TG117 is generally well drafted. This document has an extensive review of current good practise and knowledge, in order to help identify what cannot be missed by any healthcare professional working in PET/CT or PET/MRI, in terms of education (undergraduate and postgraduate), training and continuous progressive development in topics relevant for radiological protection and safety. It importantly quantitates the radiation exposure to staff and absorbed dose for patient with references and provides comparison tables of values/ practises if they differ across international organisations or countries.
We in Singapore are in compliance with most aspects, especially with the new HCSA regulations that were enforced this year. Thus there is minimal impact to our practises at NUHS and SGH. Some of the good things for Singapore to adopt are:
• SOP to account for inhalation risk during the half-yearly preventive or unscheduled maintenance of cyclotron.
• Lead shielded doors / mobile lead shield for PET patient uptake rooms.
• Increase awareness of eye lens exposure, measures to mitigate dose of staff managing PET radiopharmaceuticals. (8.1.2)
• Ensure finger dose monitoring should be provided for staff managing PET radiopharmaceuticals. It is currently undertaken in SGH. (8.3.5)
• Setup a national DRLs for Singapore with the idea of optimizing radiation exposure to our patients.
• Use auto PET radiopharmaceutical injectors in centers where there is high patient throughput like at SGH.
• With regards to (217) through (220), to define what is acceptance and commissioning testing in HCSA.
• To consider having individual and separate environmental/ temperature control for each uptake room for added patient comfort and minimize tracer uptake in brown adipose tissue in uptake rooms.
• Further optimise staff exposure (8.2.3)
There is a mistake Young Soon wishes to highlight in TG117: (line 3119)
Recommended eye dose has been reduced to 20mSv for radiation worker and should be lower for the public rather than the quoted annual dose of 15mSv.
(307) - The recommended annual public dose limits are: effective dose -1 mSv, lens of eye dose - 15 mSv, and skin dose - 50 mSv (ICRP, 2007b).
Singapore Radiological Society