Problems associated with iridium-192 wire implants

Development of a method for treating lower-eyelid carcinomas using superficial high dose rate brachytherapy

In this study, a method was developed for delivering high dose rate (HDR) brachytherapy treatments to basal cell carcinomas (BCCs) as well as squamous cell carcinomas (SCCs) of the lower eyelid via superficial catheters. Clinically-realistic BCC/SCC treatment areas were marked in the lower-eyelid region on a head phantom and several arrangements of catheters and bolus were trialled for treating those areas. The use of one or two catheters of different types was evaluated, and sources of dosimetric uncertainty (including air gaps) were evaluated and mitigated. Test treatments were planned for delivery with an iridium-192 source, using the Oncentra Brachy treatment planning system (Elekta AB, Stockholm, Sweden). Dose distributions were evaluated using radiochromic film. The proposed method was shown to be clinically viable, for using superficial HDR brachytherapy to overcome anatomical difficulties and create non-surgical treatments for BCC and SCC of the lower eyelid.

The radioactive autopsy: safe working practices

Autopsy cases involving individuals retaining radioactive substances are fortunately rare, but when they occur they can impose significant radiation safety and legal requirements. This review aims to improve the understanding of these issues so that appropriate precautions are implemented when necessary. This review describes the properties of ionizing radiations, natural and man-made sources of ionizing radiation and its use in healthcare. It identifies the most likely circumstances leading to radioactive substances being present during autopsy and sources of information, including radiation protection advice. It discusses precautions that may need to be implemented prior to, during and following autopsy. Despite the issue of appropriate information to patients and next of kin, it is inevitable that some cases will be identified only at autopsy and it is important that robust local procedures are maintained. Information must be communicated to assist safe management of the body and liaison between relevant professional groups may be needed to standardize methods of communication. Provided that appropriate precautions are implemented, determined through consultation with a qualified expert in radiation protection and by completion of risk assessment, the radioactive autopsy can be undertaken safely and in compliance with relevant legislative requirements.