scholarly journals Standard Radiation Dosimetry Models: What Interventional Radiologists Need to Know

2021 ◽  
Vol 38 (04) ◽  
pp. 405-411
Author(s):  
Linzi Arndt Webster ◽  
Alexander Villalobos ◽  
Bill S. Majdalany ◽  
Zachary L. Bercu ◽  
Ripal T. Gandhi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Radiation Dosimetry ◽  
Single Case ◽  
Internal Radiation ◽  
Liver Cancers ◽  
Y90 Radioembolization ◽  
Dose Model ◽  
The Difference ◽  
Medical Internal Radiation Dose ◽  
Yttrium 90

AbstractThoughtful and accurate dosimetry is critical to obtain the safest and most efficacious yttrium-90 (Y90) radioembolization of primary and secondary liver cancers. Three dosimetry models are currently used in clinical practice, namely, body surface area model, medical internal radiation dose model, and the partition model. The objective of this review is to briefly outline the history behind Y90 dosimetry and the difference between the aforementioned models. When applying these three models to a single case, the differences between them are further demonstrated. Each dosimetry model in clinical practice has its own benefits and limitations. Therefore, it is incumbent upon practicing interventional radiologists to be aware of these differences to optimize treatment outcomes for their patients.

A comparison between GATE4 results and MCNP4B published data for internal radiation dosimetry

2011 ◽  
Vol 50 (03) ◽  
pp. 122-133 ◽  
Author(s):  
A. A. Parach ◽  
H. Rajabi
Keyword(s):  
Nuclear Medicine ◽  
Radiation Dosimetry ◽  
Published Data ◽  
Internal Dosimetry ◽  
Internal Dose ◽  
Internal Radiation ◽  
Cross Absorption ◽  
The Difference ◽  
Male Activity ◽  
Voxel Phantoms

SummaryAim: GATE, has been designed as upper layer of the GEANT4 toolkit for nuclear medicine application including internal dosimetry. However, its results have not been fully compared to the well-developed codes and anthropomorphic voxel phantoms have never been used with GATE/GEANT for internal dosimetry. The aim of present study was to compare the internal dose calculated by GATE/GEANT with the MCNP4B published data. Methods: The Zubal phantom was used to model a typical adult male. Activity was assumed uniformly distributed in liver, kidneys, lungs, spleen, pancreas and adrenals. GATE/ GEANT Monte Carlo package was used for estimation of doses in the phantom. Simulations were performed for photon energy of 0.01–1 MeV and mono-energetic electrons of 935 keV. Specific absorbed fractions for photons and S-factors for electrons were calculated. Results: On average, GATE/GEANT produces higher photon SAF (Specific Absorbed Fraction) values (+2.7%) for self-absorption and lower values (-2.9%) for cross-absorption. The difference was higher for paired organs particularly lungs. Moreover the photon SAF values for lungs as source organ at the energy of 200 and 500 keV was considerably higher with MCNP4B compared to GATE. Conclusion: Despite of differences between the GATE4 and MCNP4B, the results can be considered ensuring. This may be considered as validation of GATE/GEANT as a proprietary code in nuclear medicine for radionuclide dosimetry applications.

Intraperitoneal yttrium-90-labeled monoclonal antibody in ovarian cancer.

1990 ◽  
Vol 8 (12) ◽  
pp. 1941-1950 ◽  
Author(s):  
J S Stewart ◽  
V Hird ◽  
D Snook ◽  
B Dhokia ◽  
G Sivolapenko ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Monoclonal Antibody ◽  
Bone Marrow ◽  
Radiation Dose ◽  
Tumor Regression ◽  
Radiation Doses ◽  
Internal Radiation ◽  
Bone Absorption ◽  
Medical Internal Radiation Dose ◽  
Yttrium 90

From March 1987 to March 1988, a phase I to II study was carried out in 25 patients with ovarian cancer. They received escalating doses of intraperitoneally (IP) administered yttrium-90 (Y-90)-labeled monoclonal antibody, HMFG1, against a tumor cell-surface antigen. Myelosuppression prevented an escalation of the administered Y-90 activity above 25 mCi. Y-90-labeled antibody was absorbed from the peritoneal cavity into the circulation. Maximum blood Y-90 activity was observed 40 hours after the IP injection with a mean of 21% of the injected activity (range, 14.2% to 26.4%) in the circulation. The radiation dose the bone marrow received from circulating Y-90-labeled antibody (the blood radiation dose) was calculated by applying the Medical Internal Radiation Dose (MIRD) formulation to the measured Y-90 activity in patients blood. Myelosuppression occurred following calculated blood radiation doses to bone marrow of only 10 to 30 cGy. The excessive myelosuppression following such modest radiation doses from circulating Y-90-labeled antibody could be explained by the uptake of Y-90 by bone. In an attempt to reduce bone absorption of Y-90, seven patients received an intravenous (IV) infusion of EDTA (Sinclair Pharmaceuticals Ltd, Godalming, United Kingdom). This increased the urinary excretion of Y-90 from a mean of 11.1% to 32.3% of the injected activity (P = .0001). Fourteen patients had assessable tumor at laparoscopy. Tumor regression was observed in one patient, and palliation of ascites in a further patient.

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

Theory-Practice Gap: The Experiences of Nigerian Nursing Students

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Titilayo Dorothy Odetola ◽  
Olusola Oluwasola ◽  
Christoph Pimmer ◽  
Oluwafemi Dipeolu ◽  
Samson Oluwayemi Akande ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Nursing Students ◽  
Developing Country ◽  
The Body ◽  
Clinical Staff ◽  
Clinical Settings ◽  
Practice Gap ◽  
The Difference ◽  
Analyse Data ◽  
Theory Practice Gap

The “disconnect” between the body of knowledge acquired in classroom settings and the application of this knowledge in clinical practice is one of the main reasons for professional fear, anxiety and feelings of incompetence among freshly graduated nurses. While the phenomenon of the theory-to-practice gap has been researched quite extensively in high-income country settings much less is known about nursing students’ experiences in a developing country context. To rectify this shortcoming, the qualitative study investigated the experiences of nursing students in their attempt to apply what they learn in classrooms in clinical learning contexts in seven sites in Nigeria. Thematic content analysis was used to analyse data gained from eight focus group discussions (n = 80) with the students. The findings reveal a multifaceted theory-practice gap which plays out along four tensions: (1) procedural, i.e. the difference between practices from education institutions and the ones enacted in clinical wards – and contradictions that emerge even within one clinical setting; (2) political, i.e. conflicts that arise between students and clinical staff, especially personnel with a lower qualification profile than the degree that students pursue; (3) material, i.e. the disconnect between contemporary instruments and equipment available in schools and the lack thereof in clinical settings; and (4) temporal, i.e. restricted opportunities for supervised practice owing to time constraints in clinical settings in which education tends to be undervalued. Many of these aspects are linked to and aggravated by infrastructural limitations, which are typical for the setting of a developing country. Nursing students need to be prepared regarding how to deal with the identified procedural, political, material and temporal tensions before and while being immersed in clinical practice, and, in so doing, they need to be supported by educationally better qualified clinical staff.

scholarly journals International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres

2021 ◽  
Author(s):  
Hugo Levillain ◽  
Oreste Bagni ◽  
Christophe M. Deroose ◽  
Arnaud Dieudonné ◽  
Silvano Gnesin ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Absorbed Dose ◽  
Steering Committee ◽  
Selective Internal Radiation Therapy ◽  
Internal Radiation ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy ◽  
Resin Microspheres ◽  
Yttrium 90 ◽  
Strong Agreement

Abstract Purpose A multidisciplinary expert panel convened to formulate state-of-the-art recommendations for optimisation of selective internal radiation therapy (SIRT) with yttrium-90 (90Y)-resin microspheres. Methods A steering committee of 23 international experts representing all participating specialties formulated recommendations for SIRT with 90Y-resin microspheres activity prescription and post-treatment dosimetry, based on literature searches and the responses to a 61-question survey that was completed by 43 leading experts (including the steering committee members). The survey was validated by the steering committee and completed anonymously. In a face-to-face meeting, the results of the survey were presented and discussed. Recommendations were derived and level of agreement defined (strong agreement ≥ 80%, moderate agreement 50%–79%, no agreement ≤ 49%). Results Forty-seven recommendations were established, including guidance such as a multidisciplinary team should define treatment strategy and therapeutic intent (strong agreement); 3D imaging with CT and an angiography with cone-beam-CT, if available, and 99mTc-MAA SPECT/CT are recommended for extrahepatic/intrahepatic deposition assessment, treatment field definition and calculation of the 90Y-resin microspheres activity needed (moderate/strong agreement). A personalised approach, using dosimetry (partition model and/or voxel-based) is recommended for activity prescription, when either whole liver or selective, non-ablative or ablative SIRT is planned (strong agreement). A mean absorbed dose to non-tumoural liver of 40 Gy or less is considered safe (strong agreement). A minimum mean target-absorbed dose to tumour of 100–120 Gy is recommended for hepatocellular carcinoma, liver metastatic colorectal cancer and cholangiocarcinoma (moderate/strong agreement). Post-SIRT imaging for treatment verification with 90Y-PET/CT is recommended (strong agreement). Post-SIRT dosimetry is also recommended (strong agreement). Conclusion Practitioners are encouraged to work towards adoption of these recommendations.

Conventional Hepatic Volumetry May Lead to Inaccurate Segmental Yttrium-90 Radiation Dosimetry

2021 ◽  
Author(s):  
Seth I. Stein ◽  
Mohamed M. Soliman ◽  
Joseph Sparapani ◽  
Raphael Doustaly ◽  
Benjamin W. Cobb ◽  
...  
Keyword(s):  
Radiation Dosimetry ◽  
Yttrium 90

scholarly journals Biodistribution and internal radiation dosimetry of a companion diagnostic radiopharmaceutical, [68Ga]PSMA-11, in subcutaneous prostate cancer xenograft model mice

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Su Bin Kim ◽  
In Ho Song ◽  
Yoo Sung Song ◽  
Byung Chul Lee ◽  
Arun Gupta ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Dosimetry ◽  
Xenograft Model ◽  
Absorbed Dose ◽  
Patient Specific ◽  
Internal Radiation ◽  
Washout Phase ◽  
Heterogeneous Tissue ◽  
Organ Level ◽  
Reported Data

Abstract[68Ga]PSMA-11 is a prostate-specific membrane antigen (PSMA)-targeting radiopharmaceutical for diagnostic PET imaging. Its application can be extended to targeted radionuclide therapy (TRT). In this study, we characterize the biodistribution and pharmacokinetics of [68Ga]PSMA-11 in PSMA-positive and negative (22Rv1 and PC3, respectively) tumor-bearing mice and subsequently estimated its internal radiation dosimetry via voxel-level dosimetry using a dedicated Monte Carlo simulation to evaluate the absorbed dose in the tumor directly. Consequently, this approach overcomes the drawbacks of the conventional organ-level (or phantom-based) method. The kidneys and urinary bladder both showed substantial accumulation of [68Ga]PSMA-11 without exhibiting a washout phase during the study. For the tumor, a peak concentration of 4.5 ± 0.7 %ID/g occurred 90 min after [68Ga]PSMA-11 injection. The voxel- and organ-level methods both determined that the highest absorbed dose occurred in the kidneys (0.209 ± 0.005 Gy/MBq and 0.492 ± 0.059 Gy/MBq, respectively). Using voxel-level dosimetry, the absorbed dose in the tumor was estimated as 0.024 ± 0.003 Gy/MBq. The biodistribution and pharmacokinetics of [68Ga]PSMA-11 in various organs of subcutaneous prostate cancer xenograft model mice were consistent with reported data for prostate cancer patients. Therefore, our data supports the use of voxel-level dosimetry in TRT to deliver personalized dosimetry considering patient-specific heterogeneous tissue compositions and activity distributions.

scholarly journals Feasibility study of assessing the Preclinical Alzheimer Cognitive Composite (PACC) score via videoconferencing

2021 ◽  
Author(s):  
Giulia Seghezzo ◽  
Yvonne Van Hoecke ◽  
Laura James ◽  
Donna Davoren ◽  
Elizabeth Williamson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Pearson Correlation ◽  
Cognitive Tests ◽  
Strong Positive Correlation ◽  
Pearson Correlation Coefficient ◽  
Face To Face ◽  
The Difference

Abstract Background The Preclinical Alzheimer Cognitive Composite (PACC) is a composite score which can detect the first signs of cognitive impairment, which can be of importance for research and clinical practice. It is designed to be administered in person; however, in-person assessments are costly, and are difficult during the current COVID-19 pandemic. Objective To assess the feasibility of performing the PACC assessment with videoconferencing, and to compare the validity of this remote PACC with the in-person PACC obtained previously. Methods Participants from the HEalth and Ageing Data IN the Game of football (HEADING) Study who had already undergone an in-person assessment were re-contacted and re-assessed remotely. The correlation between the two PACC scores was estimated. The difference between the two PACC scores was calculated and used in multiple linear regression to assess which variables were associated with a difference in PACC scores. Findings Of the 43 participants who were invited to this external study, 28 were re-assessed. The median duration in days between the in-person and the remote assessments was 236.5 days (7.9 months) (IQR 62.5). There was a strong positive correlation between the two assessments for the PACC score, with a Pearson correlation coefficient of 0·82 (95% CI 0·66, 0·98). The multiple linear regression found that the only predictor of the PACC difference was the time between assessments. Interpretation This study provides evidence on the feasibility of performing cognitive tests online, with the PACC tests being successfully administered through videoconferencing. This is relevant, especially during times when face-to-face assessments cannot be performed.

scholarly journals Evaluación del discurso narrativo en pacientes con daño cerebral leve

2012 ◽  
Vol 4 (3) ◽  
pp. 61
Author(s):  
Ana María Cachón
Keyword(s):  
Clinical Practice ◽  
Brain Injury ◽  
Single Case ◽  
Speech Analysis ◽  
Recovery Stage ◽  
Language Therapist ◽  
Speech Evaluation ◽  
Mild Brain Injury ◽  
Oral Speech ◽  
The Subject

In clinical practice there are few test that language therapist can use for the oral speech evaluation. The battery that has been frecuently used for the aphasia assessment, doesn´t usually give us this type of data, and when it happens, it is just a global description of the language of the subject, which doesn't make possible a detailed pursuit of the evolution. The relevance of linguistic production´s assessment becomes more evident in the study of patients with mild injury as well as when patient is in an advanced recovery stage. An assessment without a speech analysis uses to overestimate the subject's capacities and usually ends in an incomplete and inadequate intervention. The aim of the present work was to review different studies that include the narrative speech as part of the assessment, and to explore, with the study of a single case, some applications in this kind of studies for language evaluation in mild brain injury patients.

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