Occupational skin dose from radionuclide contamination: one country's approach at standardising skin dose estimates using Varskin.

The manipulation of unsealed radiopharmaceuticals by healthcare workers can cause accidental personal contamination leading to occupational radiation skin dose. The UK Ionising Radiations Regulations 2017 require that potential skin doses arising from reasonably foreseeable accident scenarios are included in risk assessments. Workers must be designated as classified if these dose estimates exceed 150 mSv equivalent dose averaged over 1 cm2. Updates from the UK Health and Safety Executive recently prompted many in the UK to review the classification of workers in Nuclear Medicine. Skin dose from contamination cannot be measured, it must be estimated. Varskin+ is a code that is widely recommended for estimating skin dose. The subjective choices made by users when defining modelled scenarios in Varskin+ lead to significant variation in the calculated skin doses. At the time of writing there is no definitive calculation method and all calculations rely on theoretical models. NHS Health Boards in Scotland have adopted a standardised framework for performing skin dose estimates for risk assessments. The parametric sensitivity of Varskin+ inputs were examined and the available evidence was reviewed. Generic, reasonably forseeable, worst-case accident scenarios were decided upon for: direct skin contamination, glove contamination and needlestick injury. Standardised inputs and assumptions for each scenario were compiled in a protocol that has been adopted by the Scottish Health Boards. The protocol allows for differences in practice between departments, but standardises most inputs. While significant uncertainty remains in the estimated skin doses, this approach reduces variation and enables the comparison of estimated skin doses between departments. The framework facilitates continuous improvement as more evidence is gathered to refine the standardised assumptions. Task by task skin dose estimates were made for workers in Nuclear Medicine in Scotland and many workers were designated classified as a result.

The optimisation of paediatric CT examinations in Scotland: phase one; benchmarking current performance.

To benchmark the dose from paediatric head and chest examinations on computed tomography (CT) scanners throughout Scotland, to identify scanners that may require optimisation and to provide optimisation advice based on the protocols from better performing scanners. Anthropomorphic phantoms corresponding to 1, 5 and 10 year olds were sent to 50 CT scanners around Scotland. Head and chest examinations were undertaken by local staff using local techniques on each scanner with each phantom, and details of the protocols used were recorded. Computed tomography dose index (CTDI)voland dose length product (DLP) were recorded post-scan. There is a significant variation in performance throughout Scotland. For head examinations, the highest DLP is 13 times the lowest for an equivalent sized phantom. For chest examinations, the highest is 128 times the lowest for an equivalent sized phantom. The wide range of CT dose measurements indicates the potential for variation in image quality across Scotland. Feedback has been provided to all participating sites on their individual results compared to the national data set. Specific feedback was provided where relevant on potential considerations for optimisation. Scanners that may be undertaking paediatric CT head and chest examinations in a sub-optimal manner throughout Scotland have been identified along with those aspects of a scan protocol that are most likely to lead to sub-optimal performance.

A four-layer attenuation compensated PET detector based on APD arrays without discrete crystal elements.

Scintillation detectors developed for PET traditionally use relatively thick crystals coupled to photomultiplier tubes. To ensure good efficiency the crystals typically measure between 10 and 30 mm thick. Detectors also require good spatial resolution so the scintillator is normally made up of a densely packed array of long thin crystals. In this paper, we present a novel design in which the detection crystal is divided into a number of layers along its length with an avalanche photo diode (APD) inserted between each layer. With thin layers of crystal, it is possible to use a continuous rather than a pixelated crystal. The potential advantages of this design over a conventional PMT-based detector are: (i) improved light collection efficiency, (ii) reduced dependency on dense crystal to achieve good stopping power, (iii) ease of crystal manufacture, (iv) reduced detector dead-time and increased count rate, and (v) inherent depth of interaction. We have built a four-layer detector to test this design concept using Hamamatsu S8550 APD arrays and LYSO crystals. We used the centre 16 pixels of each of the arrays to give an active area of 9.5 mm x 9.5 mm. Four crystals 9.5 mm x 9.5 mm were used with thickness increasing from 2 mm at the front to 2.5 mm, 3.1 mm and 4.3 mm at the back, to ensure a similar count rate in each layer. Calculations for the thickness of the four layers were initially made using the linear attenuation coefficient for photons at 511 keV of LYSO. Experimental results and further simulation demonstrated that a correction to the thickness of each layer should be considered to take into account the scattered events. The energy resolution for each of the layers at 511 keV was around 15%, coincidence-timing resolution was 2.2 ns and the special resolution was less than 2 mm using a statistical-based positioning algorithm.

In vivo detection of a pH-sensitive nitroxide in the rat stomach by low-field ESR-based techniques.

A study was made of the in vivo detectability of a pH-sensitive, imidazolidine spin probe, and the efficacy of low-frequency electron spin resonance (ESR)-based techniques for pH measurement in vitro and in vivo in rats. The techniques used were longitudinally-detected ESR (LODESR) and field-cycled dynamic nuclear polarization (FC-DNP) for in vitro and in vivo measurements, and radiofrequency (RF)- and X-band ESR for comparisons in vitro. The spin probe was hexamethyl imidazolidine (HMI) with a pK of 4.6. All techniques detected HMI. Detection by FC-DNP implies coupling between the free radical and solvent water spins. Separations between the three spectral lines of the nitroxide radical, relative to measurement frequency, were consistent with theory. The overall spectrum width from unprotonated HMI (pH > pK) was greater than that from protonated agent (pH < pK). This was observed in vitro and in vivo. Longer-term studies showed that HMI is detectable and has the same spectral width (i.e., is at the same pH) up to 2 hr after gavage into the stomach, although the magnitude of the signal decreases rapidly during the first hour. These findings demonstrate the suitability of LODESR and FC-DNP for monitoring HMI and measuring pH in vivo. These techniques would be useful for monitoring disease and drug pharmacology in the living system.