RADIOISOTOPES

Hospital-based cyclotron facilities require an integrated operational system after implementation of in-house fluorine-18 fluorodeoxyglucose production. This article summarizes practical issues encountered during the first two years of routine operation, including standard operating procedures and change control, equipment and environmental management, quality assurance, personnel training and backup capacity, inventory and radioactive waste management, radiation safety management, and coordination with clinical departments. Detailed analyses of individual topics, including occupational exposure, waste management, irradiation conditions, questionable quality test results, post-maintenance changes, and inventory management, are outside the scope of this article and are treated as separate topics. The experience indicates that sustainable operation depends on an integrated quality assurance system that links responsibilities, communication pathways, documentation, education, and continuous improvement. In addition to the conventional principles of time, distance, and shielding, two complementary operational radiation protection principles are proposed: avoiding production of unnecessary radioactivity beyond clinical demand and preventing concentration of occupational exposure and workload in particular workers. Radiation protection in hospital-based radiopharmacy therefore begins at the stages of production planning and workforce organization.