Medical Uses of Radiation

What Is Nuclear Medicine? Nuclear medicine—a vital component of the

rapidly emerging field of molecular imaging—is a medical specialty that uses
small amounts of radioactive materials bound to special compounds
(radiopharmaceuticals) in combination with imaging instrumentation that
examine molecular processes in the body to detect and evaluate disease,
such as brain disorders, heart disease and cancer. In addition,
radiopharmaceuticals are used for therapy in the treatment of, for example,
overactive thyroids and some cancers.

What Is Radiation? Radiation is simply a type of energy; the most familiar

form of radiation is visible light (like that produced from the sun or a light
bulb). Other forms, like X-rays and gamma rays, are employed in a number
of beneficial applications, including medicine. Natural radiation exposure
comes from the earth (rocks, soil) and outer space (cosmic rays). A small
amount of radioactive material even exists naturally in our bodies. Every
year, each person is exposed to this natural radiation and a variety of other
sources, including household smoke detectors and color television sets. Air
travel increases exposure to cosmic radiation due to the higher altitudes
(less atmospheric shielding).

How Is Radiation Used in Nuclear Medicine? In a nuclear medicine

diagnostic procedure, small amounts of radiopharmaceuticals are introduced
into the body by injection, swallowing or inhalation. The amount of the
radiopharmaceutical that is used is chosen to provide the lowest radiation
exposure to a patient while ensuring an accurate medical evaluation. These
radiopharmaceuticals are designed to go to specific organs (for example, the
liver or the heart). A special radiation detector (scintillation camera) is used
to obtain images of the distribution of the radiopharmaceutical in the body.
PET (positron emission tomography) scans provide a means to study many
types of disease in the body by determining how a disease uses radioactively
labeled sugar, thus using the body’s own processes to determine disease
status.

What Levels of Radiation Are Involved With Diagnostic Nuclear

Medicine Procedures? The amounts of radioactivity administered to the
patient are relatively small and are designed to provide the highest quality
diagnostic information possible while minimizing the radiation dose to
internal organs. The radiation dose to different patients and internal organs
varies with procedure. A typical nuclear medicine procedure may impart a
radiation dose to the patient comparable to about one to four years of
natural background radiation depending on the type of study.1 As with X-
rays, the value of diagnostic imaging is great and the risks are negligible
compared to the health benefits of having the procedure.
How Do Nuclear Medicine Procedures Compare With X-Rays and CT
scans? Nuclear medicine scans detect the radiation coming from a
radiopharmaceutical that is inside a patient’s body. In contrast, other
imaging procedures (for example, X-ray and CT scan) obtain images by using
machines that send radiation through the body. Nuclear medicine is also
different from other imaging procedures in that it determines the presence of
disease based on biological changes in tissue rather than changes in
anatomy. Nuclear medicine procedures are among the safest diagnostic
imaging exams available; the amount of radiation received from a nuclear
medicine scan is comparable to that of many diagnostic X-ray and CT
procedures.

As a Patient, What Do I Need To Know? As with all medical procedures,

the safety of nuclear medicine procedures is enhanced when patients are
well informed about the particular test or treatment and there is a clear and
open line of communication between patients and medical teams regarding
safety and the treatment protocol. Patients should know what specific
radiopharmaceutical—including what radioisotope—will be used in their
treatment or procedure. All radionuclide’s have a "half-life," which is a time
that it takes for it to decay away, so patients may continue to emit
detectable levels of radiation for different periods of time after different
treatments.

Diagnostic Tests

• Diagnostic nuclear medicine studies are performed with Tc-99m

(technetium-99m), which should not be detectable—even by sensitive
radiation monitors—three or four days after a test.
• Fluorine-18 (F-18), usually attached to glucose (FDG), is the most
common radioisotope used with PET imaging; it should be
undetectable one day after a test.
• Myocardial perfusion (blood flow) imaging can be performed with
technetium-99m (Tc-99m), thallium-201 (Tl-201) or a combination of
both. While Tc-99m is undetectable after only a few days, Tl-201 may
remain detectable for 30 days.

Treatment or Therapy

• Iodine-131 (I-131), used to treat hyperthyroidism, thyroid cancer and

lymphoma, may remain detectable for as long as three months after
treatment.

How Can I Get This Information? SNM suggests that physicians and
medical teams explain to patients the risks inherent in any nuclear medicine
procedure with regards to radiation exposure to themselves and others and
provide clear, safety instructions when discharged.
 • Patients and health care providers should discuss how long patients
may emit detectable radiation following treatment.
• Patients—especially if they are going to travel—should obtain a letter
from their doctor that contains the following information: the patient’s
name, contact information for the testing facility, the name of nuclear
medicine procedure, the date of the treatment or test, the radionuclide
that was used, its half-life, its administered activity and 24-hour
contact information.

Does Nuclear Medicine Save Lives? Yes. More than 20 million Americans
benefit each year from nuclear medicine procedures used to diagnose and
treat a wide variety of diseases. The use of radiation in these procedures—
with low risks—offers a safe and cost-effective means to provide doctors with
information that would otherwise require exploratory surgery, necessitate
more costly and invasive procedures or simply be unavailable. The risks of
not performing a needed medical exam are usually much greater than the
risks of the radiation exposures associated with the exam.

Use of Radiation in Agriculture

Agricultural Tracers

Tracers like those used in medicine are also used in agriculture to study
plants and their intake of fertilizers. The usage of tracers allows scientists
and farmers to optimize the use of fertilizing and weed killing chemicals.
Optimization of these chemicals is desirable because it saves money, and
reduces chemical pollution. When fertilizers are used in overly excessive
amounts, the excess will run off and pollute rivers nearby, as well as possibly
seeping through to the water table underground and polluting the water
supply. To prevent this, studies are conducted to find out the optimal
amount of chemical required, with fertilizers and weed killers often tagged
by nitrogen-15 or phosphorus-32 radioisotopes. These radioisotopes are
analyzed in the crops to see how much of the original chemical was actually
consumed by the plants, compared to how much was given.

The ionizing radiation from radioisotopes is also used to produce crops that
are more drought and disease resistant, as well as crops with increased yield
or shorter growing time. This practice has been in place for several decades,
and has helped feed some third-world countries. The collections of crops that
have been modified with radiation include wheat, sorghum, bananas and
beans.
Insect Control

About 10% of the world's crops are destroyed by insects. In efforts to control
insect plagues, authorities often release sterile laboratory-raised insects into
the wild. These insects are made sterile using ionizing radiation - they are
irradiated with this radiation before they hatch. Female insects that mate
with sterile male insects do not reproduce, and the population of the insect
pests can be quickly curbed as a consequence. This technique of releasing
sterile insects into the wild, called the sterile insect technique (SIT), is
commonly used in protecting agricultural industries in many countries
around the world.

The technique is considered to be safer and better than conventional

chemical insecticides. Insects can develop resistance against these
chemicals, and there are health concerns about crops treated with them.

The largest application of this technique so far was conducted in Mexico

against Mediterranean fruit-fly and screwworm in 1981. It was highly
successful, and over the next 10 years the eradication program yielded
about US$3 billion in economic benefits to the country.

SIT is in use in several countries, with support from the UN Food and
Agriculture Organisation (FAO) and the International Atomic Energy Agency
(IAEA). Australia is a large producer of many fruits and sterilizes up to 25
million fruit fly pupae per week.

Food Treatment and Preservation

Ionizing radiation is used as an alternative to chemicals in the treatment and

preservation of foods. A French scientist first discovered that radiation could
be used to prolong food shelf life in the 1920s and it became more widely
used in World War II. Today, astronauts often eat radiation-preserved food
while on space missions.

In meats and other foods of animal origin, irradiation destroys the bacteria
that causes spoilage as well as diseases and illnesses such as salmonella
poisoning. This allows for a more safer food supply, and meats that can be
stored for longer before spoilage. Additionally, irradiation also inhibit tubers
that cause fruits and vegetables to ripen. The result is fresh fruits and
vegetables that can be stored for longer before ripening.

The irradiation technique is particularly important when exporting to

countries with tropical climates, where foods can be spoiled easily due to the
warm temperatures.
Irradiation of food is carried out using accelerated electrons (beta radiation),
and ionizing radiation from sources such as the radioisotopes cobalt-60 and
cesium-137. X-rays are also sometimes used. None of these sources of
radiation used have enough energy to make the exposed foods radioactive.

the above table shows the typical doses of radiation used for food
treatment
Radiation dose
Purpose
(kilo grays, kGy)
inhibits fruit and vegetable ripening
"low" up to 1 kGy controls some bacteria in meats
controls insects in grains
destroys bacteria in meat including salmonella,
"medium" 1-10 shigella, campylobacter and Yesinia
inhibits mold growth on fruit
destroys insects and bacteria in spices
"high" more than 10
sterilizes food to the same extent achieved by high
kGy
heat

Inside the food treatment plant there is a conveyor belt or similar system
that transports the food to the radiation source, so that workers do not have
to move close to the radiation. The source is packaged in a pencil like device,
about 1cm in diameter. The room where irradiation takes place is shielded by
concrete walls to prevent radiation from escaping into the environment,
although the radiation risk is considerably much less than that from a
nuclear reactor. Where gamma radiation is used from a radioisotope source,
the radioisotope is stored in a pool of water while not in use, to also help
prevent radiation from escaping. However, the plant is in many ways similar
to any other - refrigeration is still important. No process can make food
completely spoil-proof.

Food treatment plants of this kind are monitored closely by government

health and occupational safety authorities to ensure safe working conditions
for employees, as well as safety to any nearby residents.

Food irradiation is a well-tested process. Scientists have performed

numerous decades of research, and it has been shown that irradiation will
not cause significant chemical changes in foods that may affect human
health, nor will it cause losses that may affect the nutritional content of food.
(Chemical residues left behind by irradiation are in concentrations equivalent
to about 3 drops in a swimming pool. Chemical-based preservatives and
treatments usually leave more residues.) Taste is usually unaffected. The
World Health Organization and food safety authorities in many countries
have approved irradiation as a safe method of food treatment and
preservation.

Radiation-treated food is still not very widely used today. Despite the
scientific evidence and approvals, many activist organizations claim that
irradiation is unsafe and exploit the lack of public awareness and concerns
about food safety and nuclear issues. Some even say that irradiation is a way
that governments can utilize nuclear wastes left over from weapons testing
or power generation. (However, the wastes left cannot be used in food
processing because they do not provide the right type of ionizing radiation.)
Consequently, these scare tactics deter the public and some food producers
are reluctant to use irradiation for fear of consumer boycotts. However, a
recent survey conducted in mid-1998 by the Food Marketing Institute (a
United States organization) revealed that less than one percent of all those
surveyed identified irradiation as a concern. Most said that spoilage and
microbial hazards were of great concern - they very problem that irradiation
addresses. Another study by an academic revealed that about 99% of
consumers were willing to buy irradiated food after they were shown
scientific data and irradiated food samples. This compared to 50% before
shown this data.

Irradiation poses less of a risk to human health than many chemical

treatments that are used today, which include the addition of chemical
preservatives. The use of radiation is sometimes favored to using chemical
preservatives, because no allergic side-effect results. It is also better than
heat-sterilization because irradiation does not destroy nutrients and
vitamins, whereas heat treatment does.

Irradiation is inexpensive - typical costs are about 1-20 cents per kilogram of
food irradiated.