Acta Oncologica

ISSN: 0284-186X (Print) 1651-226X (Online) Journal homepage: https://www.tandfonline.com/loi/ionc20

Beta emitters and radiation protection

Lars Jødal

To cite this article: Lars Jødal (2009) Beta emitters and radiation protection, Acta Oncologica,
48:2, 308-313, DOI: 10.1080/02841860802245163

To link to this article: https://doi.org/10.1080/02841860802245163

Published online: 08 Jul 2009.

Submit your article to this journal

Article views: 9938

View related articles

Citing articles: 13 View citing articles

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=ionc20
Acta Oncologica, 2009; 48: 308
313

ORIGINAL ARTICLE

Beta emitters and radiation protection

LARS JØDAL

Department of Nuclear Medicine, Aalborg Hospital, Aarhus University Hospital, Denmark

Abstract
Background. Beta emitters, such as 90Y, are increasingly being used for cancer treatment. However, beta emitters demand
other precautions than gamma emitters during preparation and administration, especially concerning shielding. Aim. To
discuss practical precautions for handling beta emitters in general, and specifically determine proper shielding for 90Y, while
comparing to 177Lu and 131I. The aim is achieved through the application of physical principles combined with results from
practical experience. Material and methods. Typical and maximal electron ranges were calculated for 131I, 177Lu, and 90Y,
using data from a freely available database. Bremsstrahlung yields were calculated for 90Y shielded by lead, aluminium, or
perspex. Bremsstrahlung spectrum from 90Y shielded by perspex was measured, and attenuation of spectrum by lead was
calculated. Whole-body and finger doses to persons preparing 90Y-Zevalin were measured. Conclusions. Good laboratory
practice is important to keep radiation doses low. To reduce bremsstrahlung, 90Y should not be shielded by lead but instead
perspex (10 mm) or aluminium (5 mm). Bremsstrahlung radiation can be further reduced by adding a millimetre of lead on
the outside of the primary shielding material. If suitable shielding is used and larger numbers of handlings are divided
among several persons, then handling of beta emitters can be a safe procedure.

The use of radioactive nuclides for cancer therapy is be on 90Y, while theoretical results on 131I and 177Lu
increasing. This includes not only ‘‘old’’ isotopes are presented for comparison.
such as iodine-131 (131I), but also ‘‘new’’ isotopes
such as yttrium-90 (90Y) and lutetium-177 (177Lu). Theory
These isotopes emit short-ranged beta radiation
90
(electrons), making them suitable for targeted Y has a half-life of 2.7 days, and decays by emitting
radio-therapy. If the radioactive isotope is specifi- an electron (b decay). The decay is to the ground
cally taken up by the cancer cells, or can be attached state of the stable nucleus 90Zr, making 90Y a pure
to a pharmaceutical specifically taken up by the beta emitter with no accompanying gamma radia-
cancer cells, then it is possible to deliver a very high tion.
90
radiation dose to the cancer tissue while non-cancer 39 Y 0 90 0
40 Zr1 e n̄
tissue is spared.
Along with the electron, an anti-neutrino (/n̄) is
In our department we recently started using
90 emitted. The anti-neutrino is a small particle with no
Y-Zevalin† for the treatment of non-Hodgkins electric charge and possibly no rest mass. It does not
lymphoma. Being in a nuclear medicine department, interact with the patient, other persons around, or
our staff is experienced in handling gamma emitters, our measuring apparatus. So we need not care about
but we have less experience with beta emitters. The the anti-neutrino, except to note that it carries away
aim of this paper is to give a background for some of the energy, meaning that the electron (beta
understanding the problems involved in handling particle) will have a spectrum of energies instead of a
and shielding beta emitters, present theoretical and single, well-defined energy. In the case of 90Y the
practical results on the subject, and use these data to electron energy (beta spectrum) ranges from 0 to
determine proper shielding. Examples of solutions 2 284 keV, with a mean energy of 933 keV, see
used in our department will be given. The focus will Figure 1. These relatively high energies necessitate

Correspondence: Lars Jødal, Department of Nuclear Medicine, Aalborg Hospital, Aarhus University Hospital, P.O. Box 365, DK-9100 Aalborg, Denmark.
Tel: 45 9932 3140. Fax: 45 9932 3145. Email: [email protected]

(Received 19 May 2008; accepted 2 June 2008)

ISSN 0284-186X print/ISSN 1651-226X online # 2009 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS)
DOI: 10.1080/02841860802245163
 Beta emitters and radiation protection 309

determine the thickness of shielding material neces-

sary to stop all electrons emitted, the range of the
most energetic electrons in the beta spectra was
Probability

calculated for each combination of isotope and

shielding material. Density of lead, aluminium and
perspex were taken to be 11.34 g/cm3, 2.70 g/cm3,
and 1.19 g/cm3, respectively. For 90Y, also the mean
energy emitted as bremsstrahlung pr. beta particle
incident on the shielding material was calculated for
0 500 1000 1500 2000 2500 each shielding material. For this calculation, radia-
Beta particle energy, keV tion yield was multiplied with probability density
Figure 1. Beta spectrum for Y-90.
(beta spectrum), and the product was numerically
integrated from 0 to highest electron energy.
the use of well-considered shielding when handling Bremsstrahlung spectrum from a 90Y sample
the isotope. Once the isotope is injected into the shielded by 10 mm perspex was measured with a
patient, the radiation exposure to the surroundings is Siemens e.soft gamma camera without collimator.
practically zero [1]. The camera was equipped with a standard 3/8’’
Unlike x-rays and gamma radiation, electrons are NaI(Tl) crystal. To achieve larger effective crystal
completely stopped after a certain thickness of thickness the sample was not placed directly in front
shielding material. However, in the process of being of the crystal but some meters to the side, such that
slowed down electrons may emit bremsstrahlung the radiation reached the crystal with an incident
(‘‘braking radiation’’). This radiation consists of angle of about 208. Taking effective crystal thickness
photons, and the process is utilized in x-ray tubes to be tripled, about 60% of 300 keV photons should
for the production of x-rays. When we are shielding be detected.
against electrons we want to minimize the produc- To determine the effect of lead shielding on the
tion of bremsstrahlung, as it constitutes a source of outside of perspex, the measured bremsstrahlung
radiation exposure to the otherwise shielded sur- spectrum was multiplied by energy-dependent at-
roundings. The intensity of bremsstrahlung is very tenuation for 1 mm lead. Energy-absorption attenua-
dependent on the material hit by the electrons, with tion coefficients were used for the calculation, i.e.,
higher intensities emitted from materials with high counting only locally absorbed energy as attenuated
atomic numbers than materials with low atomic (broad beam attenuation). Since some of the scat-
numbers. tered or re-emitted photons may later be absorbed,
this gives a conservative estimate of the effectiveness
of the shielding. The alternative of using total-
Material and methods absorption attenuation coefficients, i.e., counting
For the theoretical calculations, tabulated data of: scattered and re-emitted photons as attenuated
(narrow beam attenuation), would have been too
i. beta spectrum and mean beta energy for given optimistic from a radiation protection point of view.
isotope; These photons may have different directions than the
ii. electron range for given energy in given mate- original photon, but they still constitute a source of
rial; exposure.
iii. radiation yield of bremsstrahlung for given All members of our staff are monitored with film
electron energy in given material; dosimetry, worn at the chest. The films are pro-
iv. attenuation coefficients for given photon energy cessed on a monthly basis (tri-monthly for secre-
in given element (lead) taries). The design of the film holder makes it
possible to distinguish between dose from penetrat-
were taken from the freely available Windows soft- ing radiation (i.e., g and x-rays) and non-penetrating
ware Radiological Toolbox v. 2.0.0 [2]. radiation (i.e., b). The films are processed by the
To give a rough measure of beta radiation range National Institute of Radiation Protection (Statens
in tissue, the electron range in water (density 1.0 Insitut for Strålebeskyttelse, Denmark).
g/cm3) was calculated for maximal and mean beta During two preparations of 90Y-Zevalin, finger
energy for each of the isotopes 131I, 177Lu, and 90Y, doses were measured with ring dosimeters. The rings
using linear interpolation on the tabulated data. were worn at the base of left and right ring finger,
Three possible shielding materials were investigated: measuring dose on the palm side. Shielding devices
Lead, aluminium, and polymethyl methacralate described in the Discussion section were used during
(commonly known as perspex or plexiglass). To the preparations. Each ring dosimeter consisted of a
310 L. Jødal

copper ring with a TLD tablet held in place by Results on finger and fingertip doses are presented
shrinking plastic. The ring dosimeters were pre- in Table III.
pared, calibrated, and processed by the National
Institute of Radiation Protection. TLD material was
Discussion
LiF, calibrated against a Sr/Y-90 source, and preci-
sion was reported to be 915% (1 SD). Courtesy of To keep radiation exposure as low as reasonably
Svend Hvidsten, Odense University Hospital, results achievable (the ALARA principle) staffs handling
are also presented for fingertip measurements using radiopharmaceuticals must maintain good labora-
equivalent TLD tablets and similar shielding. In tory practice. This includes the use of tongs for
each preparation, 1 500 MBq of 90Y was handled, handling of radioactive solutions, doing work effec-
and about 1 200 MBq of 90Y-Zevalin was prepared. tively to keep exposure time low, and using proper
shielding for reducing exposure rate. The principles
of distance and time are the same whether the
Results
isotope handled is a gamma or a beta emitter,
Properties of 131I, 177Lu, and 90Y are compared in whereas optimal shielding depends on both the
Table I, along with ranges of beta particles in water type and energy of the radiation. Three beta-emit-
and the three shielding materials considered. Calcu- ting radioisotopes have been considered here.
lated bremsstrahlung yields from shielded 90Y are The classical radioiodine, 131I, is a beta emitter,
presented in Table II. but the beta decay is immediately followed by a
Measured bremsstrahlung spectrum from 90Y gamma decay of the excited daughter nucleus,
shielded by 10 mm perspex is shown in Figure 2. meaning that one has to shield as much against
In the same figure is also shown the attenuated gamma radiation as against beta radiation. The data
spectrum, calculated for 1 mm lead. in Table I on 131I are presented here mainly for
During an early test preparation of 90Y-Zevalin, comparison.
177
the laboratory table was contaminated with drops of Lu is gaining use for cancer therapy. The short
90
Y solution. Decontamination was made at once by range of its beta radiation makes it suitable for
one of the persons present, using no shielding. treatment of micro-metastasis, as most of the radia-
Afterwards, film dosimetry showed that the persons tion energy is distributed within a submillimetre
present at the incident had received skin doses (non- range from the site of the decay. As seen in Table I,
penetrating radiation) of 0.5, 0.7, 2.0, and 10 mSv, the beta radiation needs only relatively thin shield-
with the highest dose received by the person doing ing. 177Lu is not a pure beta emitter; the beta decay
the decontamination. These doses were attributable may be followed by emission of a photon of energy
to this single exposure. Corresponding one-month 208 keV (11%) or 113 keV (6%). From a clinical
effective doses (whole-body doses) were 0.2, 0.1, perspective this has the advantage that the distribu-
0.1, and 0.6 mSv, respectively. tion of the isotope can be visualized by a gamma
In the following year 11 preparations and injec- camera. From a radiation protection perspective, the
tions of 90Y-Zevalin were made by a team of 4 gamma radiation must be considered when shielding
persons, using perspex shielding (cf. Discussion is chosen. Three millimetres of lead will attenuate
section). Care was taken to avoid contaminations. 208 keV photons to 4% (of the 11%) and for
Film dosimetry showed that these persons had practical purposes completely absorb 113 keV
received one-year skin doses of 2.0, 2.4, 3.9, and photons. As the beta energy is low, the problem of
3.9 mSv. bremsstrahlung found with 90Y (see below) will be
small for 177Lu.
Table I. Comparison of three beta-emitters used for radiation 90
therapy. Y is increasingly being used for nuclear cancer
therapy. The isotope emits beta radiation with high
131
I 177
Lu 90
Y energy, suitable for treating tumours in the centi-
metre range. However, if care is not taken by the
Half-life 8.04 d 6.71 d 64.0 h persons preparing and injecting the radiopharma-
Radiation b  , g (100%) b  , g (17%) b
ceutical, they may receive relatively high radiation
Mean beta energy 182 keV 133 keV 933 keV
range in water 0.4 mm 0.25 mm 4.3 mm doses, and there has been at least one report of a
Maximum beta energy 807 keV 497 keV 2284 keV radiation accident among nuclear medicine staff
range in water 3.6 mm 1.9 mm 11.8 mm handling 90Y [3]. 90Y is a pure beta emitter with
range in perspex 3.1 mm 1.6 mm 10.3 mm no accompanying gamma radiation, and as seen by
range in 1.6 mm 0.8 mm 5.2 mm
Table I, even the most energetic electrons emitted
aluminium
range in lead 0.5 mm 0.3 mm 1.6 mm can be stopped by less than 2 mm lead. However, the
energy re-emitted as bremsstrahlung (x-rays) during
 Beta emitters and radiation protection 311
90
Table II. Mean bremsstrahlung yield pr. Y decay when shielded by lead, aluminium, or perspex.

Material Mean energy re-emitted as bremsstrahlung Percent of mean electron energy Bremsstrahlung relative to perspex

Perspex 3.9 keV 0.4% 1.0

Aluminium 8.5 keV 0.9% 2.2
Lead 71.8 keV 7.7% 18.2

the slowing-down process is relatively high when spectrum needs a few comments. At the lowest
lead is used as shielding material (cf. Table II). For energies the spectrum unrealistically falls to zero.
this reason, shielding materials with low atomic This is because the crystal in the camera is shielded
numbers, such as aluminium or perspex, are better from low energy radiation to avoid noise in clinical
choices. imaging. At high energy the recorded spectrum will
From a practical perspective, perspex has the underestimate the true spectrum, because high-
advantage of being transparent. Be aware, however, energy photons may pass the crystal undetected,
that perspex can be damaged by cleaning with although this has been anticipated by the recording
alcohol. This was realized the hard way by this setup (cf. Material and methods section). While the
author: One of our syringe shieldings developed spectrum shown is not the full truth, it is useful to
large cracks shortly after being sprayed with alcohol give a rough measure of the bremsstrahlung spec-
by yours truly, maybe because of the temperature trum from 70 keV to 300 keV, and an idea of
drop at the surface when the alcohol evaporated. We the spectrum above this range. Note specifically that
now disinfect perspex shielding with soap water. some of the bremsstrahlung is emitted with high
Rounding the figures in Table I, we find that energies, in principle up to the maximal electron
10 mm perspex or 5 mm aluminium is adequate energy.
shielding for 90Y. One should not be scared about Also seen in Figure 2 is the impact of adding 1
the difference between 10 and 10.3 mm or 5 and mm lead to the outside of the primary perspex
5.2 mm, since even the very seldom electron emitted shielding. As can be seen, the lead has a profound
with the highest possible energy (which might pass impact on bremsstrahlung with energies up to about
the full 10 mm of perspex or 5 mm of aluminium) 200 keV, whereas it has little effect at energies above
will have lost virtually all its energy on the way, thus 300 keV. Since most of the bremsstrahlung is
having almost no energy left for delivering radiation emitted in the lower energy range, the overall effect
dose beyond the shielding. is a considerable reduction of radiation beyond the
However, even when a low-atomic-number shield- shielding.
ing material is used, some bremstrahlung will be Vial and syringe shielding for 90Y used in our
emitted. Recorded bremsstrahlung spectrum after department are shown in Figure 3. For the vial in
10 mm perspex is shown in Figure 2. As a gamma use during the longest time of preparation we use a
camera is optimized for detection of photons in the container of perspex surrounded by lead glass (left).
range approximately 100
200 keV, the recorded This container provides very good shielding, but is
rather bulky. For shorter-period aspects of the
preparation, a container of 10 mm perspex without
secondary shielding is used (middle). Syringes are
shielded with 10 mm perspex (right).

Table III. Finger doses measured with TLD tablets for three
Intensity

individual preparations. In each case approximately 1 200 MBq of

90
Y-Zevalin was prepared by one person working with 1 500 MBq
90
Y.

left hand right hand

Base of ring finger

0 100 200 300 400 500
person A 3.2 mSv 3.7 mSv
photon energy, keV person B 2.0 mSv 0.6 mSv
Fingertips (all fingers), person C
Figure 2. Upper curve: Measured bremsstrahlung spectrum. min to max 1.6 to 6.8 mSv 0.11 to 0.75 mSv
Lower curve: Attenuated bremsstrahlung spectrum, calculated mean value 3.6 mSv 0.4 mSv
for 1 mm lead.
312 L. Jødal

Figure 3. Example of shielding. Left to right: Vial shielding made of perspex surrounded by lead glass, mini-vial shielding made of perspex,
and syringe shielding made of perspex.

Finally, staffs must also be aware of radiation Protection (ICRP) recommends annual dose limits
exposure during injection. Once 90Y is fully injected of 500 mSv for extremities/hands and for the skin
in the patient, the patient’s body gives very good (150 mSv for the lens of the eye) [4,5]. No measured
shielding for his or her surroundings. But during the finger or fingertip dose was above 7 mSv. Adding a
injection especially the fingers of the injecting person factor of two for safety, we find a limit of 35
may be exposed. This problem is enlarged by the preparations pr. person pr. year. These numbers
fact that therapy doses may have to be given slowly; refer to the handling of 1 500 MBq 90Y during
e.g., 90Y-Zevalin must be injected over 10 minutes. preparation of typically 1 200 MBq 90Y-Zevalin.
In our department we use the manual injector shown For further reading on radiation protection in
90
in Figure 4. The injector increases distance from Y-therapies, the reader is recommended the paper
fingers to activity, while at the same time providing by Cremonesi et al. [3]
shielding in the backward direction not covered by
the perspex shielding.
Conclusion
From the measured doses reported here we see
that care must be taken in the handling of 90Y. Beta emitters present other shielding issues than
Relatively large radiation doses (for laboratory work) gamma emitters. Once the beta emitter is inside the
may occur, as illustrated by the results of the patient, almost no radiation is given off to surround-
contamination incident, giving 10 mSv skin dose ings, but good laboratory practice (GLP) and
and an unknown finger dose. Good effect of proper suitable shielding are mandatory during preparation
shielding is seen by the finger and body doses and injection of the radioactive isotope. For high-
reported from clinical situations. For comparison, energy beta emitters like 90Y, lead is less suitable as
The International Commission on Radiological primary shielding material because of bremsstrah-

Figure 4. Manual injector for increased distance and improved shielding of fingers.
 Beta emitters and radiation protection 313

lung. 10 mm perspex or 5 mm aluminium provides References

good shielding of beta radiation from 90Y without [1] Zanzonico PB, Binkert BL, Goldsmith SJ. Bremsstrahlung
much bremsstrahlung production. Adding a milli- radiation exposure from pure beta-ray emitters. J Nucl Med
metre of lead on the outside of the primary shielding 1999;40:1024
8.
/ /

further reduces bremsstrahlung. With GLP and [2] Eckerman KF, Sjoreen AL. Radiological Toolbox. Oak Ridge
suitable shielding, the handling of 90Y can be a National Laboratory 2006. Available at: http://www.nrc.gov/
about-nrc/regulatory/research/radiological-toolbox.html
safe procedure, but if the number of preparations
[accessed 15-5-2008]
during a year is large, they should be divided among [3] Cremonesi M, Ferrari M, Paganelli G, Rossi A, Chinol M,
several persons. Bartolomei M, et al. Radiation protection in radionuclide
therapies with 90Y-conjugates: risks and safety. Eur J Nucl
Acknowledgements Med Mol Imaging 2006;33:1321
7.
/ /

[4] ICRP 60. 1990 Recommendations of the International

Additional data were presented from Department of Commission on Radiological Protection. Ann ICRP 1991;
Nuclear Medicine, Odense University Hospital, 21:1
201.
courtesy of Svend Hvidsten. The National Institute [5] ICRP 103. The 2007 Recommendations of the International
Commission on Radiological Protection. Ann ICRP 2007;
of Radiation Protection very helpfully provided and
37:1
332.
processed dosimeters for finger measurements.