Advanced Physics for Brachytherapy 2018

NRC Information Notice 2009-17

“The NRC has received reports of numerous medical events caused by errors in confusing the units of source strength in the specification of sources—specifically, units of air-kerma strength and apparent activity in units of millicurie (mCi).”

“human error caused all these events”

27% overdose errors with 125 I

78% overdose errors with 192 Ir

use of apparent activity for brachytherapy sources is unsafe and inexcusable