide, the frac-
tion of that spectrum reaching the detector or only a part of that Figure 1. Alderson phantom with attached dosemeters.
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B. Szermerski et al. / Z. Med. Phys. xxx (2015) xxx–xxx 3

Figure 2. Dose rate constants divided by the average value of the dosemeters on the phantom’s eyes.

were used. The Eye-D dosemeter has been developed within The net signal of the dosemeters irradiated with the radionu-
the ORAMED-project (Optimization of RAdiation protection clides was then normalized to dose by dividing by the average
for MEDical staff) [11]. It is designed for the measurement signal of the calibration dosemeters.
of Hp (3) in photon radiation fields [11]. For this purpose, it The dosemeters of the second group were fixed to the
is equipped with a cap of about 3 mm tissue-equivalent mate- phantom with a headband at typical wearing positions.
rial (polyamide with a density of ρ = 1.13 g/cm3 [11]). That These positions are both sides of the temples, between
means, beta radiation with an energy below a certain threshold the eyes, and on the forehead (figure 2). Furthermore,
energy (around 700 keV) will not contribute to the dosemeter two dosemeters were placed directly on the phantom’s eye
readout. The dosemeters were provided and evaluated by the positions.
Physikalisch-Technische Bundesanstalt (PTB) in batches of The distance between the geometric center of the source
about 100 devices. To achieve a dose calibration, each batch and the detector center of the dosemeters positioned on the
was subdivided into three groups: phantom’s eyes was varied to simulate typical working dis-
tances (20 cm, 27.5 cm, 35 cm, 42.5 cm and 50 cm). The
1. About 10 dosemeters were irradiated at PTB with a well- sources were positioned in front of the phantom at an angle of
known dose of Hp (3) = 1 mSv using a Sr-90/Y-90 source. 0◦ . The energy dependent response (indicated dose divided by
This dose is traceable to the German primary standard for true dose) of the dosemeters is taken into account by the appli-
beta dosimetry [12] and its extension to the quantity Hp (3) cation of the correction factor knuclide . The values for knuclide
[13]. were determined from the energy dependence of the doseme-
2. Most of the other dosemeters were irradiated with any of ter response for photon and beta radiation, respectively [14],
the radionuclides in question. taking into account the emissions of the nuclides [15]. Their
3. At least 10 dosemeters were not irradiated - their average values are given in table 1.
signal was subtracted from the readout of all dosemeters For each nuclide and distance r, the dose rate per activity,
from the batch (in order to obtain their net signal). Ḣp (3)/A, was obtained via
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Table 1
Source characteristics and dose rate constants for the investigated nuclides and geometries (average of values measured at both eyes and at
all distances).
Nuclide Dominant emissions Geometry knuclide Γ (Hp (3)) in (mSv·m2 )/(GBq·h)

Radiation E␥ ; E␤,max P This work From photon Otto [19] e)


keV emission c)

Tc-99m ␥ 141 0.89 5 ml solution in 10 ml syringe 0.71 ± 0.04 0.021 ± 0.006 0.025 d) 0.026
u&s
I-131 ␤- 606 0.90 Capsule in applicator 0.66 ± 0.03 0.071 ± 0.021 0.069 d) 0.068
␥ 365 0.82 u&s
F-18 ␤+ 634 0.97 5 ml solution in 10 ml syringe 0.60 ± 0.03 0.169 ± 0.049 0.169 0.005 u f)
photons 511 a) 1.94 b) 0.169 s
Ga-68 ␤+ 1899 0.89 5 ml solution in 10 ml syringe 1.00 ± 0.05 0.499 ± 0.146 0.155 1.20 u
photons 511 a) 1.78 b) 0.161 s
Y-90 ␤- 2280 0.99 Microspheres in 5 ml syringe 1.00 ± 0.05 2.566 ± 0.762 — 2.35 u
0.0 s
a
) Annihilation photons.
b
) Two photons per annihilation.
c ) See equation (3) for details.
d ) For Tc-99m and I-131 all photon emissions above 10 keV are taken into account.
e ) “u” denotes “unshielded”, i.e. photons (without annihilation photons), ␤- , and ␤+ are taken into account;

“s” denotes “shielded”, i.e. photons including annihilation photons are taken into account.
No uncertainties are given by Otto.
f ) The value for the unshielded source is rather small as the contribution from the annihilation photons is missing.

Ḣp (3) G · knuclide Hp (3) · λ The standard uncertainties u of the input values were esti-
= τ = (1)
A  A0 · (1 − exp (−λ · τ)) mated as follows:
A (t) · dt
0
• uncertainty of the distance from the center of the detector
where material to the center of the source: maximum deviation
of 3 mm, by assuming a rectangular distribution follows
• ␶ is the irradiation time, u(r) = 3 √mm = 1.7 mm;
3
• A0 is the activity at the beginning of the irradiation, • uncertainty of the initial activity, determined with a radionu-
• A(t) = A0 · exp(-λ · t) is the activity at the time t, clide calibrator (MED VIK 202 Type 5051): u(A0 ) = 5 %;
• A is the average activity during the exposure time, • uncertainty of knuclide : maximum deviation of 15 %, by
• λ = ln(2)/T1/2 is the decay constant, assuming a Gaussian distribution follows u(knuclide ) =
3 = 5%;
15 %
• T1/2 is the half-life of the nuclide,
• • uncertainty of the measured dose:
r is the distance between the source and the dosemeter,   2
• G is the dosemeter’s indication measured at the distance r,
u(G) = (0.04)2 + (0.03)2 + 0.04 + 0.01GmSv .
• Hp (3) = G · knuclide is the dose corrected for the dosemeter’s
energy dependence and Here, the single contributions are the uncertainty of the
• knuclide is the correction factor to account for the energy calibration (4 %), the non-linearity of the dose measurement
dependent response of the dosemeter. (3 %) and the coefficient of variation. The latter consists of
a contribution of 0.01 mSv independent of the dose plus a
From the dose rate per activity Ḣp (3)/A at the five distances relative contribution of 4 %. In total, u(G) usually results
r the dose rate constant Γ (Hp (3)) was determined using the in about 6.5 % to 8 % (larger for smaller doses);
mean value of the two dosemeter’s readings on the phantom’s • the contributions of the uncertainty of the half-life and the
eyes via uncertainty of the irradiation time are considered to be neg-
ligible.
  Ḣp (3) 2 G · knuclide · λ · r 2
Γ Hp (3) = ·r = (2)
A A0 · (1 − exp (−λ · τ))
Table 2 shows a typical uncertainty budget, determined
For each nuclide the notation Γ (Hp (3)) is used for the total according to the Guide to the Expression of Uncertainty in
dose rate constant for both beta and gamma emission. Measurement [16].
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Table 2
Typical uncertainty budget for the dose rate constant (example for Tc-99m measured on the left eye at a distance of r = 20 cm).
Quantity Value Standard uncertainty Distribution Sensitivity Uncertainty contribution Index a)
coefficient in mSv·m2 /(h·GBq)

H 8.116 mSv 0.526 mSv normal 2.7·10-3 1.4·10-3 44%


knuclide 0.7100 0.0355 normal 3.1·10-2 1.1·10-3 26%
r 0.20000 m 0.00173 m rectangular 2.2·10-1 3.8·10-4 3.2%
T 6.0067 h 0.0010 h normal -3.7·10-3 -3.7·10-6 0.0%
A0 1.2080 GBq 0.0604 GBq normal -1.8·10-2 -1.1·10-3 26%
␶ 74.9500 h 0.0167 h normal -4.5·10-7 -7.4·10-9 0.0%
Γ (result) 0.0220 mSv·m2 /(h·GBq) 0.0021 mSv·m2 /(h·GBq)
a ) The index shows the influence of the quantity to the total uncertainty: Index = (uncertainty contribution)2 / (uncertainty of the result)2

3 Results depth in tissue. For photons, a simple estimate of the dose rate
constant (neglecting scattering and absorption) is given by
For each of the five nuclides a curve following the
function Ḣp (3)/A = a/r b was fitted through the data   p Ka Hp (3)
Γ Hp (3) = · · (3)
points of the four different distances (Levenberg-Marquardt- 4 · π · r2 Φ Ka
method), see figure 3. The fit was carried out using the
Levenberg-Marquardt algorithm with equally weighted mea- where
sured values. The fits result in b = 2.0 within one to two
standard uncertainties. Except for I-131 b = 1.96 deviates by • p is the photon emission probability,
about four standard uncertainties from 2.0, however, this is • r is the distance for which Γ (Hp (3)) shall be determined
only a deviation of 2 %. Thus, it is assumed that the values (the common distance of 1 m was used),
obtained at different distances follow the inverse square law. • Ka /Φ is the kerma factor, i.e. conversion from photon fluence
Consequently, the dose rate constants Γ (Hp (3)) calculated for to air kerma, taken from ICRU 57 [17], and
different distances were averaged to obtain a unique value of • Hp (3)/ Ka is the conversion coefficient from air kerma to
Γ (Hp (3)) for each nuclide, see table 1, column “this work”. Hp (3), taken from Till et al. [18].
It can be seen from table 1 that the dose rate constant
Γ (Hp (3)) is larger the higher the energy of the emitted particles The resulting values are shown in table 1 in column “from
is. For Tc-99m, I-131 and F-18, only the photons contribute photon emission”. For Tc-99m, I-131 and F-18 they agree
to Γ (Hp (3)) as the particle energy of their beta emission is quite well with the measured dose rate constants within the
below about 700 keV resulting in less than 3 mm penetration given uncertainties, while the value for Ga-68 is about a factor
of three smaller than the measured one. The reason is that the
positron contribution of Ga-68 is not taken into account by
100 equation (3).
Y−90, b=2.03±0.23
Ga−68, b=2.07±0.07
F−18, b=1.96±0.04
Furthermore, the measured values are compared to liter-
I−131, b=1.95±0.01
Tc−99m, b=2.11±0.05 ature values which were recently published for dose rate
constants for the quantity Hp (3), see table 1, column “Otto”
dose rate per activity / mSv/(GBq*h)

[19]. In that column, “u” denotes “unshielded”, i.e. photons


10
(without annihilation photons), electrons and positrons are
taken into account while “s” denotes “shielded”, i.e. photons
and annihilation photons are taken into account. Scattering
and absorption of 1 m of air are also considered [19]. The
1 following can be observed:

• For Tc-99m, I-131 and F-18, the values from Otto for a
shielded source “s” roughly agree with the values mea-
0.1
sured in this work within their uncertainties. This is
15 20 25 30 35 40 45 50 55
r / cm
expected, as the sources were encapsulated in syringes or
an applicator resulting in the production of annihilation
Figure 3. Dose rate per activity for the investigated distances. The photons.
data points denote the measurements, the lines are fits of the form • For Ga-68, the measured dose rate constant lies between
f(r) = a/rb for each nuclide. The values of b are given in the legend. the ones from Otto for shielded and unshielded sources.
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The reason is that the positrons with their endpoint energy are much more penetrating than betas) contribute in addition
of 1.9 MeV are significantly but not totally absorbed by the to the betas.
solution and syringe.
• For Y-90, the measured dose rate constant roughly agrees 4 Discussion
with the value from Otto for an unshielded source as the elec-
trons with their endpoint energy of 2.3 MeV significantly The results obtained show a major difference between the
contribute to the measured value of Hp (3). handling of pure photon or beta emitters with beta endpoint
energies of less than 700 keV, such as Tc-99m, F-18 and
In conclusion, it can be said that the maximum (of I-131, on the one hand and higher energy beta emitters such
unshielded and shielded) dose rate constants from Otto [19] as Ga-68 and Y-90 on the other hand. Electrons and positrons
can be used as an upper limit to estimate the actual dose rate with energies less than approximately 700 keV are com-
constant of a given nuclide. In case photons and high-energy pletely absorbed by the 3 mm thick polyamide layer in front
beta-emitting nuclides are dominant at the point of interest, of the detector, thus the dose rate constant for F-18 mainly
i.e. where the eyes of medical staff may be located, the max- originates from the 511 keV annihilation photons, see also
imum from Otto is a good estimate of the dose rate constant. column “from photon emissions” in table 1. Also, in case
However, if the energy of the emitted betas is rather high they of I-131, the electrons are absorbed by the polyamide layer,
penetrate the cornea and anterior chamber and contribute to thus the dose rate constant is due to the gamma radiation, see
the dose to the lens of the eye, as it is the case for Ga-68. Then, the same column. In contrast, the considerably higher val-
specific measurements have to be performed to determine the ues found for Ga-68 and Y-90 are due to the high-energy
actual dose rate constant for the prevailing geometry. positron and electron fractions, respectively, meaning a large
Finally, the influence of the different wearing positions number of beta particles having sufficient energy to pene-
(WP) was assessed by calculating the ratio of the measured trate the polyamide layer of the dosemeter. The significant
dose at the respective position and the mean value of the two difference of the dose rate constant found for Ga-68 and
doses (RWP ) measured at the phantom’s eyes: Y-90 can be explained by the different mean beta energies
  (0.83 MeV and 0.93 MeV, respectively), meaning that in
Γ Hp (3) WP case of Y-90, significantly more betas are able to penetrate the
RWP =       (4) polyamide layer. For Ga-68, the dose rate constant is roughly
2 Γ Hp (3) Left eye + Γ Hp (3) Right eye
1
composed of 0.16 (mSv·m2 )/(GBq·h) from photons (see col-
umn “from photon emissions” in table 1) and consequently
This influence is shown in table 3 and figure 2. In case of 0.34 (mSv·m2 )/(GBq·h) from positrons.
F-18, Tc-99m and I-131 no significant influence on the The correction factors knuclide for pure beta-emitting and
measured dose is found as only photons contribute to the pure photon-emitting radionuclides range from 0.6 up to 1.0,
dosemeter’s readings (the photons are strongly penetrating see table 1, resulting in 40 % difference between betas and
and, therefore, not significantly affected by the different ori- photons. This implies that the dosemeters used in this work
entations of the dosemeter). In contrast, an underestimation of are not suitable for measurements in mixed radiation fields
the dose by up to a factor of 2 is possible in case of Ga-68 and of unknown composition. The large range of knuclide is due
Y-90, when the dosemeter is worn in an unfavorable position, to the 3 mm thick polyamide layer (ρ = 1.13 g/cm3 ) and the
e.g. on the temples. The reason is the angle dependence of the TLD thickness of about 0.9 mm (ρ = 2.64 g/cm3 ), resulting
dosemeter’s response. The effect is largest for Y-90 as only in an approximately 4.6 mm thick layer of tissue-equivalent
betas contribute to the dosemeter’s reading (betas are signifi- material (ρ = 1.0 g/cm3 ) between the dosemetere’s surface
cantly affected by the different orientations of the dosemeter) and the center of the detector. This is considerably larger
and slightly smaller for Ga-68 as annihilation photons (which than the definition depth of 3 mm in tissue for the quan-

Table 3
Dose rate constants divided by the average value of the two dosemeters on the phantom’s eyes.
Position RWP

Tc-99m F-18 Ga-68 Y-90 I-131

Left temple 0.98 ± 0.03 0.99 ± 0.03 0.67 ± 0.02 0.42 ± 0.01 1.03 ± 0.03
Right temple 0.95 ± 0.03 1.00 ± 0.03 0.70 ± 0.02 0.47 ± 0.01 1.00 ± 0.03
Left eye 1.01 ± 0.03 1.00 ± 0.03 0.97 ± 0.03 0.99 ± 0.03 1.00 ± 0.03
Right eye 0.99 ± 0.03 1.00 ± 0.03 1.03 ± 0.03 1.01 ± 0.03 1.00 ± 0.03
Forehead 1.00 ± 0.03 0.97 ± 0.03 0.93 ± 0.03 0.92 ± 0.03 0.97 ± 0.03
Between eyes 0.99 ± 0.03 1.00 ± 0.03 0.98 ± 0.03 0.96 ± 0.03 1.00 ± 0.03
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