External radiation exposure of personnel in nuclear medicine from F-18, Tc-99m and I-131 with special reference to fingers, eyes and thyroid

The radiation exposure of fingers, thyroid and eyes of workers handling radiopharmaceuticals during various nuclear medicine procedures was measured using thermoluminescent dosemeters. Dosemeters were placed on the finger tips of 19 workers on several different occasions for various procedures. Additionally, the routinely determined whole-body doses to various groups of workers were analysed. The finger dose measurements demonstrated clear differences between the various tasks, from 0.0012 µGy MBq(-1) (unpacking and installing (99)Mo/(99m)Tc-generator) to 3.0 µGy MBq(-1) (syringe withdrawal, injection and waste handling of (18)F-FDG). As long as the worker was handling (99m)Tc, the dose to the fingers was well below the ICRP dose limits, even when the activity was high. Special concern should, however, be devoted to the handling of (18)F, since the dose to the fingers could easily reach the dose limits. The estimated dose to eyes and thyroid was well below the dose limits. Since the introduction of the positron emission tomography/computed tomography facility, the annual whole-body dose has increased for those directly involved in the handling of (18)F. The annual whole-body dose of 0.2-2.5 mGy was, however, well below the dose limits

Radiation exposure of patients and personnel from a PET/CT procedure with F-18-FDG

The positron emission tomography (PET)/computed tomography (CT) camera is a combination of a PET camera and a CT. The image from the PET camera is based on the detection of radiation that is emitted from a radioactive tracer, which has been given to the patient as an intravenous injection. The radiation that is emitted from the radioactive tracer is more energetic than any other radiation used in medical diagnostic procedures and this requires special radiation protection routines. The CT image is based on the detection of radiation produced from an X-ray tube and transmitted through the patient. The radiation exposure of the personnel during the CT procedure is generally very low. Regarding radiation exposure of the patient, it is important to notice whether a CT scan has been performed prior to the PET/CT in order to avoid any unnecessary irradiation. The total effective dose to the patient from a PET/CT procedure is approximately 10 mSv. The major part comes from internal irradiation due to radiopharmaceuticals within the patients (e.g. (18)F-FDG: approximately 6-7 mSv), and a minor part is due to the CT scan (low-dose CT scan: approximately 2-4 mSv). If a full diagnostic CT investigation is performed, the effective dose may be considerably higher. If the patient is pregnant, a PET/CT procedure should be avoided or postponed, unless it is vital for the patient. An interruption in breastfeeding is not necessary after a PET/CT procedure of the nursing mother. Close contact between the patient and a small child should however be avoided for a couple of hours after the administration of the radiopharmaceutical. The radiation dose to the personnel arises mainly due to handling of the radiopharmaceuticals (syringe withdrawal, injection, waste handling, etc.) and from close contact to the patient. This radiation dose can be limited by using the inverse-square law, i.e. by using the fact that the absorbed dose decreases substantially with increasing distance between the radiation source and the personnel

Low-level occupational 14C contamination – results from a pilot study

This paper presents a pilot study in which specific activities of (14)C in hair and urine from 11 radiation workers handling (14)C-containing substances have been measured using accelerator mass spectrometry. Varying degrees of contamination were revealed: up to 63% excess in hair and 400% excess in urine. Although the (14)C excess reported in this study would result in low effective doses, it would be of interest to monitor the situation at other workplaces with potentially higher risks of contamination. Simultaneous measurements of (14)C in hair and urine with additional random measurements of (14)C in faeces and exhaled air could provide a means of improving dose estimates for workers handling different types of (14)C-containing substances

X-Ray and molecular imaging during pregnancy and breastfeeding - When should we be worried?

Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant - and potentially pregnant - patients and of newborn. This article reviews the current literature and recommendations on imaging during pregnancy and breastfeeding. Risks related to alternative non-ionizing radiation methods are also considered. With few exceptions, exposure of the fetus through radiography, computed tomography (CT) and nuclear medicine imaging can be limited to safe levels, although studies such as abdominal-pelvic CT cannot avoid significant exposure to fetuses. Eight to 10 weeks post-conception, the fetus has a thyroid which starts to concentrate iodide having crossed the placenta barrier resulting in unacceptably high doses to the fetal thyroid after administration of 131I- and even 123I-iodide and other radiopharmaceuticals with a high content of free radioiodine. Many radiopharmaceuticals are excreted through breast milk. Breastfeeding interruption recommendations should be followed to keep the effective dose to the infant below 1 mSv

ABSOLUTE QUANTIFICATION OF ACTIVITY CONTENT FROM PET IMAGES USING THE PHILIPS GEMINI TF PET/CT SYSTEM.

Positron emission tomography combined with computed tomography (PET/CT) is a quantitative technique suitable for diagnostics and uptake measurements. The quantitative results can be used for the purpose of the calculating absorbed dose to patients undergoing nuclear medicine investigations. Hence, the accuracy of the quantification of the activity content in organs or tissues is of great importance. When using a planar gamma camera and single photon emission computed tomography (SPECT) images, the activity content in organs and tumours has to be determined by the user, using the number of counts in the organs and the efficiency of the camera. However, when using a Philips Gemini TF PET/CT system, the activity concentration in a region of interest (ROI) is given by the system. The reliability of activity concentration values given by the Philips Gemini TF PET/CT system was studied using a Jaszczak phantom containing hot spheres of different sizes; the influence of the ROI size and the impact of organ size, that is the partial volume effect, was investigated with three different lesion-to-background ratios in the phantom. The use of a small ROI size (40 % of the large ROI size, which covered the entire sphere) showed a 15 % improvement in the recovery of the true activity. Small lesion sizes result in large underestimations of the activity concentration values

Use of wall-less (18)F-doped gelatin phantoms for improved volume delineation and quantification in PET/CT.

Positron emission tomography (PET) with (18)F-FDG is a valuable tool for staging, planning treatment, and evaluating the treatment response for many different types of tumours. The correct volume estimation is of utmost importance in these situations. To date, the most common types of phantoms used in volume quantification in PET utilize fillable, hollow spheres placed in a circular or elliptical cylinder made of polymethyl methacrylate. However, the presence of a non-radioactive sphere wall between the hotspot and the background activity in images of this type of phantom could cause inaccuracies. To investigate the influence of the non-active walls, we developed a phantom without non-active sphere walls for volume delineation and quantification in PET. Three sizes of gelatin hotspots were moulded and placed in a Jaszczak phantom together with hollow plastic spheres of the same sizes containing the same activity concentration. (18)F PET measurements were made with zero background activity and with tumour-to-background ratios of 12.5, 10, 7.5, and 5. The background-corrected volume reproducing threshold, Tvol, was calculated for both the gelatin and the plastic spheres. It was experimentally verified that the apparent background dependence of Tvol, i.e., a decreasing Tvol with increasing background fraction, was not present for wall-less spheres; the opposite results were seen in plastic, hollow spheres in commercially-available phantoms. For the types of phantoms commonly used in activity quantification, the estimation of Tvol using fillable, hollow, plastic spheres with non-active walls would lead to an overestimate of the tumour volume, especially for small volumes in a high activity background

Biokinetics of iodide in man: Refinement of current ICRP dosimetry models

A compartmental model describing the distribution and retention of radioactive iodide in thyroid and other organs is presented. The model is developed from published ICRP models. It is designed primarily for radiation dosimetry of iodine radionuclides used in nuclear medicine, but may also be useful for occupational radiation protection. In the proposed model, the distribution of iodide to the thyroid is assumed to be more rapid than in earlier models. Uptakes in stomach wall and salivary glands are considered, and the absorbed doses to these organs calculated. The partitioning of iodide between stomach wall and content is also discussed. Recirculation of organic iodine is also taken into account. Age-dependent half-times for iodide in the thyroid, as well as for organically-bound iodine are presented. The proposed model is applicable for dose estimations with different uptakes in the thyroid as well as for the situation when the thyroid is blocked, completely or incompletely

Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption.

To review early recommendations and propose guidelines for breastfeeding interruption after administration of radiopharmaceuticals, based on additional biokinetic and dosimetric data

A biokinetic and dosimetric model for ionic indium in humans

This paper reviews biokinetic data for ionic indium, and proposes a biokinetic model for systemic indium in adult humans. The development of parameter values focuses on human data and indium in the form of ionic indium(III), as indium chloride and indium arsenide. The model presented for systemic indium is defined by five different pools: plasma, bone marrow, liver, kidneys and other soft tissues. The model is based on two subsystems: one corresponding to indium bound to transferrin and one where indium is transported back to the plasma, binds to red blood cell transferrin and is then excreted through the kidneys to the urinary bladder. Absorbed doses to several organs and the effective dose are calculated for 111In- and 113mIn-ions. The proposed biokinetic model is compared with previously published biokinetic indium models published by the ICRP. The absorbed doses are calculated using the ICRP/ICRU adult reference phantoms and the effective dose is estimated according to ICRP Publication 103. The effective doses for 111In and 113mIn are 0.25 mSv MBq-1 and 0.013 mSv MBq-1 respectively. The updated biokinetic and dosimetric models presented in this paper take into account human data and new animal data, which represent more detailed and presumably more accurate dosimetric data than that underlying previous models for indium