Radioprotection 2026, 61( 2), 146 – 155 © C. Michel et al., Published by EDP Sciences 2026 https:// doi. org / 10.1051 / radiopro / 2025035 Available online at: www. radioprotection. org
ARTICLE
Radiation protection management for the deceased patients in nuclear medicine. Part 1: staff in charge of body transport and embalming
C. Michel *, D. Célier and A. Isambert Autorité de Sûreté Nucléaire et de Radioprotection( ASNR), F-92260, Fontenay-aux-Roses, France. Received: 14 March 2025 / Accepted: 7 September 2025
Abstract – In France, in 2007 and 2008, a few deaths occurred for patients who had recently undergone nuclear medicine treatments. Following these events, since there were few guidelines, the French Institute for Radiation Protection and Nuclear Safety( IRSN) investigated radiation protection measures applicable after the death of such patients. An initial study conducted between 2008 and 2016 was updated in 2022 to account for new clinically introduced radionuclides. This article consolidates these efforts to provide a comprehensive overview of operational guidelines for professionals involved in the body transport and embalming of deceased patients after a nuclear medicine treatment. Dose assessments were performed using conservative assumptions based on insights from funeral service professionals. As a result, post-mortem waiting periods required to meet a dose constraint of 300 mSv per operation were established. Except for iodine-131 used in cancer treatment( Sodium iodide, MIBG, and Lipiocis ®) and therapeutic indium-111 pentetreotide, the recommended waiting periods were estimated to be less than a week. These recommendations will serve as a valuable resource for nuclear medicine departments and funeral professionals to manage the death of a patient after nuclear medicine treatment.
Keywords: radioactive corpse / nuclear medicine / radiation protection / body transport / embalming
1 Introduction
In France, in 2007 and 2008, a few deaths occurred for patients who had recently undergone nuclear medicine treatments, due to unexpected circumstances and not associated to their treatment nor their disease. Two cases were identified as significant from a radiation protection perspective: the patients died from heart attack less than 24 h after administration: one following iodine-131 MIBG( metaiodobenzylguanidine) treatment( Djoumessi et al., 2009), and the other after treatment with samarium-153 lexidronam pentasodium( Quadramet ®)( Lortal et al., 2009). Following these events, the French Institute for Radiation Protection and Nuclear Safety( IRSN) investigated radiation protection measures to implement after the death of patients who underwent nuclear medicine treatments.
Over the period 2008 – 2016, IRSN conducted an initial study( IRSN, 2017) on radiation exposure risks for professionals involved in transport of deceased patients, and in their embalming. More recently, in 2022, the French Nuclear Safety Authority( ASN) requested IRSN to update the previous
* Corresponding author: celian. michel @ asnr. fr assessments including the new clinically introduced radionuclides( IRSN, 2023).
Although early death of patients following nuclear medicine treatment is rare, there is a lack of consensual recommendations to manage such cases. This is highlighted in reports published by the European Commission( European Commission, 1998), the International Commission on Radiological Protection( ICRP Publication 94, 2004), and the International Atomic Energy Agency( IAEA, 2009). Furthermore, to date, no other studies than that of Djoumessi( Djoumessi et al., 2009) have been identified in the literature that assess the radiation exposure of professionals involved in the transport and embalming of deceased patients after nuclear medicine treatments.
Therefore, the aim of this article is to provide a comprehensive overview of practical recommendations from IRSN studies dealing with the occupational radiation protection for the transport and embalming of deceased patients. This includes the main radionuclides used in nuclear medicine as well as the newly ones introduced clinically. A separate study focusing on the exposure of crematorium staff handling radioactive deceased patients has also been conducted and will be presented in a forthcoming publication( Michel et al, accepted).
This is an Open Access article distributed under the terms of the Creative Commons Attribution License( https:// creativecommons. org / licenses / by / 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.