Journal of Nuclear and Radiation Physics, Vol. 4, No. 2, 2009, pp.

55-63

MODELLING DOSE ASSESSMENT DURING NUCLEAR

MEDICINE

Khaled Abdelaziza and H.M. Diabb

a
Nuclear Law Department, National Center for Nuclear Safety and Radiation Control
(NCNSRC), Atomic Energy Authority
b
Radiation Protection Department, National Center for Nuclear Safety and Radiation
Control (NCNSRC), Atomic Energy Authority

Rec. 27/1/2009 Accept. 24/9/2009

Radiation doses to staff preparing radiopharmaceuticals in a radionuclide dispensary

have been evaluated by the determination of gamma dose rates on the exterior surfaces
of cylindrical vessels containing radioactive solutions. A theoretical model based on
Monte Carlo calculation has been used. Calculated results are compared with
experimentally determined results for 99mTc (a pure gamma emitter) in polypropylene
containers of various wall thickness. Calculated results for the γ-ray dose rates to the
skin of the fingers, for partially filled plastic syringes, are compared with other
published results, for 59Fe, 198Au, 113m In, 131I, 203Hg and 99mTc in syringes of various
diameters and wall thicknesses. The calculations are extended to provide results for the
γ ray dose rate distribution along the external surfaces of partially filled syringes for
198
Au and 99mTc. These results are used to objectively derive guidelines for the safe
handling of cylindrical vessels containing γ emitting radionuclides, without the use of
extra shielding, good agreement was obtained.
It is recommended, when using syringes without syringe guards, that the fingers should
never approach the active volume closer than the rear end of the syringe barrel, and that
syringes should not be filled beyond 75% of their capacity. These results are used to
objectively derive guidelines for the safe handling of cylindrical vessels containing γ
emitting radionuclides, without the use of extra shielding.

Keywords: Radiation protection to staff member in nuclear medicine, Finger dose rate.

INTRODUCTION
A very important part of following ALARA (As Low As Reasonably
Achievable) principles is the establishment of a formal program for personnel
monitoring and bio-assay [1]. Medical use of radioactive materials falls broadly into
56 Khaled Abdelaziz and H.M. Diab

two categories: diagnostic and therapeutic procedures. Diagnostic procedures using

radioactive materials, e.g. used in nuclear medicine, involve the use of relatively small
amounts of radioactive materials to facilitate imaging of certain organs. Two examples
of nuclear medicine procedures are the use of 99mTc in the diagnosis of bone, heart or
other organs and radioactive iodine in the imaging of the thyroid gland [2]. The
radioactive materials typically are injected into the patient and allow physicians to
locate and identify tumors, size anomalies, or other physiological or functional organ
problems [2]. Radionuclides such as, 59Fe, 198Au, 113mIn, 131I, 203Hg and 99mTc have γ -
emissions that readily penetrate through medical or laboratory containers including
syringes, vials and test tubes. Because of the manual handling of syringes the fingers
are frequently the organ most at risk in the clinical and laboratory setting [3]. Usually
the same technician each day loads syringes with the radioisotope to be injected. In
each loading operation, the syringe is held by the same fingers. Thus, the same skin of
the same fingers is repeatedly in contact with the syringe. If the same technician
performs the intravenous injection, again the same areas of skin are exposed. It is
usually the same person each day, and again, the same part of the skin of the same
fingers is exposed, day after day, year after year [4]. Syringe guards are available, but
are found to be inconvenient and often not used. The skin is particularly at risk to
exposure from low energy x-rays or β particles. However, there is also some risk due to
exposure from γ rays [5]. The current annual dose limits for the skin of radiation
workers is 500 mSv averaged over 1 cm2 regardless of the area exposed and at a depth
of 20–100 µm [6]. For γ-rays, this dose limit equates to 10 mGy per week [6].
Whitton (1973) [7] has reported that the average skin thickness on the finger
tips is 369±112 µm, while on the sides of the fingers it is 223±93 µm. The range of
values indicated the standard deviation in the variation of the average epidermal
thickness, for a given body site, over a large number of people. Takaku and Kida
(1972) [8] have made measurements of total β -particle and γ -ray dose rates at three
positions on the surfaces of plastic syringes containing 59Fe, 198Au, 131I, and 203Hg.
While Henson (1973) [9] employed models to calculate the separate β -particle and γ -
ray dose rates at two positions on the surfaces of plastic syringes for the above four
radionuclides together with 32P, 75Se, 169Yb, 113mIn and 99mTc. J. E. Pattison et al (1996)
[3] employed theoretical models and verified by experiment for 99mTc and 198Au in
various cylindrical containers using ultra-thin layer graphite-loaded lithium fluoride
(LiF) discs.
In this work, a γ-ray absorbed dose rates was calculated to the exterior surface
of syringe using a model based on Monte Carlo (MC) calculations. A cylinder is
divided into a large number of points. The dose rate from each point is combined to
give the total dose rate at a point on the exterior surface of the cylindrical container.
The calculated method was verified experimentally using TLD dosimeter (lithium
fluoride LiF 100) considering that, the common type of the syringe was made from
polypropylene. Results are compared with other published results for 59Fe, 198Au, 131I
and 99m Tc in syringes of various diameters and wall thickness. The results are used to
derive guidelines for the safe handling of cylindrical vessels containing γ-emitting
radionuclides, without the use of extra shielding.
 MODELLING DOSE ASSESSMENT DURING NUCLEAR 57

THEORETICAL CALCULATION MODEL

For a uniformly distributed gamma-emitting isotope, the dose rate at any point
p due to the isotope in the infinitesimal volume dV at any other point at a distance r
from point p, as shown if fig (1) is given by.

ο e − µr
d D = CΓ dV (1)
r2

Figure 1. Diagram for Calculating Dose at Point p

from the Gamma Rays Emitted from the Volume Element dV.

Where C is the concentration of the isotope, Γ is the specific gamma-ray

emission and µ is the linear energy absorption coefficient. The dose rate at point p due
to the entire isotope in the tissue is computed from all the infinitesimal volume
elements [8].

e − µr
ο V
D = C Γ∫ 2
dV (2)
0 r
Eq. (1) can be rewritten as;
ο
D = C Γg (3)

e − µr
V
where g = ∫0 r 2 dV (4)

The factor, g, depends only on the geometry of the source, hence it is called the
geometry factor. The geometry factor in Eq. (4) applies to a given point within a
volume of source. The geometrical factor takes into account the effects of both distance
and energy absorption on the intensity of gamma photons as they penetrate the
medium.
58 Khaled Abdelaziz and H.M. Diab

Monte Carlo Simulations

The analytical solution of dose rate equation (2) in any volume source with any
shape except sphere is not found up till now and maybe impossible so the need of
modeling and found numerical solution becomes so important to calculate dose rate in
daily work or environmental studies.
The MC method is a mathematical technique for solving a problem that is
dependent upon probability in some manner. The technique is useful when exact
formulation describing a process may be too difficult, or even impossible, to derive and
solve by direct methods. The MC method constructs a stochastic model representing
the process of interest. A set of high quality random numbers is then used to sample the
probability distribution functions defined by the model. The result is an estimate of a
physical quantity characteristic of the process, specified with a measured degree of
confidence. Two of the main reasons why we use MC methods are because of their
anti-aliasing properties and their ability to approximate quickly an answer that would
be very time-consuming to find out the answer too if we were using methods to
determine the exact answer. Fig. 2 represents a 3D view of the calculated cylinder
volume.

Figure 2. A 3D view of the Cylinder shielded.

A computer program (in Delphi language) was programmed and tested by the
first author to carry out gamma-ray dose rate outside volume sources or on the exterior
surface of volume containers fill of radioactive substance based on Monte Carlo
simulation techniques.
Radionuclides such as, 59Fe, 198Au, 113m In, 131I, 203Hg and 99mTc have γ-
emissions that readily penetrates through medical or laboratory containers including
syringes, vials and test tubes. The simulated sources are syringes with volume 1, 2.5
and 5 ml with dimensions tabulated in table (1), the properties of solutions and wall
materials for the containers in the present work for dominant photon energies are
tabulated in table (2).
 MODELLING DOSE ASSESSMENT DURING NUCLEAR 59

Table 1. Dimensions of syringes used by Henson (1973)

Syringe volume Internal radius Wall thickness

Barrel length (mm)
(ml) (mm) (mm)
1 2.30 1.0 70
2.5 4.45 1.4 55
5 6.42 0.79 59

Table 2. The properties of solutions and wall materials for the containers in the present work
for dominant photon energies are tabulated in.

Solutions and Density Mass attenuation coefficients (cm2 g-1) J.E. Pattison 1996
wall material (g cm-3) 59
Fe 198
Au 113m
In 131
I 203
Hg 99m
TC
Water 1.00 0.0659 0.1050 0.1071 0.1106 0.1225 0.1541
IM HCl 1.035 - 0.1048 - - - -
Polypropylene 0.90 0.0676 0.1077 0.1098 0.1135 0.1254 0.1567

Experimental work

In this study, the theoretical model was experimentally verified using TLD
(LiF-100) discs. Before each use, the discs were annealed for 1 h at 400oC followed
with 100oC for 2 hours [10]. Calibration of the discs was performed using 90Sr/90Y
gamma equivalent irradiator (Harshow 4000, USA).
A common type of polypropylene syringe was used to measure the dose rate
around. The syringes were filled with 99mTc in aqueous solution (supplied as
pertechnetate with initial activities of approximately 10 GBq). Dose rate was
measured by placing four discs around each of the syringe (as shown in Fig. 1) which
were then left to irradiate for about 36-48h. Four discs were used as controls (to
monitor background dose). The TLD discs were read on a Harshow 4000.
The dose received by each individual disc for each syringe was then
calculated taking into consideration the various corrections and calibration factors. The
testes with 99mTc were repeated three times providing twelve measurements of dose
rate of each syringe.
TLD

Radioactive solution
Figure 3. The syringe held with radioactive Solution and thermoluminescent dosimeter (TLD)
60 Khaled Abdelaziz and H.M. Diab

THEORETICAL RESULTS
Useful comparisons may be made with the measured dose rates of Takaku and
Kida (1972), and the calculated dose rates of Henson (1973), for a number of
radioisotopes and syringe sizes. The dimensions of the syringes used by Henson (1973)
are shown in table 1. Dose rates at points on the surface of partly filled syringes and
centered over the active volume.
The results are shown in table 3. In general, the results of this study are lower
than Henson’s results. The average difference between the two sets of results, for all
results, is – 6: 9%. Agreement is particularly poor for the 99mTc results, where the
average difference is −12:8%. However, there are very high correlations (r = 0:996)
between Henson’s results and the results of this study, for each of the radionuclides
listed, which suggests the presence of systematic errors. A possible cause of the
observed differences could be that Henson used different values of than were used in
this study. Henson did not indicate in his paper the values of that he used.

Table 3. Comparison of calculated gamma– ray dose rates with values adapted from Henson
[9], Pattison [3] and our study
Volume Dose rates (mGy/MBq min) per gram
Syringe 59
Fe 198
Au 113m
In
Injected
(ml)
(ml) 1 2 3 1 2 3 1 2 3
1.0 0.3 123.0 121.0 118.6 44.6 44.7 43.5 35.4 33.3 32.5
2.5 1.0 60.4 62.7 60.6 23.6 23.2 22.2
5.5 1.0 28.8 27.1 25.6 21.0 20.2 19.0
3.0 18.4 14.7 14.2 13.1 11.0 10.6
5.0 11.8 10.3 9.7 7.9 7.6 7.2
131 203 99m
I Hg Tc
1.0 0.3 43.3 42.4 41.4 26.2 24.3 23.7 14.4 13.7 13.4
2.5 1.0 23.6 22.0 21.1 13.1 12.6 12.1
5.0 1.0 9.2 8.3 7.7
5.0 3.0 5.2 4.5 4.3
5.0 5.0 4.0 3.1 2.9

EXPERIMENTAL RESULTS
For a 5-ml syringe containing 3 ml of liquid, the absorbed dose at the midpoint
of the liquid region was 5.1 mGy/MBqmin. This is in good agreement with
calculations and measurements reported in the literature. The syringe dimensions and
the volume of the liquid (source) region are variable input parameters. Table 4
illustrated the variation of volume used and the dose received due to preparation of
syringe compared with the calculated results. From the results obtained, it was found
 MODELLING DOSE ASSESSMENT DURING NUCLEAR 61

that, there is a good correlation between the calculated dose around the syringe and the
measured dose rate using TLD discs.

Table 4. Comparison of calculated gamma– ray dose rates with measurements

Syringe Volume Calculated dose rate TLD measurements
(ml) Injected (ml) (mGy/MBqmin.) (mGy/MBqmin.)
1.0 0.3 13.4 15.2
5 1 7.7 8.4
5 3 4.3 5.1
5 5 2.9 3.1

DISCUSSION
Various factors can influence the dose rate at the surface of the syringe.
Principal among these factors are: (1) the volume of liquid required to contain the
desired amount of radioactivity; the larger the volume, the lower the dose rate at any
given point; (2) the composition, wall thickness, and diameter of the syringe; (3) the
amount of radioactivity being used and (4) the specific radioactive element involved. It
is apparent from the readings over the loaded and unloaded areas of the syringe that 2
important factors influence exposure to the skin: (1) the portion of syringe held during
loading or injecting; and (2) the time the syringe is held [11]. To minimize exposure of
the skin, the syringe should be held by the portion of the barrel farthest from the
radioactivity, and for the shortest time possible. In loading a syringe, one should hold
the barrel by the extreme rear-end, quickly aspirate the necessary volume, and lay the
syringe down promptly [12].

RECOMMENDATION
Reduction in occupational radiation dose levels is an important consideration
in the overall ALARA program. By using radiation attenuating gloves, a significant
reduction with a mean of 42% in radiation exposure to extremities was noted with
minimal effects on dose preparation time, dose handling, and technologist comfort. It is
recommended, when using syringes without guards, that, the fingers should never
approach the active volume closer than the rear end of the syringe barrel, and the
syringes should not be filled beyond 75 % of their capacity.

REFERENCES
1- Wandergouw H.F. "Guidelines to Radiopharmacy", Scientific Pub. Co., New
York, 136-137, 1982.
2- Jansen S.E., van Aswegen A., Lotter M.G., Herbst C.P., Otto A.C. "Staff radiation
doses during eight years in a nuclear medicine radiopharmacy", Nucl Med
Commun. 1994; 15:114–118.
62 Khaled Abdelaziz and H.M. Diab

3- John E Pattison, Darren J Bachmann and Alun H Beddoe, "Gamma dosimetry at

surfaces of cylindrical containers", J. Radiol. Prot. 1996 Vol. 16 No 4, 249-261.
4- R.S. Clayton, M.D., J. E. White, M.D., M. Briedenand A. Rodriguez, R.T. EL
Paso, "Skin exposure from handling syringes containing radioactive isotopes",
Personnel Communication, Vol. 150, No. 4, 1969.
5- Harding LK, Hesslewood S, Ghose SK, Thomson WH. "The value of syringe
shields in a nuclear medicine department", Nucl Med Commun. 1985; 6:449–454.
6- ICRP 1991 "International Commission on Radiation Protection"
Recommendations of the ICRP Publication 60 Ann., Vol. 21, (Oxford:
Pergamon).
7- Whitton J T, "New values for epidermal thickness and their importance" Health
Phys. 16 1–8, 1973.
8- Takaku Y and Kida T, "Radiation dose to the skin and bone of the fingers from
handling radioisotopes in a syringe", Health Phys. 22 295–7, 1972.
9- Henson P W, "Radiation dose to the skin in contact with unshielded syringes
containing radioactive substances", Br. J. Radiol. 46 972–7, 1973.
10- Dhanse, S. Martin, C. J.; Hillditch, T. E.; Elliott, A. T. "A study of doses to the
hands during dispensing of radiopharmaceuticals", Nuclear Medicine
Communications, 21(6):511-519, June 2000.
11- Tandon, Pankaj; Venkatesh, Meera; Bhatt, "Extremity Dosimetry for Radiation
workers Handling Unsealed Radionuclides in Nuclear Medicine Departments in
India", Health Physics. 92(2):112-118, February 2007.
12- Hilditch TE, Elliott AT, Anstee DE, Murray T. "Fifteen years of radiological
protection experience in a regional radiopharmacy", Health Phys. 1990; 59:109–
116.
 MODELLING DOSE ASSESSMENT DURING NUCLEAR 63

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