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The trailer must be sited in an area which can withstand the load involved, where there is easy access to the hospital and to an adequate power supply. Prior to the trailer being sited a risk assessment must be undertaken. This must take due account of the use and occupancy of adjacent areas and buildings. It must also consider if there is sufficient boundary shielding in the trailer. Consultation with the RPA at an early stage is essential with regard to the development of the risk assessment. In addition, special attention must be given to the arrangements for PET or PET/CT in trailers. Particular attention must be given to the floor and the roof of trailers, which in practice may not be shielded. Thus attention is required to buildings above or below the trailer and within range of the radiation emerging from it. Furthermore, the restricted space inside the trailer may result in the need for a higher level of shielding than normal for internal boundaries, for example, in the operator’s console. As is the case for fixed PET or PET/CT installations (Section 4.6), consideration must also be given to the provision of designated toilet facilities for injected patients in addition to having appropriately shielded waste storage facilities put in place. Consideration may be given to locating the trailer within close proximity to the nuclear medicine department where similar radiation protection issues will be of concern. The RPA should be consulted with regard to the appropriateness of using existing nuclear medicine facilities for PET patients as the higher energy radiation (Section 4.6.1) may interfere with the operation of standard nuclear medicine imaging equipment. 34 The Design of Diagnostic Medical Facilities where Ionising Radiation is used
4. Nuclear medicine 4.1 Introduction Diagnostic nuclear medicine uses chemical or pharmaceutical compounds labelled with a radioactive substance and administered to a patient via ingestion, inhalation or intravenous injection. The distribution of the radiopharmaceutical in the patient is later imaged either with a gamma camera, or another imaging or measurement device. The radioactive isotope used to label the pharmaceutical is, in the majority of cases, 99m Tc, and in Ireland the labelling generally takes place on site. This requires appropriate facilities to be provided. Therapeutic uses of radionuclides also occur in general hospitals, but less frequently and involving lower patient numbers. The design of a nuclear medicine department should take account of several issues including radiation protection, air quality and infection control. It is important to consult with the RPA, the radiopharmacist, medical physicist, the infections control officer and the radiologist or nuclear medicine physician throughout the design phase (NHS, 2001). Where no radiopharmacist is available, the advice of a pharmacist should be sought. A nuclear medicine facility must deal with all the problems of receiving, storing, handling, injecting, measuring and imaging, and waste disposal for radioactive materials in a hospital setting. 4.1.1 Location and access The nuclear medicine department has close functional and operational relationships with the radiology/ imaging service, with which it is frequently combined. However, many of its functions need to be self contained. Close proximity with general paediatric or obstetric imaging facilities should be avoided (this is particularly important for PET). Shielding and layout should be such that activities in adjoining areas, such as film storage or low level counting, are not affected by the presence or use of radioactive material. Access for both ambulatory and trolley patients is required. Some areas within nuclear medicine will be designated as controlled areas with access restricted to nuclear medicine staff. Entrance to controlled areas should be marked with a warning notice (at eye level) stating that the area is controlled. Other areas within the department may be designated as supervised areas and access to these will be regulated by appropriate signage and systems of work. In determining location, ease of access for delivery of radioactive material and removal of waste must be considered. These activities may take place out of hours, so design and operational considerations are involved. Direct egress for patients without going through the busy public areas of the hospital is desirable, but not always possible. The requirements for appropriate access for cleaning staff should also be considered at the design stage. Ideally all the hospital’s activities involving radioactive material should be centralised into one location to avoid transport of radioactive materials between units. Exceptions to this include some laboratories within the Pathology Service and some research laboratories (Section 4.5). Some clinical areas such as Endocrinology or Haematology may also use radioactive materials but, as far as possible, the handling of larger amounts of radioactivity should be centralised. The Design of Diagnostic Medical Facilities where Ionising Radiation is used 35
Page 1: RPII 09/01 The Design of Diagnostic
Page 4 and 5: Foreword The original Code of Pract
Page 6 and 7: 4. Nuclear medicine 35 4.1 Introduc
Page 8 and 9: 1. Legal and administrative framewo
Page 10 and 11: e made as soon as possible. It shou
Page 12 and 13: It should be noted that it is the u
Page 14 and 15: Records should be kept as they will
Page 16 and 17: 2. Identify the persons (staff and
Page 18 and 19: 3.1.3 Computed Tomography (CT) CT a
Page 20 and 21: Photo 3.2: Interventional X‐ray r
Page 22 and 23: 3.3 Radiography rooms 3.3.1 General
Page 24 and 25: X Figure 3.2: Dedicated chest room
Page 26 and 27: Figure 3.4: DXA room Operator’s c
Page 28 and 29: Figure 3.5b: A dental radiography s
Page 30 and 31: Radiation shielding calculations fo
Page 32 and 33: There are large variations in the s
Page 34 and 35: e assessed by the RPA as part of th
Page 38 and 39: It is recognised worldwide that the
Page 40 and 41: The operator console should be loca
Page 42 and 43: Figure 4.3: A possible layout for a
Page 44 and 45: The workstation should be adequatel
Page 46 and 47: uptake probe and associated equipme
Page 48 and 49: The layout of the department should
Page 50 and 51: The control/console room should pro
Page 52 and 53: 5. Shielding calculations 5.1 Gener
Page 54 and 55: Table 5.2: Suggested minimum distan
Page 56 and 57: Table 5.4: Workload data from NCRP
Page 58 and 59: 5.2.4 Primary radiation A barrier i
Page 60 and 61: The primary beam will be attenuated
Page 62 and 63: 1 χ = ln αγ B −γ 1+ + β α
Page 64 and 65: . The reduction in the dose rate fr
Page 66 and 67: R D(t) = . t D(0) × t Equation 5.8
Page 68 and 69: 5.3.1 Radiology shielding calculati
Page 70 and 71: Example 2: Dedicated chest room (BI
Page 72 and 73: Example 4: Dental X‐ray room (BIR
Page 74 and 75: Example 6: Shielding required for a
Page 76 and 77: 6. Some practical considerations 6.
Page 78 and 79: 6.1.4 Brick There are many types of
Page 80 and 81: Walls are generally shielded to ful
Page 82 and 83: 6.3.3 Doors As illustrated in Chapt
Page 84 and 85: Photo 6.4 Lead blinds protecting wi
Page 86 and 87:
Chapter 2). It is becoming common t
Page 88 and 89:
Gaps in shielding are more likely t
Page 90 and 91:
ICRP. 2007. Recommendations of the
Page 92 and 93:
Appendices Appendix A: Dose limits
Page 94 and 95:
Appendix C: Radiation transmission
Page 96 and 97:
Figure C.1: Transmission of primary
Page 98 and 99:
Figure C.5: 2 mm lead equivalent th
Page 100 and 101:
Table D.3: Physical properties & ef
Page 102 and 103:
Appendix E: Schematic diagrams of r
Page 104 and 105:
Figure E.7: Shielding around the ed
Page 106 and 107:
Figure F. 3: Sample radiation warni
Page 108 and 109:
Notes 106 The Design of Diagnostic
Page 110:
Notes 108 The Design of Diagnostic
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