Appendix A: Training Requirements For Human Use of Radioactive Materials

  1. Requirements For Human Use of Radioactive Materials

    1. Training in basic radioisotope handling techniques (200 hours) should consist of lectures, laboratory sessions, discussion groups or supervised experience in a nuclear laboratory in the following areas:
      1. Radiation physics and instrumentation
      2. Radiation protection
      3. Mathematics pertaining to the use and measurement of radioactivity
      4. Radiation biology
      5. Radiopharmaceutical chemistry
    2. Experience with the types and quantities of radioactive material for which application is being made, or equivalent (500 hours) is required.
    3. Supervised clinical training in an institutional nuclear medicine program (500 hours) is required. The clinical training should cover all appropriate types of diagnostic procedures to include:
      1. Supervised examination of patients to determine the suitability for radioisotope diagnosis and recommendation on dosage to be prescribed.
      2. Collaboration in calibration of the dose and the actual administration of the dose to the patient including calculation of the radiation dose, related measurement and plotting data.
      3. Follow-up of patients when required.
      4. Study and discussion with preceptor of case histories to establish most appropriate diagnostic procedures, limitations, contraindications, etc.

  2. Requirements for Specific Diagnostic and Therapeutic Procedures

    1. Training (80 hours) in basic radioisotope handling techniques is required, including:
      1. Radiation physics and instrumentation.
      2. Radiation protection.
      3. Mathematics pertaining to the use and measurement of radioactivity.
      4. Radiation biology.
    2. Clinical training in specific therapy procedures is required, including:
      1. Iodine-131 for treatment of hyperthyroidism with active participation in the treatment of 10 patients.
      2. Iodine-131 for treatment of thyroid carcinoma; clinical experience in diagnosis of thyroid function and treatment of hyperthyroidism and/or cardiac dysfunction with active participation in the treatment of 3 patients with thyroid carcinoma.
      3. Phosphorous-32 for treatment of polycythemia vera, leukemia and/or bone metastases; treatment of 3 patients with any combination of these three conditions.
      4. Colloidal phosphorous-32 intracavitary treatment; active participation in the treatment of 3 patients.

  3. Requirements for Therapy Procedures Involving Sealed Sources

    1. Training in basic radioisotope handling techniques (200 hours) as described in section I.A of this Appendix is required.
    2. Clinical training in specific therapy procedures should include:
      1. Radiation sources for interstitial, intracavitary, or surface treatment of cancer; active practice in therapeutic radiology with a minimum of three years experience.
      2. Beta ray applicators for the treatment of superficial eye disease; active practice in therapeutic radiology or ophthalmology and experience in the therapeutic use of beta rays or low-energy X-rays.

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