Brief Report

Global Health & Medicine. 2024; 6(4):244-250.
DOI: 10.35772/ghm.2024.01023

Evaluation of X-ray protective goggles in mitigating eye lens radiation
exposure during radiopharmaceutical handling and patient care in
nuclear medicine
Tomoko Oikawa1,*, Kaori Saito1, Keiichi Kurihara1, Daisuke Horikawa1, Katsuhiko Uruno1, Hironori Kajiwara2,
Shuhei Ohashi1, Masatoshi Hotta3, Naoyuki Yagi1, Hideaki Kitamura1, Shinichi Hasegawa1, Ryogo Minamimoto3,4
1

Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan;
Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan;
3
Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan;
4
Department of Integrated Image Information Analysis, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
2

Abstract: The aim of this study is to estimate eye lens exposure dose when handling radiopharmaceuticals and interactingwith patients receiving radiopharmaceuticals, and to verify the usefulness of X-ray protective goggles in mitigatingsuch radiation exposure using phantoms. To evaluate radiation exposure during the handling of radiopharmaceuticals,
we employed a fluorescent glass dosimeter to measure the radiation doses associated with 99mTc, 123I, 131I, 111In, and 18F
at distances of 30 cm and 60 cm, followed by calculation of the 3 mm dose equivalent rate (3DER). We then estimatedthe dose reduction rates for various scenarios, including the use of syringe shields and X-ray protective goggles withlead equivalences of 0.07, 0.15, 0.75, and 0.88 mmPb, as well as their combined application. X-ray protective goggles
with lead equivalence of 0.75 mmPb outperformed those with 0.07 mmPb and 0.15 mmPb, for all radionuclides and at
both source distances. X-ray protective goggles with 0.88 mmPb outperformed those with 0.75 mmPb during handlingof 131I and 111In at a distance of 30 cm. In the remaining scenarios, X-ray protective goggles with 0.88 mmPb resulted
in marginal reductions or no discernible additional effects. The overall shielding effect of X-ray protective goggles wasless pronounced for 131I and 18F, but the combined use of a syringe shield with X-ray protective goggles with 0.75 or 0.88
mmPb improved the dose reduction rate for all scenarios. In simulating patient care, X-ray protective goggles with 0.88
mmPb demonstrated a dose reduction effect of approximately 50% or more. X-ray protective goggles could reduce the3DER for the eye lens, and were more effective when combined with a syringe shield. It is valid to use a lead equivalenceof 0.88 mmPb to fully harness the protective capabilities of X-ray shielding goggles when dealing with all five types of
nuclides in clinical settings.
Keywords: X-ray protective goggles, eye lens protection, radiation shielding, single photon emission computed
tomography (SPECT), positron emission tomography (PET)Introduction
Prior to 2011, the accepted threshold dose for radiationinduced cataracts was set as 1.5 Gy, but several studies
have suggested that cataracts could develop withradiation exposure of less than this (1-5). In responseto this evidence, the International Commission on
Radiological Protection (ICRP) issued a statement on
tissue reactions to radiation exposure (Seoul Statement)in April 2011, lowering the threshold radiation dosefor potential cataracts to 0.5 Gy. Furthermore, thelimit of the equivalent dose to the eye lens of radiation
workers was changed to "20 mSv on average for five
years and not to exceed 50 mSv in any one year" fromthat previously set as "not to exceed 150 mSv peryear" (6,7). The Ordinance on Prevention of Ionizing
Radiation Hazards in Japan was revised to align withthe threshold set by the ICRP, which was effective from
April 1, 2021.
Regarding X-ray examinations, X-ray protective
glasses have been recommended for cardiac
interventional radiology (IVR) based on reports that
0.07 mmPb X-ray protective glasses enable a reduction
in eye lens exposure of approximately 60% (8,9). In
nuclear medicine examinations, the use of syringe
shields, lead-containing protective plates, and X-ray
protective glasses have been shown to reduce radiation
exposure of eye lens (10-12). Matsutomo et al. reported
that the use of 0.75 mmPb X-ray protective goggles
when handling radiopharmaceuticals resulted in a(244)

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significant radiation dose reduction of 68.8% for 99mTc,
60.6% for 111In, and 68.1% for 123I (12). However,there have been no reports examining the usefulnessof X-ray protective goggles when it is necessary to benear a patient lying in bed during a nuclear medicine
examination, such as when the patient's condition
requires assistance.
The aim of this study was to estimate the 3 mmdose equivalent rate (3DER) for the eye lens and theusefulness of X-ray protective goggles when handlingradiopharmaceuticals with five nuclides, 99mTc, 123I, 131I,
111
In, and 18F. In addition, for the two major nuclides
18
F and 99mTc, we estimated the 3DER when interactingwith patients receiving radiopharmaceuticals, andassessed the utility of X-ray protective goggles for
mitigating exposure of eye lens to radiation.
The standard method for managing the equivalentdose to the eye lens is to use 1cm dose equivalent, 3 mmdose equivalent, and 70 μm dose equivalent, dependingon the type and energy of radiation. However, because
a glass dosimeter was used in this study, the 3 mm dose
equivalent rate was calculated by measuring air kerma.
This verification was conducted using phantoms.
Materials and Methods
Dose measurements were performed using a fluorescentglass dosimeter/small element system (Dose Ace
FGD-1000; ACG TECHNO GLASS Co., Ltd.
Shizuoka, Japan). Dosimetry was performed using
a radiophotoluminescent glass dosimeter (RPLD)
attached to the eyeball of a CT head phantom. Typesof RPLD were GD-352M for the assessment of 99mTc,
and GD-302M for the assessment of 18F, 131I, 111In,
and 123I. We read an initial value of air kerma foreach fluorescent glass dosimeter. After irradiation(measurement) while in the holder, preheating was

performed at 70 oC for 30 minutes, and the measured
values were read after being left at room temperature
until the temperature dropped to below 30 oC (13).
Regarding syringe shields, a UG-WS-25 shield(UNIVERSAL GIKEN, Kanagawa, Japan) was used
for SPECT preparations and a UG-FWS-TR50 tungsten
shield (UNIVERSAL GIKEN) was used for 18F
preparations. We used a NEMA IEC body phantom toverify measurements when interacting with patients.
Four types of X-ray protective goggles were used: 0.07
mmPb Panorama Shield (TORAY MEDICAL, Tokyo,
Japan), 0.15 mmPb EC-10 XRAY (ERICA OPTICAL,
Fukui, Japan), 0.75 mmPb X-Guard Click Monarch(SHOWA OPT, Osaka, Japan), and 0.88 mmPb Dr. B-Go
(Dr. Japan, Tokyo, Japan) (Figure 1).
Verification of radiation dose
The nuclides assessed in this study were selected basedon the results of a survey that included the frequency
of use of nuclides in nuclear medicine in Japan,
which appear to be generally consistent with those in
use worldwide (14). Radiation measurements wereconducted for sealed syringes containing 260 MBq of
99m
Tc, 50 MBq of 111In, 158 MBq of 123I, 36.5 MBq of
131
I, and 240 MBq of 18F, and these doses were set tosimulate their use in a clinical scenario.
In the assessment of simulated patient care during
a nuclear medicine examination, the backgroundconcentrations of the phantom were 18.0 kBq/ml for99m
Tc and 2.65 kBq/ml for 18F, following accepted
guidelines for phantom testing (15,16).
Estimation of 3 mm dose equivalent
In this study, air kerma read were taken five times
and the average value was used. To estimate the

Figure 1. Characteristics of X-ray protective goggles.

(245)

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exposure of eye lens to radiation when handlingradiopharmaceuticals and simulated patient care, we
calculated the 3DER by the formula (A) as follows:

E: 3 mm dose equivalent rate per radioactivity (μSv/
min/GBq)
D: air kerma (μGy)λ: decay constant (/min)
B: radioactivity amount at start of measurement(GBq)t: measurement time (min)k: conversion factor from air kerma to 3 mm dose
equivalent (Sv/Gy)
The mutual response value of RPLD to the energy of
the radionuclide was fixed to 0.9 (12,13). The conversion
coefficient from air kerma to 3 mm dose equivalent (k)was 1.449 for 99mTc and 123I, 1.286 for 131I, 1.372 for 111In,
and 1.210 for 18F (12,17).
Verification when handling radiopharmaceuticals
The distance between the eye lens and the radioactive
material was set at 60 cm based on the average lengthof the arm in Japanese individuals. A setting of 30 cm
was also used, to allow for bending of the elbows during
work (12). Radiation measurements were conducted
continuously for 1 hour for the following four situations:i) with no protection, ii) using only the syringe shield,iii) using only the X-ray protective goggles, and iv) using
both the syringe shield and the protective goggles.
Simulated patient care
In the simulation of patient care during a nuclear

medicine examination, measurements were obtainedat distances of 30 and 60 cm, and the height of the bed
was set at 95 cm. Measurements were made with theeyeball of the brain phantom set at heights of either 150
and 165 cm from the floor, consistent with the averageheights of Japanese women and men, respectively (Figure2). Radiation dose measurements were conducted
continuously for 30 minutes, and the 3DER was
calculated for these specific conditions.
Results and Discussion
In this study, we estimated the 3DER for the eye lensand the usefulness of X-ray protective goggles whenhandling radiopharmaceuticals prepared with eachof five nuclides ( 99mTc, 123I, 131I, 111In, 18F). For thetwo major nuclides, 18F and 99mTc, we also estimated
3DER when interacting with patients receiving
radiopharmaceuticals and assessed the utility of X-ray
protective goggles.
Shielding effect of syringe shield when handlingradiopharmaceuticals
Table 1 summarizes the shielding effect of the syringe
shield for each radionuclide at radioactive source
distances of 30 and 60 cm. The syringe shield reduced
the 3DER of 99mTc, 123I, 111In, and 18F by more than 70%,
and reduced the 3DER of 131I by about 30%. Except for
18
F, the reduction in 3DER was more pronounced at a
distance of 60 cm than at 30 cm.
In simulation of bone scintigraphy ( 99mTc, 950MBq) and PET examination ( 18 F, 240 MBq), if
radiopharmaceuticals are handled for 5 minutes a day
at a distance of 30 cm and without radiation protection,
the annual eye lens equivalent dose (240 days) is
estimated as 5.94 mSv/year for 99mTc and 8.63 mSv/year
for 18F, based on the results of the 3DER.

Figure 2. Phantom installation diagram (Horizontal/vertical direction).

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Table 1. Comparison of 3mm dose equivalent rate with and without syringe shield at distance of 30 cm and 60 cm
Radionuclide

99m

Tc

123

I

131

I

111

In

18

F

Protection

None
Syringe shield
None
Syringe shield
None
Syringe shield
None
Syringe shield
None
Syringe shield

Distance of 30 cm

Distance of 60 cm

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

5.21 ± 0.06
0.93 ± 0.00
8.94 ± 0.31
2.58 ± 0.08
16.70 ± 1.35
11.88 ± 0.55
25.71 ± 0.68
8.13 ± 0.36
29.97 ± 0.19
4.85 ± 0.08

82.1
71.1
28.9
68.4
83.8

5.21 ± 0.06
0.93 ± 0.00
8.94 ± 0.31
2.58 ± 0.08
16.70 ± 1.35
11.88 ± 0.55
25.71 ± 0.68
8.13 ± 0.36
29.97 ± 0.19
4.85 ± 0.08

82.1
71.1
28.9
68.4
83.8

Table 2. Reduction of 3 mm dose equivalent rate by X-ray protective goggles (distance-dependent variations)Radionuclide

99m

Tc

123

I

131

I

111

In

18

F

Goggle forprotection

None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb

Distance of 30 cm

Distance of 60 cm

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

5.21 ± 0.06
3.62 ± 0.07
3.39 ± 0.05
0.83 ± 0.10
0.89 ± 0.06
8.94 ± 0.31
5.00 ± 0.09
4.53 ± 0.19
2.58 ± 0.14
2.75 ± 0.19
16.70 ± 1.35
15.53 ± 0.85
14.35 ± 0.80
12.27 ± 0.71
10.31 ± 0.29
25.71 ± 0.68
13.52 ± 0.45
13.42 ± 0.28
10.57 ± 0.43
7.62 ± 0.36
29.97 ± 0.19
26.96 ± 0.10
26.62 ± 0.22
22.82 ± 0.05
21.90 ± 0.10

30.6
34.9
84.1
82.9
44.1
51.3
71.1
69.2
7.0
14.1
26.6
38.3
47.4
47.8
58.9
70.4
10.1
11.2
23.9
26.9

1.63 ± 0.05
1.28 ± 0.09
1.10 ± 0.12
0.39 ± 0.05
0.43 ± 0.05
6.15 ± 0.08
2.11 ± 0.37
2.24 ± 0.14
0.78 ± 0.09
0.65 ± 0.08
8.61 ± 0.29
6.66 ± 0.55
5.22 ± 0.00
4.70 ± 0.71
6.00 ± 1.26
13.92 ± 0.58
7.93 ± 0.28
5.29 ± 0.28
3.86 ± 0.28
3.46 ± 0.43
8.34 ± 0.11
8.00 ± 0.19
7.10 ± 0.08
6.84 ± 0.07
6.82 ± 0.04

21.5
32.9
76.0
73.4
65.8
63.5
87.3
89.5
22.7
39.4
45.5
30.3
43.1
62.0
72.3
75.2
4.0
14.8
18.0
18.2

Shielding effect of X-ray protective goggles whenhandling radiopharmaceuticals
Table 2 summarizes the shielding effect of X-ray
protective goggles for each radionuclide at radioactive
source distances of 30 and 60 cm.
X-ray protective goggles with lead equivalence of0.75 mmPb outperformed those with 0.07 mmPb and0.15 mmPb, for all radionuclides and at both source
distances. X-ray protective goggles with 0.88 mmPb
outperformed those with 0.75 mmPb during handlingof 131I and 111In at a distance of 30 cm. However, in theremaining scenarios, X-ray protective goggles with leadequivalence of 0.88 mmPb resulted in only marginal

reductions or no discernible additional effects. The
overall shielding effect of X-ray protective goggles wasless pronounced for 131I and 18F in comparison with theother radionuclides.
All of the tested X-ray protective goggles
demonstrated a dose reduction effect, and the dose
reduction rate tended to improve as the lead equivalence
increased. In particular, by using 0.88 mmPb X-ray
protective goggles, a high dose reduction effect ofapproximately 70% or more was obtained for 99mTc, 123I,
and 111In, and the reduction rate was about 20% to 40%
for 131I and 18F.
Although it has been reported that syringe shields
alone are effective in reducing radiation exposure(247)

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Table 3. Reduction of 3 mm dose equivalent rate by X-ray protective goggles with syringe shield (distance-dependent
variations)Radionuclide

99m

Tc

123

I

131

I

111

In

18

F

Goggles combinedwith a syringe
shieldSyringe shield only
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
Syringe shield only
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
Syringe shield only
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
Syringe shield only
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
Syringe shield only
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb

Distance of 30 cm

Distance of 60 cm

3 mm dose
equivalent rate
(μSv/min/GBq)

Reduction(%)

Reduction(%)
by goggle

3 mm dose
equivalent rate
(μSv/min/GBq)

Reduction(%)

Reduction(%)
by goggle

0.93 ± 0.00
0.79 ± 0.06
0.79 ± 0.09
0.52 ± 0.07
0.31 ± 0.00
2.58 ± 0.08
1.19 ± 0.12
0.68 ± 0.00
0.71 ± 0.14
0.95 ± 0.19
11.88 ± 0.55
8.87 ± 0.58
10.96 ± 0.55
6.52 ± 0.46
5.74 ± 0.55
8.13 ± 0.36
4.07 ± 0.62
2.95 ± 0.43
5.49 ± 0.43
2.34 ± 0.85
4.85 ± 0.08
4.66 ± 0.08
4.61 ± 0.04
3.03 ± 0.05
3.45 ± 0.08

82.1
84.9
84.9
90.1
94.1
71.1
86.7
92.4
92.0
89.4
28.9
46.9
34.4
60.9
65.6
68.4
84.2
88.5
78.7
90.9
83.8
84.4
84.6
89.9
88.5

15.6
15.6
44.4
66.7
54.0
73.7
72.4
63.2
25.3
7.7
45.1
51.7
50.0
88.5
78.7
90.9
3.9
5.0
37.5
29.0

0.27 ± 0.06
0.10 ± 0.00
0.31 ± 0.07
0.31 ± 0.10
0.21 ± 0.10
0.78 ± 0.09
0.48 ± 0.14
1.02 ± 0.12
0.71 ± 0.14
1.22 ± 0.08
5.35 ± 0.71
4.83 ± 0.36
4.96 ± 0.36
2.48 ± 1.26
2.87 ± 0.74
4.17 ± 0.56
2.44 ± 0.43
2.74 ± 0.58
2.95 ± 0.43
2.95 ± 0.23
1.87 ± 0.07
1.54 ± 0.11
1.67 ± 0.10
1.09 ± 0.05
1.09 ± 0.08

83.5
93.7
81.0
81.0
87.3
87.3
92.3
83.4
88.4
80.1
37.9
43.9
42.4
71.2
66.7
70.1
82.5
80.3
78.9
78.8
77.5
81.6
80.0
87.0
87.0

61.5
-15.4
-15.4
87.3
52.4
28.7
33.3
19.1
9.8
7.3
53.7
46.3
41.5
34.2
29.3
29.3
18.0
11.0
42.0
42.0

(10), wearing X-ray protective goggles may provide
an additional reduction in the exposure of eye lens toradiation, especially in cases of difficulties such as
mismatches between syringe and syringe shields.
Shielding effect of combined syringe shield with X-ray
protective goggles when handling radiopharmaceuticals
Table 3 shows the results of measurements performed
using both a syringe shield and goggles. "Reduction[%] by goggle" in Table 3 is the percentage differencein the 3DER between using only a syringe shieldand using both a syringe shield and goggles. At bothdistances, radiation dose tended to decrease as the leadequivalence of the X-ray protective goggles increased,
particularly for 131I and 111In. Dose reduction depended
largely on the use of a syringe shield and the source
distance for 99mTc, and on the use of a syringe shield for123
I. When a syringe shield and X-ray protective goggles
were both used at a distance of 30 cm from the source,
improvements in dose reduction rate were observed
for all nuclides. Based on these results, it is consideredbeneficial to wear X-ray protective goggles in addition
to using a syringe shield when the radiation worker
should stay close to the radiation source and handle
radionuclides with high energy and a long half-life.
In terms of effects on the 3DER and the reduction
rate, it is imperative to use X-ray protective goggles

with a minimum 0.75 mmPb to fully harness theprotective capabilities of it when dealing with all five
types of nuclides in clinical settings.
The dose reduction rate achieved using a syringe
shield or X-ray protective goggles was lower for 131I
than for other nuclides. The reason for this finding
appears to be that 131I has an energy of 364 keV and ahalf-life of about 8 days, which are both higher values
than for other nuclides. However, the present results
indicate that combined use of a syringe shield with
X-ray protective goggles would contribute to improving
the dose reduction rate for 131I.
When handling 18F radiopharmaceuticals, the 3DER
can be reduced from 8.63 mSv/year to 1.40 mSv/year
by using a syringe shield, and that further reductions
can be achieved by the combined use of a syringe shieldwith X-ray protective goggles.
Verification of shielding effect of X-ray protective
goggles in simulated patient care
Table 4 shows the results of the shielding effectof X-ray protective goggles for two radionuclides(99mTc and18F) at distances of 30 and 60 cm from the
NEMA phantom. At all distances and heights, the dose
reduction rate improved as lead equivalence increased.
The results of the NEMA phantom study indicatedthat X-ray protective goggles with 0.88 mmPb are(248)

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Table 4. Reduction of 3 mm dose equivalent rate by X-ray protective goggles based on NEMA phantom study (distancedependent variations)Radionuclide

99m

Tc

Height(cm)

Goggle forprotection

150

None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb
None
0.07 mmPb
0.15 mmPb
0.75 mmPb
0.88 mmPb

165

18

F

150

165

Distance of 30 cm

Distance of 60 cm

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

3 mm dose equivalent rate
(μSv/min/GBq)

Reduction(%)

1.45 ± 0.20
1.45 ± 0.35
1.16 ± 0.20
0.87 ± 0.20
0.58 ± 0.35
1.04 ± 0.33
0.87 ± 0.25
0.69 ± 0.34
0.52 ± 0.48
0.52 ± 0.31
18.09 ± 1.64
18.09 ± 0.00
16.44 ± 1.64
9.87 ± 5.07
9.87 ± 1.16
13.81 ± 3.00
12.83 ± 6.64
11.84 ± 1.96
9.87 ± 3.08
6.91 ± 1.57

0.0
20.0
40.0
60.0
16.7
33.9
50.0
50.0
0.0
9.1
45.5
45.5
7.1
14.3
28.6
50.0

1.16 ± 0.35
1.13 ± 0.29
0.87 ± 0.29
0.58 ± 0.20
0.46 ± 0.22
1.04 ± 0.30
1.04 ± 0.38
0.97 ± 0.30
0.52 ± 0.40
0.52 ± 0.56
14.80 ± 2.01
13.16 ± 2.01
11.51 ± 1.64
8.22 ± 1.64
4.93 ± 2.60
13.32 ± 1.90
13.32 ± 1.43
10.36 ± 1.12
7.40 ± 2.32
5.92 ± 2.43

2.5
25.0
50.0
60.0
0.0
6.9
50.0
50.0
11.1
22.2
44.4
66.7
0.0
22.2
44.4
55.6

optimal for achieving maximum dose reduction under
all circumstances. Even at a source distance of 60 cm,
the present results demonstrated the efficacy of X-ray
protective goggles for reducing radiation dose, andthat this effect was more prominent when using X-ray
protective goggles with 0.88 mmPb equivalence.
The use of X-ray protective goggles of 0.75 mmPb
equivalence reduced radiation dose for various radiation
sources, as found in the assessment of dose to theeyeball in a CT head phantom (Table 2). However, the0.88 mmPb X-ray protective goggles reduced the doseby more than 50%, which was greater than that with the
0.75 mm X-ray protective goggles in the assessment
performed using the NEMA phantom to simulatepatient care. Considering the difference between theradiation source and the NEMA phantom, 0.88 mmPb
X-ray protective goggles might be the most effective
for reducing radiation coming from a wider range ofsources.
With reference to background radiation dose in thephantom studies according to the Imaging Guidelines forPhantom Studies (15,16), in simulation of the situationof attending to each patient for 10 minutes, for 10 people
per day, the estimated radiation exposure received frompatients was 6.44 mSv/year for 99mTc and 11.85 mSv/
year for 18F. Under this condition, when exposure during
handling of radiopharmaceuticals is also taken into
account, the average value over a five-year period could
exceed the dose limit for 18F. In simulation of patientcare of PET examination, the 3DER can be reduced
from 11.85 mSv/year to 6.46 mSv/year by using 0.88
mmPb X-ray protective goggles. In the case of the othernuclides, using this equipment will also contribute tominimizing the 3DER.
The results showed that X-ray protective goggles
could reduce the 3DER for the eye lens, and weremost effective when combined with a syringe shield.
However, it is imperative to use a syringe shield with aminimum equivalence of 0.88 mmPb to fully harness theprotective capabilities of X-ray shielding goggles when
dealing with all five types of nuclides in clinical settings.
Matsutomo et al. reported that for X-ray protective
goggles, lead equivalence of around 0.75 mmPb or
higher is desirable when handling radiopharmaceuticals(12), in agreement with the present results. Our study
additionally assessed a greater variety of nuclides andconducted a simulation of patient care. However, it isimportant to note that as the lead equivalence increases,
the increasing weight of the goggles and narrowingof the field of view may become burdensome for thewearer, particularly when worn for a long period oftime. Moreover, some protective goggles cannot be
used while wearing corrective eyeglasses. In addition,
lutetium oxodotreotide ( 177Lu), which has recently
been used in Japan as a nuclear medicine treatment forneuroendocrine tumors, has a very high dose of 7.4 GBq
per dose, so it is expected that crystalline lens protection
glasses specialized for nuclear medicine examinations
will be developed in the future.
Acknowledgements
We thank Kazuhiko Nakajima for producing 18F and
Kahori Miyake for managing the funds.
Funding: This work is supported by the PDRadiopharma(249)

Global Health & Medicine. 2024; 6(4):244-250.

www.globalhealthmedicine.com

Inc. (PDR academic support [Shogaku Kifu program]).
Conflict of Interest: The authors have no conflicts ofinterest to disclose.
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---Received March 4, 2024; Revised July 27, 2024; Accepted
August 5, 2024.
Released online in J-STAGE as advance publication August 7,
2024.
*Address correspondence to:
Tomoko Oikawa, Department of Radiological Physics andTechnology, National Center for Global Health and Medicine,
1-21-1, Toyama, Shinjyuku-ku, Tokyo 162-8655, Japan.
E-mail: toikawa@hosp.ncgm.go.jp(250)