newsmaker: Lionel Zuckier, MD
media coverage: New York Newsday, USA Today, Bergen Record, The Economist, Toronto Globe and Mail, Consumer Reports, MSNBC, Yahoo Health News

It's a perfectly ordinary Monday in the New York City subways where packs of early morning commuters jam into already congested cars hoping to make their underground journey without extra hassles or exasperating delays. Now that post-9/11 anxieties have waned, in general, to an almost pre-terrorist simmer, most riders don't anticipate more than the usual jarring sounds of the transportation system grinding out its daily runs.

But deep in the city's guts a shrill alarm cuts through the usual clamber and jars even the sleepiest traveler. The uniformed policeman stops his stroll mid-step to confront a 60-ish woman in a gray business suit trying to push her way through the crowds to the soon-to-open subway car. This member of New York's finest may have a radiation emergency on his hands, and the source, according to his beeper-size radiation detector, is this innocuous looking woman who looks more alarmed than alarming.

On an Atlantic City-bound bus, midway through the Lincoln Tunnel, a middle-aged man is quietly engrossed in The Conspiracy Club, the newest Jonathan Kellerman thriller about a young, naïve psychologist pitted against a savvy serial killer. So absorbed is he in his reading that at first he is completely unaware of the sirens spelling danger in his own life. A tunnel is no place to be caught when radiation detectors sound - escape may well be impossible. The farthest thing from this man's mind is playing a role in a real-life drama; yet, strange as it sounds, he is the culprit who has set off the sirens. The Port Authority police make a dramatic entrance, assess the situation and get ready to block the unassuming traveler from "jumping ship."

Lionel Zuckier, MD, professor of radiology at UMDNJ-New Jersey Medical School (NJMS) and director of nuclear medicine and PET at UMDNJ-University Hospital, has recently garnered significant attention nationwide for his efforts in the radiation-detection world. With a primary focus on the clinical practice of nuclear medicine and a sideline interest in the measurement of radioactivity, Zuckier has recently stepped into center stage on an issue that was nonexistent prior to 9-11.

Since that time, roughly 10,000 mobile, beeper-size radiation sensors have been distributed by the Department of Homeland Security for use in this country. They are clipped to belts worn by police officers and border patrol agents, among others, and are generally hidden from sight under uniform jackets, invisible to passers-by. In addition, stationary detectors are strategically placed at major tunnels, points of entry and other critical locales such as federal buildings and installations. Capable of picking up even minute traces of radioactivity, their extreme sensitivity is reassuring. But this equipment also creates scenarios like the two described above. With more than 16 million medical studies and treatments involving radioactivity performed annually in the U.S., the sensors are homing in on individuals with no terrorist agenda.

Zuckier says that such incidents started multiplying post-9-11 to the point where the Society of Nuclear Medicine and the Nuclear Regulatory Commission both recommended that patients undergoing nuclear medicine procedures be provided with verifiable documentation following their treatment. The "kicker" was that no one knew how long patients undergoing a specific procedure can trigger these devices. "A colleague in the Hudson County Department of Health, Gary Garetano, approached me with this question from a Homeland Security point of view," explains Zuckier, whose background in physics and nuclear medicine prepared him to devise an experimental approach to tackle the question.

Colleagues from Hudson County's Department of Health and the Department of Homeland Security's Environmental Measurements Laboratory in Manhattan met at UMDNJ-University Hospital, bringing a selection of radiation detectors used in the field, and were joined by Venkata Lanka, MS, NJMS radiation safety officer. They measured the sensitivity of five detectors against a panel of the seven most common radionuclides used in medical procedures. Then, collaborating with Michael Stabin, PhD, from Vanderbilt University, an expert in calculating excretion rates of radiopharmaceuticals, Zuckier combined these numbers with the radioactivity given to patients for various procedures to determine how long patients could trigger alarms at a monitoring distance of one meter.

The results were presented at the annual meeting of the Radiological Society of North America in November 2004. Iodine therapy for thyroid cancer or overactive thyroid can set off alarms for up to 95 days. Thallium, used in diagnostic cardiac exams, can be detected for up to 30 days. Bone and thyroid scans can trigger alarms for up to three days, and PET scans less than one day.

Zuckier endorses the Society of Nuclear Medicine and the Nuclear Regulatory Commission's recommendations that patients carry letters stating the details of the procedure they underwent, their potential to set off radiation alarms, and a 24-hour telephone number for verification. "These tiny amounts of radiation are not considered dangerous to the patient," states Zuckier, "although being stopped without a letter could prove to be inconvenient and embarrassing." In fact, acting Governor Richard Codey was stopped by security before entering the White House in late February. The reason? He had set off radioactivity sensors due to a recent stress test.

Zuckier is also interested in the larger issue of radiation measurement in the post 9-11 world. On a roof of UMDNJ's Bergen Building on the Newark campus, he has set up two Geiger counters. While hundreds of University employees housed in the building blithely go about their workday, these devices take continuous readings in the surrounding environment and feed them into a computer nestled under a desk in the Poison Control Center. Zuckier retrieves this information from his home or office PC by inputting a code that allows him access to the Web site where the readings are stored. Should a radiation emergency, such as a dirty bomb or reactor accident, affect the Newark environs, he will probably be one of the first to know. Any blip in the readings would alert him to a potential danger. A similar device - which he installed about five years ago outside Jacobi Hospital in the Bronx - continues to give real time readings of radiation levels in that area.

His current vision includes a network of Geiger counters placed strategically throughout New Jersey, which would provide the crucial information necessary to identify "hotspots" in a radiation emergency. So far, his idea for this inexpensive warning system (each Geiger counter costs about $200 and needs to be hooked up to a personal computer) has not taken off, though New Jersey State Climatologist David Robinson is exploring the feasibility of mounting these Geiger counters on strategically placed weather monitoring stations throughout the state.

"I worry that if there were ever a radiation emergency affecting New Jersey, decision makers would have no rapid method of assessing radioactivity levels on a geographic scale," Zuckier says. This simple technology could potentially provide vital information in a scenario of unimaginable complexity.