THU-K - Special Session: American Academy of Health Physics (AAHP) Therapy Patient Release IssuesThursday 10/15/20 2:00 PM - 4:40 PM |
| Chair(s): Andy Miller |
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THU-K.1
2:00 PM The NCRP 155 implementation of patient release criteria MB Bellamy*, MSKCC
; LT Dauer, MSKCC
Abstract: The criteria for releasing patients treated with therapeutic amounts of radiopharmaceuticals remains an important issue for the radiation protection community. A well-informed analysis of the release of a patient should be based both on details of the medical treatment and on the patient's specific living circumstance. This presentation will summarize the NCRP 155 basis for patient release decisions by considering dose limits to members of the public, the therapeutic radionuclides, effective half-lives, occupancy factors and the potential exposures to a member of the public. Methods to determine the release time and typical dose rates will be presented along with suggestions for developing post-release patient precautions. |
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THU-K.2
2:30 PM Updates to U.S. Nuclear Regulatory Commission Patient Release Program L Dimmick*, US NRC
Abstract: The current requirements in 10 CFR 35.75, often referred to as the “Patient Release Rule,” were promulgated in 1997 and establish the regulatory framework for the release of individuals from licensee control who have been administered unsealed byproduct material or implants containing byproduct material. The 1997 rule changed the patient release requirements to allow licensees to release patients on a dose-based limit. Previously, licensees could only release patients based on the amount of activity inside the patient’s body. Patient release has a prodigious and controversial history. As such, the Commission directed the NRC staff to evaluate its program for regulating patient release after radioisotope therapy. The NRC staff completed its evaluation in 2018. From this evaluation, the NRC considers that radiation exposure to other individuals from released patients can be safely controlled by the current patient release criteria, patient dose calculations, and by the adherence to patient release instructions. The NRC considers that the current patient release criteria appropriately balances public safety with patient access to medical treatment. The NRC staff concluded that the current patient release regulations are protective of public health and safety, and that rulemaking to change the release criteria is not warranted. Staff determined that a comprehensive update to NRC patient release guidance, including incorporation of guidance currently provided in generic communications and updates to the equations and methodologies described in the NRC guidance to calculate dose to members of the public from released patients would improve the patient release program. This presentation will provide an overview of the NRC’s evaluation and an update on guidance development. |
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THU-K.3
3:00 PM Nuclear Regulatory Commission Revised Guidance for the Release of Patients Administered Radioactive Material MA Sheetz*, University of Pittsburgh
Abstract: Nuclear Regulatory Commission (NRC) Regulatory Guide 8.39 “Release of Patients Administered Radioactive Material” was developed to provide licensees guidance on compliance with the “Patient Release Rule” at 10 CFR 35.75, promulgated in 1997. This rule changed the requirements for the release of patients undergoing radionuclide therapy from an activity limit to a dose based limit for members of the public. Since that time, there have been several challenges and evaluations on the appropriateness of the rule with respect to providing for the protection of public health and safety. In response to the NRC staff evaluations and stakeholder input on the rule, Regulatory Guide 8.39 is being updated in two phases to improve on the instructions provided to patients, and the methodologies to calculate the potential public dose from the released patient. This presentation will provide an overview of the Phase 1 revision, and issues to be addressed in the Phase 2 revision process. Comments from the Advisory Committee on the Medical Use of Isotopes (ACMUI) on the revised guidance will also be presented. |
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THU-K.
3:30 PM BREAK
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THU-K.4
3:40 PM Current and Emerging Issues with the Release of Radioactive Patients from Licensee Control BP Lemieux*, UK HeathCare
; R El Khouli, UK HealthCare
Abstract: The evolving therapy landscape presents a host of new considerations to medical radiation safety professionals designing and implementing patient release safety programs. Where once the majority of radiopharmaceutical therapies were NaI-131 and permanent implant brachytherapy, increasing use of other radiopharmaceuticals and treatment methodologies has changed the landscape. The need for close collaboration with physician partners and other members of the care team is paramount. Enhanced patient interviews and pre-treatment screening play an important role in team development of the plan for providing optimal care that incorporates appropriate radiation safety practices and includes consideration of medical and social challenges faced the by the patient and their family. This assessment process must also include consideration for how in-patients are managed prior to release and a process for planned transition to release and home care. This presentation will include an overview and discussion of these critical issues and highlight some key practices for fostering integration into the care team as well as additional added benefits for patient and staff safety. |
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THU-K.5
4:10 PM RADAR: The Resource for Release of Nuclear Medicine Therapy Patients MG Stabin*, NV5/Dade Moeller
; CS Marcus, David Geffen School of Medicine at UCLA
Abstract: The RAdiation Dose Assessment Resource (RADAR) Committee of the Society of Nuclear Medicine and Medical Imaging is THE resource for any information on internal and external dosimetry, in nuclear medicine and radiation protection. RADAR has (1) established the seminal document regarding the correct approach to releasing radioactive patients (Licensee Over-Reliance On Conservatisms In NRC Guidance Regarding The Release Of Patients Treated With 131I. Health Phys. 93(6):667– 677; 2007) and (2) developed a completely free on-line calculator for releasing radioactive patients with a rational scientific and mathematical basis (http://www.doseinfo-radar.com/ExposureCalculator.html). In this talk, we shall present the basis of our calculations and recommendations, and explain why automatic reliance on NUREG 1556 (which has been repeatedly been shown to be inaccurate and wildly conservative, leading to inconveniences to patients, their families, and payment problems to hospitals) is not reasonable. Our free resources are clearly more correct than the recommendations in the NUREG, and should be adopted by all licensees involved in releasing radioactive patients. |
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THU-K.6
5:30 PM AAHP Business Meeting
Abstract: Please register here if you would like to attend the Business Meeting (it is a separate registration link; registration is complimentary and open to all): https://register.gotowebinar.com/register/3539339334870724880 |