Purpose: Presently, any exact standard of radiopharmaceutical doses in pediatric nuclear medicine doesn't exist in the universe. So hospitals are following by manual of vial kit or guidelines of America and Europe based on recommended adult doses adjusted for body mass (MBq/kg) or body surface area (MBq/$m^2$). However, especially for children younger than 1 year and heavier than 50 kg, it's hard to estimate exact dosage for those children. Materials and Methods: In order to obtain objective data of multipliers for pediatric studies, we surveyed 4 major hospitals in Korea. After receiving feedbacks, we changed dosage to multiplier. And we compared multipliers of Korea to America's and Europe's. Results: Most hospitals in Korea are following by body mass formula (MBq/kg). On the other hand, standards don't include proper factors for a child younger than 1 year and heavier than 50 kg. Multipliers for 3 kg children who are injected lower doses than needed are America:0.12, Europe:0.09, Korea:0.05, multipliers for 30 kg children who are injected proper doses are America:0.58, Europe:0.51, Korea:0.45 and multipliers for 60 kg children who are injected more doses than needed are America:0.95, Europe:0.95, Korea:0.91. Conclusions : Through the survey, when calculating doses for children, usually output doses are based on adult doses adjusted for body mass (MBq/kg) but research has shown that standards of all of the compared standards don't reflect exact multipliers for children younger than 1 year and heavier than 50 kg. Therefore, we should give an effort to reduce needless radiation exposure in children by establishing a proper doses standard and also developing better image reconstruction software.
Michal Biegala;Marcin Brodecki;Teresa Jakubowska;Joanna Domienik-Andrzejewska
Nuclear Engineering and Technology
/
v.56
no.1
/
pp.335-339
/
2024
Employees of nuclear medicine facilities performing medical procedures with the use of open radioactive sources require continuous detailed control of exposure to ionizing radiation. Thermoluminescent (TL) detectors placed in dosimeters: for the whole body, for lenses, ring and wrist dosimeters were used to assess exposure. The highest whole-body exposure of (1.70 ± 1.09) µSv/GBq was recorded in nurses administering radiopharmaceutical to patients. The highest exposure to lenses and fingers was recorded for employees of the quality control zone and it was (8.08 ± 2.84) µSv/GBq and a maximum of (1261.46 ± 338.93) µSv/GBq, respectively. Workers in the production zone received the highest doses on their hands, i.e. (175.67 ± 13.25) µSv/GBq. The measurements performed showed that the analyzed workers may be classified as exposure category A. Wrist dosimeters are not recommended for use in isotope laboratories due to underestimation of ionizing radiation doses. Appropriately selected shields, which significantly reduce the dose received by employees, must be used in isotope laboratories. Periodic measurements confirmed that the appropriate optimization of exposure reduces the radiation doses received by employees.
Skeletal metastases are common in patients suffering from various primary cancers. Radiopharmaceuticals are an effective option for bone pain palliation. In this work, the radiation absorbed dose of 177Lu-EDTMP radiopharmaceutical was estimated for adult man based on biodistribution data in Wistar rats. The MIRD dose calculation method and the Sparks and Aydogan methodology were applied. The results shows that about 46% of injected activity is cumulated on the surface of the trabecular and cortical bones. Radiation absorbed doses of red bone marrow and osteogenic cells were estimated to about 1.1 and 6.2 mGy/MBq, respectively. The maximum administrated activity was obtained 27 MBq/kg of body weight with an effective dose of 0.23 mSv/MBq. The results were compared with other available data from literature. This study indicated that 177Lu-EDTMP provides therapeutic efficacy for achieving bone pain palliation with low undesired dose to other normal organs.
Purpose: The whole body bone scan is an examination that visualizing physiological change of bones and using bone-congenial radiopharmaceutical. The patients are intravenous injected radiopharmaceutical which labeled with radioactive isotope ($^{99m}Tc$) emitting 140 keV gammarays and scanned after injection. The 3 principles of radiation protection from external exposureare time, distance and shielding. On the 3 principles of radiation protection basis, radiopharmaceutical might just as well be injected rapidly for reducing radiation because it might be the unopened radiation source. However the radiopharmaceuticals are injected into patient directly and there is a limitation of distance control. This study confirmed the change of radiation exposure as change of distance from radiopharmaceutical and observed the change of radiation exposure afte rsetting a shelter for help to control radio-technician's exposure. Materials & methods: For calculate the average of injection time, the trained injector measured the injection time for 50 times and calculated the average (2 minutes). We made a source as filled the 99mTc-HDP 925 MBq 0.2 mL in a 1 mL syringe and measured the radiation exposure from 50 cm,100 cm,150 cm and 200 cm by using Geiger-Mueller counter (FH-40, Thermo Scientific, USA). Then we settled a lead shielding (lead equivalent 6 mm) from the source 25 cm distance and measured the radiation exposure from 50 cm distance. For verify the reproducibility, the measurement was done among 20 times. The correlation between before and after shielding was verified by using SPSS (ver. 18) as paired t-test. Results: The radiation doses according to distance during 2 minutes from the source without shielding were $1.986{\pm}0.052{\mu}$ Sv in 50 cm, $0.515{\pm}0.022{\mu}$ Sv in 100 cm, $0.251{\pm}0.012{\mu}$ Sv in 150 cm, $0.148{\pm}0.006{\mu}$ Sv in 200 cm. After setting the shielding, the radiation dose was $0.035{\pm}0.003{\mu}$ Sv. Therefore, there was a statistical significant difference between the radiation doses with shielding and without shielding ($p$<0.001). Conclusion: Because the great importance of whole body bone scan in the nuclear medicine, we should make an effort to reduce radiation exposure during radiopharmaceutical injections by referring the principles of radiation protection from external exposure. However there is a limitation of distance for direct injection and time for patients having attenuated tubules. We confirmed the reduction of radiation exposure by increasing distance. In case of setting shield from source 25 cm away, we confirmed reducing of radiation exposure. Therefore it would be better for reducing of radiation exposure to using shield during radiopharmaceutical injection.
Lee, Bu Hyung;Kim, Sung Ho;Kwon, Soo Il;Kim, Jae Seok;Kim, Gi-sub;Park, Min Seok;Park, Seungwoo;Jung, Haijo
Progress in Medical Physics
/
v.27
no.3
/
pp.146-155
/
2016
As the probability of exposure to radiation increases due to an increase in the use of radioisotopes and radiation generators, the importance of a radiation safety management field is being highlighted. We intend to help radiation workers with exposure management by identifying the degree of radiation exposure and contamination to determine an efficient method of radiation safety management. The personal exposure doses of the radiation workers at the Korea Institute of Radiological & Medical Sciences measured every quarter during a five-year period from Jan. 1, 2011 till Dec. 31, 2015 were analyzed using a TLD (thermoluminescence dosimeter). The spatial dose rates of radiation-controlled areas were measured using a portable radioscope, and the level of surface contamination was measured at weekly intervals using a piece of smear paper and a low background alpha/beta counter. Though the averages of the depth doses and the surface doses in 2012 increased from those in 2011 by about 14%, the averages were shown to have decreased every year after that. The exposure dose of 27 mSv in 2012 increased from that in 2011 in radiopharmaceutical laboratories and, in the case of the spatial dose rate, the rate of decrease in 2012 was shown to be similar to the annual trend of the whole institute. In the case of the surface contamination level, as the remaining radiation-controlled area with the exception of the I-131 treatment ward showed a low value less than $1.0kBq/m^2$, the annual trend of the I-131 treatment ward was shown to be similar to that of the entire institute. In conclusion, continuous attention should be paid to dose monitoring of the radiation-controlled areas where unsealed sources are handled and the workers therein.
Objective: This study evaluated the safety and objective response of combining $^{131}I$-labeled-metuximab (Licartin) with transarterial chemoembolization (TACE) in the treatment of unresectable hepatocellular carcinoma (HCC). Materials and Methods: In a multicenter open-label clinical trial, 341 enrolled patients with stage III/IV HCC according to TNM criteria were nonrandomly assigned to a trial group (n=167) and a control group (n=174), undergoing TACE following hepatic intra-arterial injection of licartin or TACE alone from July 2007 to July 2009. Radiopharmaceutical distribution was evaluated. The primary endpoint was overall survival; secondary endpoints included time-to-progression (TTP), toxicity and adverse events (AEs). Results: The radiobiological distribution demonstrated better localization of licartin in liver tumors than other tissues (P<0.01). The organ absorbed doses to liver and red marrow were $3.19{\pm}1.01Gy$ and $0.55{\pm}0.22Gy$, respectively. The 1-year survival rate was significantly higher [79.47% vs. 65.59%, hazard ratio (HR), 0.598, P=0.041] and TTP significantly improved ($6.82{\pm}1.28$ vs. $4.7{\pm}1.14months$, P=0.037) compared with the control group. Patients at stage III achieved more benefit of one year survival than stage IV in the trial group (86.9% vs. 53.8%, P<0.001). There were significant different toxicities in leukocytopenia, thrombocytopenia and increased total bilirubin level [P<0.001, P=0.013, P<0.01, relative risk (RR) 1.63, 1.33, 1.43], but no differences in severe AEs of upper GI hemorrhage and severe liver dysfunction between the groups (5.39% vs. 2.3%, P=0.136). Conclusions: Owing to excellent tumor-targeting, promised efficacy and favourable toxicity profile, the novel combination therapy of licartin and TACE could be applied in patients with unresectable HCC.
Purpose: A Pixelated BSGI gamma camera has features to enhance resolution and sensitivity and minimize the distance between detector and organs by narrow FOV. Therefore, it is known as useful device to examine small organs such as thyroid, parathyroid and gall bladder. In general, when we would like to enlarge the size of images and obtain high resolution images by gamma camera in nuclear medicine study, we use pinhole collimator. The purpose of this study is to evaluate the usefulness of Pixelated BSGI gamma camera and to compare to it using pinhole collimator in thyroid scan which is a study of typical small organs. Materials and methods: (1) The evaluation of sensitivity and spatial resolution: We measured sensitivity and spatial resolution of Pixelated BSGI with LEHR collimator and Infinia gamma camera with pinhole collimator. The sensitivity was measured by point source sensitivity test recommended by IAEA. We acquired images considering dead time in BSGI gamma camera for 100 seconds and used $^{99m}TcO4-\;400{\mu}Ci$ line source. (2) The evaluation of thyroid phantom: The thyroid phantom was filled with $^{99m}TcO4-$. After set 300 sec or 100 kcts stop conditions, we acquired images from both pixelated BSGI gamma camera and Infinia gamma camera with LEHR collimator. And we performed all thyroid studies in the same way as current AMC's procedure. Results: (1) the result of sensitivity: As a result, the sensitivity and spatial resolution of pixelated BSGI gamma camera were better than Infinia's. The sensitivities of pixelated BSGI and Infinia gamma camera were $290cps/{\mu}Ci$ and $350cps/{\mu}Ci$ respectively. So, the sensitivity of pixelated BSGI was 1.2 times higher than Infinia's (2) the result of thyroid phantom: Consequently, we confirmed that images of Pixelated BSGI gamma camera were more distinguishable between hot and cold spot compared with Infinia gamma camera. Conclusion: A pixelated BSGI gamma camera is able to shorten the acquisition time. Furthermore, the patients are exposed to radiation less than before by reducing amount of radiopharmaceutical doses. Shortening scan time makes images better by minimizing patient's breath and motion. And also, the distance between organ and detector is minimized because detector of pixelated BSGI gamma camera is small and possible to rotate. When patient cannot move at all, it is useful since device is feasible to move itself. However, although a pixelated BSGI gamma camera has these advantages, the effect of dead time occurs over 2000 cts/s since it was produced only for breast scan. So, there were low concentrations in organ. Therefore, we should consider that it needs to take tests to adjust acquisition time and amount of radiopharmaceutical doses in thyroid scan case with a pixelated BSGI gamma camera.
This study derived measures to reduce exposure doses by identifying factors which affect the external radiation dose rate of patients treated with radiopharmaceuticals for PET-CT tests. The external radiation dose rates were measured on three parts of head, thorax and abdomen at a distance of 50cm from the surface of 60 PET-CT patients. It showed there are changes in factors affecting the external radiation dose rate over time after the administration of F-18 FDG. The external radiation dose rate was lower in the patients with more water intake than those with less water intake before the injection of radiopharmaceuticals at all three points: right after the injection of radiopharmaceuticals (average 4.17 mins), after the pre-PEET-CT urination step (average 77.47 mins), and right after the PET-CT test (average 114.15 mins). The study also found there is a need to increase the amount of water intake before the injection of radiopharmaceuticals in order to maintain a low external radiation dose rate in patients. This strategy is only possible under the assumption that the quality of the video has not changed after conducting this study on the relations between the image and quality. This study also found a need to use radiopharmaceuticals with the minimum amount needed for each patient because F-FDG doses affects the external radiation dose rate at the point right after the injection of radiopharmaceuticals. Urination frequency was the most significant factor to affect the external radiation dose rates at the point right after the PET-CT test and the point after the pre-PET-CT urination step. There is a need to realize the strategy to increase the urination frequency of patients to maintain the external radiation dose rate low (average 77.47 mins) before and after the injection of radiopharmaceuticals. In addition, at this point, there is a need to take advantage of personal strategies because the external radiation dose rate is lower if the fasting time is shorter, the contrast medium is used, and the amount of water intake is increased after the administration of radiopharmaceuticals. Finally this study found the need to be able to generalize these findings through an in-depth research on the factors affecting the external radiation dose rate, which includes radiopharmaceutical dose, urination frequency, the amount of water intake, fasting time and the use of contrast medium.
Purpose: Those who access to the nuclear medicine department are classified as radiation workers, temporarily access group, and occasional access group as defined by the atomic energy law. The radiation workers and temporarily access people wear a personal radiation dosimeter for checking their own radiation absorbed dose periodically. However, because of the sanitation workers, classified as temporarily access group, who are working in the nuclear medicine department are moved in a cycle with other departments and their works are changeful, it is hard to control their radiation absorbed dose. Thus, this study is going to examine the state of the sanitation worker's radiation absorbed dose, and then make sure whether they are classified as temporarily access group or not. Materials and methods: In the first instance, the first sanitation worker who works in vitro laboratory and PET room and the second sanitation worker who works in gamma camera rooms (invivo room) wore radiation dosimeter-OSL(Optically Stimulated Luminescence)- to measure their own radiation absorbed dose during work time from May to June 2011. Secondly, this study was taken place 5 places in gamma camera rooms, 2 places in PET bed room, operating room, waiting room and cyclotron room in PET and 4 places in vitro laboratory. And then to measure the radiation space dose rate, it is measured 10 times each of places as sanitation worker's work flow by using radiation survey meter. Results: The radiation absorbed dose on OSL of the first c who works in vitro laboratory and PET room and the second one who works in gamma camera rooms are 0.04, 0.02 mSv per month respectively. That means the estimated annual radiation absorbed doses are less than 1mSv as 0.48, 0.24 mSv/yr respectively. The radiation space dose rates as sanitation worker's work flow using survey meter are 0.0037, 0.0019 mSv/day, so the estimated annual radiation absorbed dose are 0.93, 0.47 mSv/yr respectively. The weighted exposure dose of first sanitation worker of each places are 1.62% in cyclotron room, 3.88% in waiting room, 2.39% in operating room, 81.01% in bed room of PET and 11.01% in vitro laboratory. The weighted exposure dose of second sanitation worker of each places are 45.22% in radiopharmaceutical laboratory, gamma 30.64% in camera rooms, 15.65% in waiting room, 8.49% in reading room. Conclusion: The annual radiation absorbed doses on OSL of both sanitation workers are less than 1 mSv per year and the annual radiation absorbed doses by using survey meter are less than 1mSv either, but close up to 1 mSv. Thus, to clarify whether the sanitation workers are temporarily access group or not, and to be lessen their s radiation absorbed dose, they should be educated about management of radiation and modified their work flow or work time appropriately, their radiation absorbed dose would be lessen certainly.
Journal of the Korea Academia-Industrial cooperation Society
/
v.11
no.6
/
pp.2118-2123
/
2010
Korean individual occupational exposure control is focused on the retrospective service to the over-exposed person by the reading of personal dosimeter. Since the radiophamaceuticals using in the nuclear medicine department are uncontained radiation sources, the potential exposure at working environment is very high. Moreover, a patient remains radioactive for hours or even days after the administration of a radiopharmaceutical for diagnosis or treatment. Thus, the proper working environmental exposure control must be established and executed to protect not only the affiliated employees, but also guardians accompanying patients and temporarily visiting public from the exposure by the patients. Japanese radiation protection law regulates working environmental radiation exposure by regularly measuring and filing the environmental dose for years. This study was aimed at measuring working environmental radiation dose in the nuclear medicine department of an university hospital located in Daejeon, Korea. We measured the accumulation radiation dose in air at 8 locations in the nuclear medicine department by using the same method as in Japan with glass dosimeters. The highest dose rate, 0.23 mSv per month, was measured at the waiting room, and the second one is at reception desk. Even though the doses were lower than the Korean constraint dose rate (0.3 mSv/week) at the boundary of the radiation controlled area, it was over the dose limit of public (1 mSv/y) and environment (0.25 mSv/y). Conclusionally, it was found that the new or additional procedure was necessary to less the exposure dose to the receptionist and guardians by the environmental radiation dose in the nuclear medicine department.
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