Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine II. Somatically Effective Dose Equivalents to the Patients and Assessment of Risk

1982 ◽  
Vol 21 (03) ◽  
pp. 92-98 ◽  
Author(s):  
R. Poppitz
Keyword(s):  
Nuclear Medicine ◽  
Effective Dose ◽  
Radiation Risk ◽  
Patient Exposure ◽  
Diagnostic Nuclear Medicine

Es wird über die somatisch effektiven Äquivalentdosen bei den häufigst verwendeten nuklearmedizinischen diagnostischen Applikationen in Bulgarien 1980 berichtet. Unter Verwendung der ICRP Risikofaktoren für stochastische somatische Wirkungen wurde der Erwartungswert strahleninduzierter maligner Neubildungen mit tödlichem Ausgang in der Zukunft, bedingt durch diese medizinische Bestrahlungsart, berechnet. Dieser Wert (ca. 10 Neubildungen) ist verhältnismäßig klein im Vergleich zu der Gesamtzahl der offiziell registrierten Malignome in Bulgarien. Ein Vergleich der traditionell verwendeten Bevölkerungsdosen (z.B. GSD, LSD) für Bulgarien und für andere Länder wurde ebenfalls durchgeführt. Es wird empfohlen, durch eine verminderte Anwendung von 131J-Jodid in der in vivo Schilddrüsendiagnostik eine Herabsetzung der Strahlenbelastung der Patienten zu erreichen.

Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine I. Survey of Diagnostic Nuclear Medicine Procedures in Bulgaria in 1980

1982 ◽  
Vol 21 (03) ◽  
pp. 85-91 ◽  
Author(s):  
R. Poppitz
Keyword(s):  
Nuclear Medicine ◽  
Radiation Risk ◽  
Patient Exposure ◽  
Diagnostic Nuclear Medicine ◽  
Nuklearmedizinische Diagnostik ◽  
Nuclear Medicine Procedures

Um die Strahlenexposition und das Strahlenrisiko für die Bevölkerung durch die nuklearmedizinische Diagnostik in Bulgarien zu ermitteln, wurde eine Erhebung für das Jahr 1980 über die Arten und Anzahl der Applikationen von Radiopharmaka, über die verwendeten Aktivitäten und über die Geschlechts- und Altersverteilung der untersuchten Patienten durchgeführt. Die Gesamtzahl diagnostischer in vivo Applikationen betrug 116418 (davon 40,5% bei Männern und 59,5% bei Frauen), d.h. 13,1 Applikationen per 1000 Einwohner. Die applizierte Gesamtaktivität aller 44 verwendeter Radiopharmaka betrug ca. 2,1 TBq (56 Ci). Die Geschlechts- und Altersverteilung der untersuchten Patienten war ähnlich jener in anderen Ländern: nur 17,4% aller Patienten waren im reproduktionsfähigen Alter, 52,7% waren über 45 Jahre alt. Im Vergleich zu anderen entwickelten Ländern war in Bulgarien im Jahr 1980 der Anteil der 131J-Jodid-Untersuchungen verhältnismäßig hoch.

Chelators and metal complex stability for radiopharmaceutical applications

2019 ◽  
Vol 107 (9-11) ◽  
pp. 1087-1120 ◽  
Author(s):  
Nkemakonam C. Okoye ◽  
Jakob E. Baumeister ◽  
Firouzeh Najafi Khosroshahi ◽  
Heather M. Hennkens ◽  
Silvia S. Jurisson
Keyword(s):  
Nuclear Medicine ◽  
Metal Complex ◽  
Complex Stability ◽  
Critical Aspect ◽  
Technetium 99M ◽  
Diagnostic Nuclear Medicine ◽  
Key Factor ◽  
The 1960S ◽  
Therapeutic Nuclear Medicine

Abstract Diagnostic and therapeutic nuclear medicine relies heavily on radiometal nuclides. The most widely used and well-known radionuclide is technetium-99m (99mTc), which has dominated diagnostic nuclear medicine since the advent of the 99Mo/99mTc generator in the 1960s. Since that time, many more radiometals have been developed and incorporated into potential radiopharmaceuticals. One critical aspect of radiometal-containing radiopharmaceuticals is their stability under in vivo conditions. The chelator that is coordinated to the radiometal is a key factor in determining radiometal complex stability. The chelators that have shown the most promise and are under investigation in the development of diagnostic and therapeutic radiopharmaceuticals over the last 5 years are discussed in this review.

scholarly journals Patient radiation dose assessment system for diagnostic nuclear medicine procedures: Implementation and first results

2020 ◽  
Vol 35 (4) ◽  
pp. 380-385
Author(s):  
Dea Dundara-Debeljuh ◽  
Slaven Jurkovic ◽  
Ivan Pribanic ◽  
Neva Girotto ◽  
Svjetlana Grbac-Ivankovic ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Radiation Dose ◽  
Radiation Risk ◽  
Assessment System ◽  
Dose Assessment ◽  
Medical Documentation ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures ◽  
Radiation Dose Assessment ◽  
Patient Radiation Dose

Dose assessment of diagnostic nuclear medicine procedures is necessary to further optimize respective procedure, estimate radiation risk, improve radiation safety and verify compliance of local practice with guidelines. In line with Council Directive 2013/59/EURATOM, patient medical documentation should include information related to radiation exposure. The aim of this work is to present the patient radiation dose assessment system designed for routine clinical use, that uses in-house designed worksheets for dose calculation based on relevant parameters introduced by the ICRP publications. Dose reports provide information about the absorbed dose delivered to the target and non-target organs of interest and the effective dose for each diagnostic procedure. The data from the dose reports was used to investigate average patient exposure levels during a one-year period and the results are presented. The implemented system has improved the quality of services provided and understanding of radiation risks. Moreover, the presented results have stimulated further optimization of nuclear medicine processes.

Nuclear-medical irradiation during pregnancy

2009 ◽  
Vol 48 (01) ◽  
pp. 10-16 ◽  
Author(s):  
E.A. Nekolla ◽  
D. Noßke ◽  
J. Griebel ◽  
G. Brix ◽  
V. Minkov
Keyword(s):  
Nuclear Medicine ◽  
Radiation Effects ◽  
Radiation Risk ◽  
Diagnostic Procedures ◽  
Excess Risk ◽  
Individual Risk ◽  
Reference Levels ◽  
Diagnostic Nuclear Medicine ◽  
Hereditary Effects ◽  
Individual Risk Assessment

Summary Aim: To estimate and evaluate the risks for the offspring due to the administration of radiopharmaceuticals to women during the first pregnancy weeks after conception (weeks p.c.). Methods: The in-utero exposition of the embryo due to diagnostic nuclear medicine procedures, for which diagnostic reference levels (DRL) are specified, as well as due to radio iodine therapy (RIT) was determined. To this end, it is assumed that the activity of the diagnostic radiopharmaceuticals administered to the mother corresponds with the DRL and amounts to 600 MBq or 4 GBq 131I for RIT of benign or malignant thyroid disease, respectively. Based on these data, the radiation risk for the offspring was assessed and compared with the spontaneous risks (R0). Results: The dose for the offspring does not exceed 7.8 mSv for the diagnostic procedures considered, resulting in an excess risk for the offspring of less than 0.12% (R0 ~ 25%) to die from cancer during life, of less than 0.07% (R0 ~ 0.2%) to develop cancer up to the age of 15 years, and of less than 0.16% (R0 ~ 2%) for hereditary effects. RIT during the first 8 weeks p.c. results in doses for the offspring of about 100–460 mSv, resulting in an excess risk for malformations of the child of 3.4%–22% (R0 ~6%). Conclusions: The risk of stochastic radiation effects for the offspring due to a diagnostic nuclear medicine procedure of the mother during the first 8 weeks p.c. is – compared with the spontaneous risks – very small; deterministic effects are unlikely. In contrast, deterministic effects for the offspring may occur following RIT. In order to decide on a possibly indicated abortion after RIT, an individual risk assessment is mandatory.

Diagnostic nuclear medicine procedures in Germany between 1996 and 2002

2006 ◽  
Vol 45 (01) ◽  
pp. 1-9 ◽  
Author(s):  
D. Noßke ◽  
P. Schnell-Inderst ◽  
M. Hacker ◽  
K. Hahn ◽  
G. Brix ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Effective Dose ◽  
Insurance Companies ◽  
German Population ◽  
Diagnostic Nuclear Medicine ◽  
Public Health Information ◽  
Health Insurance Companies ◽  
Effective Doses ◽  
Application Frequency ◽  
Nuclear Medicine Procedures

Summary Aim: Man-made radiation exposure to the German population predominantly results from the medical use of ionizing radiation. It was therefore the aim of the present study, to provide public health information concerning diagnostic nuclear medicine procedures carried out in Germany between 1996 and 2002. Material and methods: Application frequencies for 10 groups of procedures were estimated from official reimbursement data provided by the German health insurance companies. Mean effective doses for these examinations were estimated from data provided by 14 clinics and 10 practices concerning the radiopharmaceuticals in use and the activities administered. Results: During the period 1996-2002, a total of (3.83 ± 0.31) million nuclear medicine procedures were performed in average per year, which corresponds to a mean annual application frequency of approximately 47 examinations per 1 000 inhabitants. More than 90% of the examinations were scintigraphies of the thyroid (37%), skeleton (25%), myocardium (13%), lungs (8%) and kidneys (8%). The averaged collective effective dose was (10.2 ± 1.4) ⋅103 manSv per year, which corresponds to a mean annual per caput effective dose of about (0.12 ± 0.02) mSv. Three types of procedures were responsible for about 80% of the total collective effective dose: scintigraphies of the myocardium (36%), skeleton (33%) and thyroid (10%). Averaged over all procedures carried-out, the mean effective dose per examination was (2.7 ± 0.8) mSv. Conclusion: The average effective dose per inhabitant and year caused by nuclear medicine examinations is markedly lower than that resulting from medical X-ray procedures (0.12 vs. 1.8 mSv). Reduction of patient exposure may be achieved, for example, by replacing 201Tl-labeled radiopharmaceuticals by 99mTc-labeled compounds.

scholarly journals Estimated collective effective dose to the population from nuclear medicine examinations in Slovenia

2013 ◽  
Vol 47 (3) ◽  
pp. 304-310 ◽  
Author(s):  
Damijan Skrk ◽  
Dejan Zontar
Keyword(s):  
Nuclear Medicine ◽  
Effective Dose ◽  
Radiation Protection ◽  
National Survey ◽  
Diagnostic Procedures ◽  
Patient Exposure ◽  
Protection Measures ◽  
Comparison Of Results ◽  
Patient Protection ◽  
Per Capita

Abstract Background. A national survey of patient exposure from nuclear medicine diagnostic procedures was performed by Slovenian Radiation Protection Administration in order to estimate their contribution to the collective effective dose to the population of Slovenia. Methods. A set of 36 examinations with the highest contributions to the collective effective dose was identified. Data about frequencies and average administered activities of radioisotopes used for those examinations were collected from all nuclear medicine departments in Slovenia. A collective effective dose to the population and an effective dose per capita were estimated from the collected data using dose conversion factors. Results. The total collective effective dose to the population from nuclear medicine diagnostic procedures in 2011 was estimated to 102 manSv, giving an effective dose per capita of 0.05 mSv. Conclusions. The comparison of results of this study with studies performed in other countries indicates that the nuclear medicine providers in Slovenia are well aware of the importance of patient protection measures and of optimisation of procedures.

scholarly journals Patient Exposure from Radiologic and Nuclear Medicine Procedures in the United States: Procedure Volume and Effective Dose for the Period 2006–2016

Radiology ◽  
2020 ◽  
Vol 295 (2) ◽  
pp. 418-427 ◽  
Author(s):  
Fred A. Mettler ◽  
Mahadevappa Mahesh ◽  
Mythreyi Bhargavan-Chatfield ◽  
Charles E. Chambers ◽  
Jennifer G. Elee ◽  
...  
Keyword(s):  
United States ◽  
Nuclear Medicine ◽  
Effective Dose ◽  
The United States ◽  
Patient Exposure ◽  
Procedure Volume ◽  
Nuclear Medicine Procedures

In Vivo Diagnostic Nuclear Medicine

1983 ◽  
Vol 8 (9) ◽  
pp. 434-439 ◽  
Author(s):  
WALTER A. GOETZ ◽  
WILLIAM R. HENDEE ◽  
DAVID L. GILDAY
Keyword(s):  
Nuclear Medicine ◽  
Diagnostic Nuclear Medicine

Patients with fever of unknown origin (FUO): diagnosis by nuclear medicine imaging

2001 ◽  
Vol 40 (03) ◽  
pp. 59-70 ◽  
Author(s):  
W. Becker ◽  
J. Meiler
Keyword(s):  
Nuclear Medicine ◽  
Fever Of Unknown Origin ◽  
Tumor Imaging ◽  
White Blood Cells ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
Recurrent Fever ◽  
Nuclear Medicine Imaging

SummaryFever of unknown origin (FUO) in immunocompetent and non neutropenic patients is defined as recurrent fever of 38,3° C or greater, lasting 2-3 weeks or longer, and undiagnosed after 1 week of appropriate evaluation. The underlying diseases of FUO are numerous and infection accounts for only 20-40% of them. The majority of FUO-patients have autoimmunity and collagen vascular disease and neoplasm, which are responsible for about 50-60% of all cases. In this respect FOU in its classical definition is clearly separated from postoperative and neutropenic fever where inflammation and infection are more common. Although methods that use in-vitro or in-vivo labeled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, they are only of limited value in FUO-patients in establishing the final diagnosis due to the low prevalence of purulent processes in this collective. WBCs are more suited in evaluation of the focus in occult sepsis. Ga-67 citrate is the only commercially available gamma emitter which images acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore Ga-67 citrate is currently considered to be the tracer of choice in the diagnostic work-up of FUO. The number of Ga-67-scans contributing to the final diagnosis was found to be higher outside Germany than it has been reported for labeled WBCs. F-l 8-2’-deoxy-2-fluoro-D-glucose (FDG) has been used extensively for tumor imaging with PET. Inflammatory processes accumulate the tracer by similar mechanisms. First results of FDG imaging demonstrated, that FDG may be superior to other nuclear medicine imaging modalities which may be explained by the preferable tracer kinetics of the small F-l 8-FDG molecule and by a better spatial resolution of coincidence imaging in comparison to a conventional gamma camera.

Radiation exposure of patients undergoing nuclear medicine procedures in Germany between 1996 and 2000

2005 ◽  
Vol 44 (05) ◽  
pp. 119-130 ◽  
Author(s):  
P. Schnell-Inderst ◽  
D. Noßke ◽  
M. Weiss ◽  
A. Stamm-Meyer ◽  
G. Brix ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Cardiovascular System ◽  
Effective Dose ◽  
Current Status ◽  
Annual Number ◽  
Statistical Parameters ◽  
Public Health Information ◽  
Nuclear Medicine Procedures ◽  
And Gender ◽  
Icrp Publication

Summary:The aim of this study was to estimate both the frequency and effective dose of nuclear medicine procedures performed in Germany between 1996 and 2000 for different subgroups of patients. Methods: Electronically archived data from 14 hospitals and 10 private practices were restored and statistically analyzed. The effective dose per examination was calculated according to ICRP publication 80 using the tissue weighting factors given in ICRP publication 60. Based on the data collected, statistical parameters were computed to characterize the frequency and effective dose of the various nuclear medicine procedures. Results: In total, 604,771 nuclear medicine procedures performed in 433,709 patients were analyzed. On average, 1.4 examinations were carried out per patient and year. The median effective dose was 1.7 [5.-95. percentile; mean: 0.4–8.5; 2.9] mSv per examination and 2.3 [0.5–11.2; 3.5] mSv per patient. Interestingly, the mean effective dose per examination, but not the number of examinations per year increased with the age of the patients. Most frequent were examinations of the thyroid (36.7%), the skeleton (27.1%) and the cardiovascular system (11.1%), which were associated with a median effective dose of 0.5 [0.5–1.1; 0.7] mSv, 3.4 [2.9–5.1; 3.6] mSv and 7.3 [3.2–21.0; 9.5] mSv, respectively. Over the five-year period examined, the total annual number of PET procedures (222.3%) as well as of examinations of thyroid (24.5%), skeleton (17.9%), and the cardiovascular system (14.9%) increased markedly, whereas a decrease was observed for brain (-39.3%), lung (-20.2%) and renal (-15.0%) scans. Conclusion: The age- and gender-specific data presented in this study provide detailed public health information on both the current status and recent trends in the practice of diagnostic nuclear medicine examinations.

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