Quantifying the Increase in Radiation Exposure Associated with SPECT/CT Compared to SPECT Alone for Routine Nuclear Medicine Examinations

Purpose. We quantify the additional radiation exposure in terms of effective dose incurred by patients in the CT portion of SPECT/CT examinations. Methods. The effective dose from a variety of common nuclear medicine procedures is calculated and summarized. The extra exposure from the CT portion of the examination is summarized by examination and body part. Two hundred forty-eight scans from 221 patients are included in this study. The effective dose from the CT examination is also compared to average background radiation. Results. We found that the extra effective dose is not sufficient to cause deterministic effects. However, the stochastic effects may be significant, especially in patients undergoing numerous follow-up studies. The cumulative effect might increase the radiation exposure compared to patient management with SPECT alone. Conclusions. While the relative increase in radiation exposure associated with SPECT/CT is generally considered acceptable when compared with the benefits to the patient, physicians should make every effort to minimize this effect by using proper technical procedures and educating patients about the exposure they will receive.

Download Full-text

Radiation exposure of the staff at the therapeutic and diagnostic nuclear medicine department

Nuklearmedizin ◽

10.3413/nukmed-0163 ◽

2008 ◽

Vol 47 (04) ◽

pp. 175-177 ◽

Cited By ~ 4

Author(s):

J. Dolezal

Keyword(s):

Nuclear Medicine ◽

Radiation Exposure ◽

Effective Dose ◽

Radiation Protection ◽

Annual Effective Dose ◽

Protection Measures ◽

Professional Groups ◽

Personal Dosimetry ◽

The Mean ◽

Administered Activity

SummaryAim: To assess a radiation exposure and the quality of radiation protection concerning a nuclear medicine staff at our department as a six-year retrospective study. Therapeutic radionuclides such as 131I, 153Sm, 186Re, 32P, 90Y and diagnostic ones as a 99mTc, 201Tl, 67Ga, 111In were used. Material, method: The effective dose was evaluated in the period of 2001–2006 for nuclear medicine physicians (n = 5), technologists (n = 9) and radiopharmacists (n = 2). A personnel film dosimeter and thermoluminescent ring dosimeter for measuring (1-month periods) the personal dose equivalent Hp(10) and Hp(0,07) were used by nuclear medicine workers. The wearing of dosimeters was obligatory within the framework of a nationwide service for personal dosimetry. The total administered activity of all radionuclides during these six years at our department was 17,779 GBq (99mTc 14 708 GBq, 131I 2490 GBq, others 581 GBq). The administered activity of 99mTc was similar, but the administered activity of 131I in 2006 increased by 200%, as compared with the year 2001. Results: The mean and one standard deviation (SD) of the personal annual effective dose (mSv) for nuclear medicine physicians was 1.9 ± 0.6, 1.8 ± 0.8, 1.2 ± 0.8, 1.4 ± 0.8, 1.3 ± 0.6, 0.8 ± 0.4 and for nuclear medicine technologists was 1.9 ± 0.8, 1.7 ± 1.4, 1.0 ± 1.0, 1.1 ± 1.2, 0.9 ± 0.4 and 0.7 ± 0.2 in 2001, 2002, 2003, 2004, 2005 and 2006, respectively. The mean (n = 2, estimate of SD makes little sense) of the personal annual effective dose (mSv) for radiopharmacists was 3.2, 1.8, 0.6, 1.3, 0.6 and 0.3. Although the administered activity of 131I increased, the mean personal effective dose per year decreased during the six years. Conclusion: In all three professional groups of nuclear medicine workers a decreasing radiation exposure was found, although the administered activity of 131I increased during this six-year period. Our observations suggest successful radiation protection measures at our department.

Download Full-text

Elevated Radiation Exposure Associated With Above Surface Flat Detector Mini C-Arm Use

Hand ◽

10.1177/1558944717743600 ◽

2017 ◽

Vol 14 (4) ◽

pp. 565-569

Author(s):

Dennis P. Martin ◽

Talia Chapman ◽

Christopher Williamson ◽

Brian Tinsley ◽

Asif M. Ilyas ◽

...

Keyword(s):

Radiation Exposure ◽

Prolonged Exposure ◽

Background Radiation ◽

Image Intensifier ◽

Body Part ◽

Operating Table ◽

Dependent Manner ◽

Body Parts ◽

Flat Detector ◽

Dose Dependent

Background: This study aims to test the hypothesis that: (1) radiation exposure is increased with the intended use of Flat Surface Image Intensifier (FSII) units above the operative surface compared with the traditional below-table configuration; (2) this differential increases in a dose-dependent manner; and (3) radiation exposure varies with body part and proximity to the radiation source. Methods: A surgeon mannequin was seated at a radiolucent hand table, positioned for volar distal radius plating. Thermoluminescent dosimeters measured exposure to the eyes, thyroid, chest, hand, and groin, for 1- and 15-minute trials from a mini C-arm FSII unit positioned above and below the operating surface. Background radiation was measured by control dosimeters placed within the operating theater. Results: At 1-minute of exposure, hand and eye dosages were significantly greater with the flat detector positioned above the table. At 15-minutes of exposure, hand radiation dosage exceeded that of all other anatomic sites with the FSII in both positions. Hand exposure was increased in a dose-dependent manner with the flat detector in either position, whereas groin exposure saw a dose-dependent only with the flat detector beneath the operating table. Conclusions: These findings suggest that the surgeon’s hands and eyes may incur greater radiation exposure compared with other body parts, during routine mini C-arm FSII utilization in its intended position above the operating table. The clinical impact of these findings remains unclear, and future long-term radiation safety investigation is warranted. Surgeons should take precautions to protect critical body parts, particularly when using FSII technology above the operating with prolonged exposure time.

Download Full-text

Burden of Medical Radiation Exposure in Children with Sickle Cell Disease.

Blood ◽

10.1182/blood.v114.22.1525.1525 ◽

2009 ◽

Vol 114 (22) ◽

pp. 1525-1525 ◽

Cited By ~ 1

Author(s):

Courtney L. Wendel ◽

Jon A. Anderson ◽

Timothy J. Blackburn ◽

Charles T. Quinn

Keyword(s):

Nuclear Medicine ◽

Sickle Cell Disease ◽

Radiation Exposure ◽

Sickle Cell ◽

Ct Scans ◽

Radiographic Study ◽

Cell Disease ◽

Medical Radiation ◽

Medical Radiation Exposure

Abstract Abstract 1525 Poster Board I-548 BACKGROUND Children with sickle cell disease (SCD) present to medical attention repeatedly throughout childhood for medical complications. Chest radiographs are often obtained for fever and respiratory symptoms, and plain radiographs are often ordered because of bone pain. Computed tomography (CT) and nuclear medicine (NM) studies may also be obtained for other complications. Exposure to medical radiation may increase the risk of cancer, especially in children. Growing children are inherently radiosensitive because of their high proportion of dividing cells, and children have more remaining years of life than adults during which cancer can develop. Therefore, it is important to determine the magnitude of medical radiation exposure in children with SCD because they could be so frequently exposed. METHODS We reviewed the medical records for all members of the Dallas Newborn Cohort (Blood 2004;103:4023-7) to determine the number and type of radiographic studies each individual received from 1996 to the present. We recorded the type of radiographic study, body location, clinical indication, date of study, age at the time of study, and the number and types of views when applicable. We also recorded slice thickness and mode for CT scans as well as injection activity, radionuclide, and type of radiopharmaceutical for nuclear medicine studies. To account for different lengths of follow-up, we standardized the number of radiographic studies to yearly rates for each individual to determine the projected number of studies a SCD patient would receive by 18 years of age. RESULTS We studied 938 patients (52.8% male) with a mean follow-up of 9.4 years (median 9.2, range 0.1 – 20.6). 571 had sickle cell anemia (SS), 283 had sickle-hemoglobin C disease (SC), 63 had Sβ+-thalassemia (Sβ+), and 21 had Sβ0-thalassemia (Sβ0). We identified 9,246 radiographic studies, including 8,697 radiographs, 441 CT scans, and 108 NM studies. 711 (76%) patients had at least one radiographic study. Patients with SS or Sβ0 were more likely to have had at least one radiographic study than those with SC or Sβ+ (77% vs. 65%; P<0.0001). The mean number of studies per patient was 9.9 [95% confidence interval (C.I.) 8.9 – 10.9; range 0 – 115], corresponding to a mean rate of 1.5 per year (95% C.I. 1.3 – 1.6; range 0 – 27.3). We project that a patient with SCD will be exposed to the radiation from 26.7 (95% C.I. 24.1 – 29.3; range 0 – 492.1) radiographic studies by 18 years of age. Approximately 5% of patients with SCD will be exposed to 100 or more radiographic studies during childhood. CONCLUSIONS Children with SCD are frequently exposed to medical radiation. Some are exposed to over 100 radiographic studies. Radiographs of the painful part are frequently obtained but are infrequently indicated. Because growing children are more radiosensitive than adults and have more remaining years of life, medical radiation exposure could be clinically significant. We are now calculating the radiation effective doses for this cohort to quantify the risk of malignancy. It is prudent to limit the medical radiation exposure of this high-risk population. Disclosures No relevant conflicts of interest to declare.

Download Full-text

ASSESSMENT OF INDOOR RADIATION DOSE RECEIVED BY THE RESIDENTS OF NATURAL HIGH BACKGROUND RADIATION AREAS OF COASTAL VILLAGES OF KANYAKUMARI DISTRICT, TAMIL NADU, INDIA

Green Chemistry & Technology Letters ◽

10.18510/gctl.2015.111 ◽

2015 ◽

Vol 1 (01) ◽

pp. 01-05

Author(s):

R.Ragel Mabel Saroja

Keyword(s):

Solid State ◽

Radiation Dose ◽

Gamma Radiation ◽

Radiation Exposure ◽

Effective Dose ◽

Tamil Nadu ◽

Background Radiation ◽

Annual Effective Dose ◽

Indoor Radon ◽

High Background

Radiation exposure and effective dose received through two routes of exposure, viz. external and internal, via inhalation, by residents of coastal villages belonging to Natural High Background Radiation Areas (NHBRA) of Kanyakumari District and Tamil Nadu inIndiawere studied. While the indoor gamma radiation levels were monitored using Thermo Luminescent Dosimeters (TLDs), the indoor radon and thoron gas concentrations were measured using twin chamber dosimeters employing Solid State Nuclear Track Detectors (SSNTDs, LR-115-II). The average total annual effective dose was estimated and found to be varied from 2.37 to8.64 mSv.

Download Full-text

Cumulative exposure to ionising radiation from diagnostic imaging tests: a 12-year follow-up population-based analysis in Spain

BMJ Open ◽

10.1136/bmjopen-2019-030905 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030905 ◽

Cited By ~ 2

Author(s):

Blanca Lumbreras ◽

Josee María Salinas ◽

Isabel Gonzalez-Alvarez

Keyword(s):

Diagnostic Imaging ◽

Radiation Exposure ◽

Effective Dose ◽

Population Based ◽

Cumulative Exposure ◽

Routine Practice ◽

Age Group ◽

Catchment Population ◽

Cumulative Effective Dose

ObjectivesTo calculate each patient’s cumulative radiation exposure and the recurrent tests during a 12-year study period, according to sex and age, in routine practice.DesignRetrospective cohort study.SettingA general hospital with a catchment population of 224 751 people, in the Southeast of Spain.ParticipantsPopulation belonged to the catchment area of that hospital in 2007. We collected all consecutive diagnostic imaging tests undergone by this population until 31 December 2018. We excluded: imaging tests that did not involve radiation exposure.Main outcome measuresThe cumulative effective dose and the recurrent imaging tests by sex and age at entry of study.ResultsOf the 224 751 people, 154 520 (68.8%) underwent an imaging test. The population had 1 335 752 imaging tests during the period of study: 1 110 077 (83.0%) plain radiography; 156 848 (11.8%) CT; 63 157 (4.8%) fluoroscopy and 5670 (0.4%) interventional radiography. 25.4% of the patients who had a CT, underwent five or more CTs (5.4% in the 0–20 years age group). The median total cumulative effective dose was 2.10 mSv (maximum 3980.30) and 16.30 mSv (maximum 1419.30 mSv) if we considered only doses associated with CT. Women received more effective dose than men (median 2.38 vs median 1.90, p<0.001). A total of 7142 (4.6%) patients received more than 50 mSv, with differences in men and women (p<0.001) and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT.ConclusionsNearly 5% of patients received doses higher than 50 mSv during the 12-year period of study and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT. The rate of recurrent examinations was high, especially in older patients, but also relevant in the 0–20 years age group.

Download Full-text

Aquisition of age- and sex-dependent patient data for the calculation of annual radiation exposure in nuclear medicine: a German pilot study

Nuklearmedizin ◽

10.1055/s-0038-1625591 ◽

2004 ◽

Vol 43 (02) ◽

pp. 45-56 ◽

Cited By ~ 2

Author(s):

P. Schnell-Inderst ◽

D. Noßke ◽

M. Weiss ◽

A. Stamm-Meyer ◽

G. Brix ◽

...

Keyword(s):

Nuclear Medicine ◽

Radiation Exposure ◽

Effective Dose ◽

Accurate Determination ◽

Routine Data ◽

Diagnostic Procedures ◽

Sex Type ◽

Bone Scans ◽

One Year

Summary Aim: A pilote study for estimation of radiation exposure due to diagnostic procedures in nuclear medicine using routine data of hospitals and practices in Germany. Methods: Hospitals and practices willing to participate in the study supplied data of one year (1997), containing information on patients´ identification number, age, sex, type of diagnostic procedure, radiopharmaceutical, administered activity, type of health insurance (private/ public), inpatient/outpatient status, and so-called Leistungsziffer, which describes the type of medical performances in Germany. The effective dose per examination was calculated according to ICRP 80. Mean, standard deviation, median, 5th and 95th percentiles of the effective dose were calculated, stratified by type of organ system and also by sex and age, including patients of ≥18 years. Results: 82 039 examinations from patients of 9 hospitals and practices were analyzed. The median (5-95th percentiles) of the effective dose per examination for all patients was 2.9 mSv (0.4-8.5 mSv); 1.2 examinations per patient and year were performed on average. The three most frequent examinations were bone scans (median 3.4 mSv; 2.9-5.1), thyroid (0.9 mSv; 0.4-2.2) and cardiovascular studies (7.3 mSv; 3.8-20.2). The median effective dose for 18 to 40 years old women was 1.0 mSv (0.4-5.8), for women between 41 and 65 years 2.2 mSv (0.4-7.3) and for women older than 65 years 2.4 mSv (0.5- 7.6). The corresponding values for men were 2.6 mSv (0.3-7.6); 3.3 mSv (0.4-9.1), and 3.4 mSv (0.5- 8.8). Conclusion: It was possible to gain an accurate determination of radiation exposure of diagnostic procedures in nuclear medicine by routine data.

Download Full-text

Application of radioactive substances in research in nuclear medicine: current trends and radiation exposure to the study subjects

Nuklearmedizin ◽

10.1055/s-0038-1625923 ◽

2001 ◽

Vol 40 (04) ◽

pp. 116-121 ◽

Cited By ~ 3

Author(s):

E.-R. Schwarz ◽

B. Bauer ◽

D. Noßke ◽

A. Erzberger ◽

G. Brix ◽

...

Keyword(s):

Nuclear Medicine ◽

Radiation Exposure ◽

Effective Dose ◽

Radiation Protection ◽

Fold Increase ◽

Human Beings ◽

Aim Analysis ◽

Diagnostic Studies ◽

Radioactive Substances ◽

Federal Institute

SummaryAim: Analysis of the application of radioactive substances in research in the field of nuclear medicine in human beings and of the resulting radiation exposure to study subjects. Methods: Assessment of applications for approval submitted in accordance with Paragraph 41 of the Radiation Protection Ordinance, evaluated by the Federal Office for Radiation Protection together with the Federal Institute for Pharmaceuticals and Medical Products, within the period from 1997 to 1999. Results: The focus of the studies on the diagnostic application of radioactive substances in medicine evaluated has, since 1998, shifted from oncological to neurological and psychological aspects, while, at the same time, the number of PET studies increased constantly. The proportion of healthy study subjects included in the diagnostic studies increased from 7 to 22%. The number of therapeutic applications of radioactive substances has, since 1997, undergone a three-fold increase, and in the process of this, the focus of attention lay within the area of radioimmuno-therapy and endovascular brachy-theropy. The effective dose was, among up to 49% of the investigated healthy study subjects higher than 5 mSv, and among up to 6% of these subjects was at levels of over 20 mSv. Up to 22% of the patients received, within the scope of diagnostic studies, an effective dose of between 20 and 50 mSv. An exceeding of the 50 mSv limit occurred among up to 3% of the patients. Conclusions: In spite of the increasing numbers of PET applications, conventional nuclear medicine has maintained its importance in the field of medical research. Further developments in the areas of radiochemistry and molecular biology led to an increase in the importance of radio-immuno therapy. The evaluation of new radiopharmaceuticals and the extension of basic biomedical research, resulted in an increase in the proportion of healthy study subjects included in the studies. The radiation exposure among subjects resulting directly from the studies showed, for the period of evaluation, an overall trend towards reduction.

Download Full-text

Radiation Exposure to the Patient During Diagnostic Coronary Angiogram at Dhulikhel Hospital

Kathmandu University Medical Journal ◽

10.3126/kumj.v13i1.13755 ◽

2015 ◽

Vol 13 (1) ◽

pp. 61-63

Author(s):

S Humagain ◽

R Maharjan ◽

R Koju

Keyword(s):

Radiation Exposure ◽

Background Radiation ◽

Cumulative Effect ◽

Interventional Cardiology ◽

Fluoroscopy Time ◽

Coronary Angiogram ◽

Dose Area Product ◽

Area Product ◽

Necessary Evil ◽

Age Range

Background Radiation is a necessary evil in Coronary Angiogram. The Interventional Cardiology procedure provides huge benefit to the patient but at the cost of radiation. There is evidence of cumulative effect of radiation. Therefore it is essential to keep the radiation dose as minimum as possible.Objective The aim of this study is to find out radiation exposed to the patient undergoing diagnostic coronary angiogram.Method A retrospective study was done. Those patients who underwent diagnostic coronary angiogram were selected for the study. There were total of 166 patients. Radiation exposure in terms of fluoroscopy time in minute and dose area product (DAP) in Gy.cm2 was recorded.Result Out 166 patients 92 were male and 74 female. Age range was from 39 to 79 years with mean age 58.13±9.14. Amount of contrast used was in range of 30 to 100 ml with mean of 45.54±14.06. Range of fluoroscopy time was 2.60 to 37.00 minutes with mean 11.38±6.80. Mean fluoroscopy time in male was 10.92±5.82 minutes and in females it was 11.92±7.68 minutes, with p 0.331. The range of DAP was 11.00 Gy.cm2 to 106.00 Gy.cm2 with mean 40.73±23.58 Gy.cm2. The mean DAP in male and female was 38.77±23.26 Gy.cm2 and 43.16±23.90 Gy.cm2 respectively with p 0.234.Conclusion From this study we can conclude that the radiation exposure to our patient undergoing coronary angiogram is similar to the international values in terms DAP but more in terms of fluoroscopy time. When males and females compared there is no difference.Kathmandu University Medical Journal Vol.13(1) 2015; 61-63

Download Full-text

Microcirculation of the fingers in Raynaud’s syndrome

Nuklearmedizin ◽

10.1055/s-0038-1623922 ◽

2005 ◽

Vol 44 (01) ◽

pp. 29-32 ◽

Cited By ~ 5

Author(s):

I. Garai ◽

J. Varga ◽

G. Szücs ◽

Z. Galajda ◽

C. András ◽

...

Keyword(s):

Nuclear Medicine ◽

Quantitative Data ◽

Cost Effective ◽

Semiquantitative Analysis ◽

Perfusion Scintigraphy ◽

Visual Evaluation ◽

Raynaud’S Syndrome ◽

Raynaud's Syndrome ◽

Primary Form

Summary Aim: We investigated the circulatory characteristics of patients suffering of primary and secondary Raynaud’s syndrome. Patients, methods: We examined 106 patients presenting with the classical symptoms of Raynaud’s syndrom (47 primary, 59 secondary) by hand perfusion scintigraphy developed by our Department of Nuclear Medicine. After visual evaluation we analyzed the images semiquantitatively, using the finger to palm ratio. We statistically compared the patients with primary and those with secondary Raynaud’s syndrome. Results: By visual evaluation we constated regional perfusion disturbances in 42 from 59 patients with secondary Raynaud’s syndrome. However, this was observed in only 3 from 47 patients with the primary form of this disease. This difference was statistically significant (p <0.001). Semiquantitative analysis showed that the finger/palm ratios (FPR) were significantly lower (p <0.05) for the patients with primary Raynaud’s syndrome. No differences in the FPR values concerning sex or right and left side. Conclusion: The hand perfusion scintigraphy with 99mTc-DTPA is a noninvasive, cost effective diagnostic tool, which objectively reflects the global and regional microcirculatory abnormalities of the hands, and provides quantitative data for follow-up.

Download Full-text

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

Nuklearmedizin ◽

10.1055/s-0038-1625201 ◽

2005 ◽

Vol 44 (05) ◽

pp. 119-130 ◽

Cited By ~ 10

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.

Download Full-text