Radiation protection issues in radionuclide therapy – workers (medical staff), third persons, waste management

Radionuclide therapies for treatment of diseases is common practice worldwide, while new radionuclides create new challenges for radiation protection. Many guidelines are still applicable for implementing dose constraints, using appropriate calibrated instruments for dose rate and contaminations measurements and following good practices of waste management. Special caution and considerations are needed to prevent annual dose limits to be exceeded in some situations with new radionuclide therapies. In fractionated therapies, dose constraints should be set considering anticipated repetition of the treatment. In handling of alpha emitters all contamination pathways need to be considered and training of workers is essential both to prevent contamination and to detect and measure contaminations. Waste management is an issue if there are radionuclides of long half-lives considering also possible impurities. In case there is a need for cremation after a radionuclide therapy with alpha emitters, it may be necessary to wait even several months prior to cremation