Reformatting Licenses Adoption of 10 CFR 35

January 2011 RHB will amend all licenses to reflect Part 35 format beginning in January Licenses will have similar appearance to existing format Changes to groups and authorized use Some easier than others

Review of Part 35 Groups Group 1  : uptake, dilution and excretion studies, no WD required Groups 2 and 3  : imaging and localization studies, no WD required Groups 4 and 5  : use of unsealed radioactive material, WD is required

Review of Part 35 Groups Group 6  : use of sources for manual brachytherapy Group 7  : use of sealed sources for diagnosis Groups 6 and 8  : use of sealed source in remote HDR afterloader, Teletherapy or GSR : Other medical uses not specially addressed in 10 CFR 35 subparts D - H

“Other medical uses of byproduct material or radiation from byproduct material” Also called “Emerging Technologies” Procedure may not necessarily be new –Yttrium-90 TheraSpheres and/or SIRSpheres –Best Vascular, Inc. Beta-Cath IntravascularBrachytherapy System –NeoVista, Inc. Epi-Rad Ophthalmic –I-125 GliaSite Radiation Therapy System

(cont.) Leksell Gamma Knife Perfexion I-125 and Pd-103 LDR seeds used for localization of non-palpable lesions Nucletron seed Selectron System, Isotron Brachytherapy Sources and Nucletron FIRST System

Generators Old Group 3: Reagent kits and generators for preparation of radiopharmaceuticals listed for Group 2 Group 2 and 3 combined in : imaging and localization studies Authorization found in , Training for imaging and localization studies: –Board certification (ABR, ABNM) or –Training and experience including eluting generator systems appropriate for preparation of radioactive drugs for imaging and localization studies, measuring and testing the eluate for radionuclide purity, and processing the eluate with reagent kits to prepare labeled radioactive drugs; and

License Example 6.Nuclide A.Any radioactive material permitted by 10 CFR B.Any radioactive material permitted by 10 CFR Nuclide A.Groups 1 and 2 as specified in Item 9. Any radionuclide with atomic numbers Authorized Use A. Any uptake, dilution and excretion study permitted by 10 CFR B. Any imaging and localization study permitted by 10 CFR NEW FORMATOLD FORMAT 9. Authorized Use Group 1 Diagnostic studies involving measurement of uptake, dilution, or excretion, but not involving imaging. Group 2Diagnostic studies involving imaging

License Example 6. Nuclide7. Form8. Possession Limit A. Iridium-192 permitted by 10 CFR A. Sealed sources (Varian Medical Systems, Inc., Models Gammamed 232) A. Total 20 Ci in 2 sources. No single source to exceed 12 Ci. Authorized Use To be used for nuclear medicine procedures as specified below: A. One source for medical use described in 10 CFR , in a Varian Medical Systems, Model GammaMed Plus HDR remote afterloading unit. The source activity may not exceed 12 curies at the time of medical use. One source in a shipping container as necessary for replacement of the above source in the remote afterloader unit. (Was Group 6)

Administration of I-131 Physician authorization for 10 CFR will be specified to make the transition from Groups 4 and 5. If previously authorized for Group 4, then “10 CFR , quantities less than or equal to 33 mCi I-131 only.” If previously authorized for Group 5, then “10 CFR , I-131 only.” , Oral administration of I-131 in quantities less than or equal to 33 mCi for imaging and localization studies.

Brachytherapy Not a clear transition for Group 6 Manual Brachytherapy: 10 CFR HDR Brachytherapy: 10 CFR TheraSpheres, SIR Spheres, other newer modalities: 10 CFR

Physician Authorizations Will specify quantity of of I-131, allow all of , or list exclusions All of , likely no exclusions Will specify HDR, GSR or Teletherapy Will specify other uses

Grandfathering Provisions for Physician Authorized Use Read the Information Notices!! Harder to do after January 1 due to use of new forms and required preceptor signatures

Other changes No Alternate RSO for Medical Licenses –RSO can name qualified individual in writing –RSO still responsible for radiation safety program –ARSO does not exist in Part 35 No Custodian of Sealed Sources (due to repeal of Title 10 CCR ) This responsibility belongs to the RSO.

Summary Reformatted licenses will include Part 35 structure “Groups” going away Authorizations for use not necessarily given for the entire category Read your information notices and request any changes before January 1.