Thesis

56 Part I Chapter 2 Table 6. (continued) Absorbed dose per unit activity administered (mGy/MBq) Organ Adult 15 years 5 years Testes 0.0024 0.0033 0.0058 Thymus 0.0010 0.0013 0.0030 Thyroid 0.0013 0.0016 0.0035 Uterus 0.0063 0.0076 0.011 Remaining organ 0.0019 0.0023 0.0045 Effective dose (mSv/MBq) 0.0057 0.0070 0.014 3. Radiation protection Staff radioprotection measures follow the recommendations for good practice (lead castle, syringe shields, wearing gloves during tracer preparation and injection, etc.). The exposure of caregivers on hospital wards is very low and no data are available to recommend any specific safety measures, apart from those aimed at limiting contamination. It is recommended to wear disposable gloves for personal care in the 24 hours following the administration of radiopharmaceuticals labelled with technetium-99m. Urine and feces are disposed of into the toilet. Pads, catheters, and containers should be handled with gloves. If hospital waste management only accepts materials free of radioactivity, it is recommended that for hospitalized patients all solid waste is collected during three days and kept in storage for four days to allow sufficient radioactive decay. For the patient’s family no special measures are required. In case of an erroneous tracer administration to a patient for whom the radiopharmaceutical was not intended, it is recommended that the patient is sufficiently hydrated and encouraged to urinate frequently, in order to limit the radiation dose to the bladder and pelvis. No special radioprotection measures are required in case of a patient’s death. Issues requiring further clarification The role of 99mTc-phosphonate bone scintigraphy in follow-up of treated cancer patients is still a matter of discussion. There is general agreement that bone scintigraphy is indicated in symptomatic patients. However, it is unproven whether bone scintigraphy is cost-effective in all asymptomatic patients at risk of metastases (with worse prognostic factors). There are discussions in order to establish which

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