Justification of differential approach to management of patient biological waste in nuclear medicine departments

The development of nuclear medicine technologies in the Russian Federation contributes to the implementation of new diagnostic radiopharmaceuticals in practice. Theranostic pairs such as antibodies and peptides labeled diagnostic and therapeutic radionuclides are beginning to be commonly used. The use of radionuclides with a longer half-life in radionuclide diagnostics causes the updating of the approaches to management of liquid waste generated as a result of the patient’s metabolic activity during the time spent in the radionuclide diagnostics department. Management of liquid radioactive waste in radionuclide diagnostic department is regulated by guidelines MU 2.6.1.1892-04. The guidelines are not the regulatory document. These were developed about 20 years ago, and do not considering features of the modern methods in radionuclide diagnostics, promising radionuclides with half-life of several days, and new criteria for classifying as a radionuclide waste in accordance with Resolution of the Government of the Russian Federation No. 1069. The aim of the study was the assessment of the radionuclide activities excreted from patient after radiopharmaceutical injection in radionuclide diagnostics departments in order to define the waste management pathways. In a result, all diagnostic and therapeutic radiopharmaceuticals were divided into the categories: radiopharmaceuticals with ultrashort-lived radionuclides, which can be discharged into the hospital sewerage without any restrictions; radiopharmaceuticals with ¹³¹I, which need the special sewerage; the other radiopharmaceuticals, which need to assess the volume of discharged radionuclide activities during the projection of the nuclear medicine department. The method of assessment of the radionuclide activities entering the hospital sewerage is presented. 

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