Imaging of accidental contamination with F-18-solution; a quick trouble-shooting procedure

Document Type: Case report


1 Department of Molecular Radiotherapy & Nuclear Medicine, Docrates Cancer Center, Helsinki, Finland

2 Department of Radiation Physics, Docrates Cancer Center, Saukonpaadenranta, Helsinki, Finland



 To the best of our knowledge, imaging of accidental exposure to radioactive fluorine-18 (F-18) due to liquid spill has not been described earlier in the scientific literature. The short half-life of F-18 (t½=110 min), current radiation safety requirements, and Good Manufacturing Practice (GMP) regulations on radiopharmaceuticals have restrained the occurrence of these incidents. The possibility of investigating this type of incidents by gamma and positron imaging is also quite limited. Additionally, a quick and precise analysis of radiochemical contamination is cumbersome and sometimes challenging if the spills of radioactive materials are low in activity. Herein, we report a case of accidental F-18 contamination in a service person during a routine cyclotron maintenance procedure. During target replacement, liquid F-18 was spilled on the person responsible for the maintenance. The activities of spills were immediately measured using contamination detectors, and the photon spectrum of contaminated clothes was assessed through gamma spectroscopy. Despite protective clothing, some skin areas were contaminated, which were then thoroughly washed. Later on, these areas were imaged, using positron emission tomography (PET), and a gamma camera (including spectroscopy). Two contaminated skin areas were located on the hand (9.7 and 14.7 cm2, respectively), which showed very low activities (19.0 and 22.8 kBq respectively at the time of incident). Based on the photon spectra, F-18 was confirmed as the main present radionuclide. PET imaging demonstrated the shape of these contaminated hot spots. However, the measured activities were very low due to the use of protective clothing. With prompt action and use of proper equipments at the time of incident, minimal radionuclide activities and their locations could be thoroughly analyzed. The cumulative skin doses of the contaminated regions were calculated at 1.52 and 2.00 mSv, respectively. In the follow-up, no skin changes were observed in the contaminated areas.


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  1. Covens P, Berus D, Cavaliers V, Struelens L, Verellen D. Skin contamination of nuclear medicine technologists: incidence, routes, dosimetry and decontamination. Nucl Med Comm. 2012;33(10):1024-31.
  2. Bixler A, Springe G, Lovas R. Practical aspects of radi­ation safety for using fluorine-18. J Nucl Med Technol. 1999;27(1):14-6.
  3. Schleipman AR, Gerbaudo VH, Castronovo FP Jr. Radi­ation disaster response: preparation and simulation experience at an academic medical center. J Nucl Med Technol. 2004;32(1):22-7.
  4. Hussain RP. Management of radioactive spills in nucle­ar medicine; teaching and assessing with objectively structured assessment of technical skills. World J Nucl Med. 2015;14(2):89-94.
  5. Inoue Y, Asano Y, Satoh T, Tabata KI, Kikuchi K, Woodhams R, et al. Phase IIa clinical trial of Trans-1- amino-3-18F-fluoro-cyclobutane carboxylic acid in met­astatic prostate cancer. Asia Oceania J Nucl Med Biol. 2014;2(2):87-94.
  6. Kim JS, Park SY. Inflammatory pseudotumor in the epi­dural space of lumbosacral spine on 18F-FDG PET/CT. Asia Oceania J Nucl Med Biol. 2014;2(2):138-42.
  7. Saha GB. Fundamentals of nuclear pharmacy. 2nd ed. New York: Springer Science Business Media; 1984. P. 238
  8. Eckerman KF, Wolbarst AB, Richardson AC. Limiting values of radionuclide intake and air concentration and dose conversion factors for inhalation, submersion, and ingestion: Federal guidance report No. 11 (No. EPA- 520/1-88-020). Washington, DC: Office of Radiation Programs; Oak Ridge National Lab, TN (USA); 1988. P. 122-56.
  9. Covens P, Berus D, Cavaliers V, Struelens L, Vanhavere F, Verellen D. Skin dose rate conversion factors after contamination with radiopharmaceuticals: influence of contamination area, epidermal thickness and percu­taneous absorption. J Radial Prot. 2013;33(2):381-93.
  10. Moore PH Jr, Mettler FA Jr. Skin decontamination of commonly used medical radionuclides. J Nucl Med. 1980;21(5):475-6.
  11. Ruhman N, Grantham V, Martin C. The effectiveness of decontamination products in the nuclear medicine de­partment. J Nucl Med Technol. 2010;38(4):191-4.