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.

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.

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.

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.

scholarly journals SOLLID – a single centre study to develop methods to investigate the effects of low radiation doses within nuclear medicine, to enable multicentre epidemiological investigations

2020 ◽  
pp. 20200072
Author(s):  
Glenn Flux ◽  
Iain Murray ◽  
Dominic Rushforth ◽  
Paul Gape ◽  
Carla Abreu ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Large Scale ◽  
Current Model ◽  
Standard Of Care ◽  
Diagnostic Procedures ◽  
Radiation Doses ◽  
Relative Risks ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures ◽  
Low Levels

There is continuing debate concerning the risks of secondary malignancies from low levels of radiation exposure. The current model used for radiation protection is predicated on the assumption that even very low levels of exposure may entail risk. This has profound implications for medical procedures involving ionising radiation as radiation doses must be carefully monitored, and for diagnostic procedures are minimised as far as possible. This incurs considerable expense. The SOLLID study (ClinicalTrials.gov Identifier: NCT03580161) aims to develop the methodology to enable a large-scale epidemiological investigation of the effect of radiopharmaceutical administrations to patients undergoing diagnostic nuclear medicine procedures. Patients will undergo a series of scans in addition to that acquired as standard of care to enable the radiation doses delivered to healthy organs to be accurately calculated. Detailed analysis will be performed to determine the uncertainty in the radiation dose calculations as a function of the number and type of scans acquired. It is intended that this will inform a subsequent long-term multicentre epidemiological study that would address the question definitively. Secondary aims of the study are to evaluate the range of absorbed doses that are delivered from diagnostic nuclear medicine procedures and to use current risk models to ascertain the relative risks from these administrations.

scholarly journals Lifetime Risk of Radiation Induced Severe Hereditary Stochastic (SHS) Effects in Medical Radiation Personnel

2021 ◽  
Vol 15 (5) ◽  
pp. 1105-1107
Author(s):  
Saman Shahid ◽  
Asma Majeed ◽  
Rana Aatif Siddique ◽  
Khalid Masood ◽  
Shahid Ali
Keyword(s):  
Radiation Effects ◽  
Genetic Diseases ◽  
Radiation Risk ◽  
Lifetime Risk ◽  
Dose Assessment ◽  
Risk Assessments ◽  
Whole Body ◽  
Medical Radiation ◽  
Effective Doses ◽  
Hereditary Effects

Background: Hereditary risk assessments in medical radiation workers must be accentuated as a precaution against genetic diseases. Ionizing radiations can induce hereditary or genetic radiation effects. Aim: To evaluate the lifetime risk of severe hereditary stochastic (SHS) effects in INMOL’s medical radiation personnel. Methods: The determination of the ‘whole-body’ effective doses was performed by ‘dose assessment algorithm’. We adopted the procedure described by ICRP for the assessment of lifetime severe hereditary annual risks by using ‘nominal probability coefficient’. Results: The AAEDs were between 1.41-1.79 mSv (in NM), 1.07-1.43 mSv (in RT) and 1.21-1.70 mSv (in RD) during 2014-2018. A declining trend is observed in AAED values in five consecutive years, due to improvements in radiation protection and safety measures. The risks of severe hereditary effects were also decreased from 2014-2018. The SHS risk was decreased from 5.012×10-4 to 3.948 ×10-4 in NM, 4.004×10-4 to 2.996×10-4 in RT and 4.76×10-4 to 3.388×10-4 in DR department. Conclusion: This study is emphasizing towards evaluating risks of hereditary effects from chronic exposure of radiations in occupational workers to avoid further late genetic complications. Such quantitative indicators would be useful in comparing other lifetime death risks from other harmful substances. Keywords: Hereditary Stochastic Effects; Annual Average Effective Doses; Nominal Probability Coefficient; Medical Radiation; Occupational Radiation Risk Assessments

Abstract

2000 ◽  
Vol 30 (1) ◽  
pp. 1-1 ◽  
Keyword(s):  
Nuclear Medicine ◽  
Radiation Effects ◽  
Diagnostic Procedures ◽  
Pregnant Patient ◽  
Unborn Child ◽  
Potential Harm ◽  
Increased Risk ◽  
Therapeutic Procedures ◽  
Radiation Workers ◽  
Higher Doses

Thousands of pregnant patients and radiation workers are exposed to ionising radiation each year. Lack of knowledge is responsible for great anxiety and probably unnecessary termination of pregnancies. For many patients, the exposure is appropriate, while for others the exposure may be inappropriate, placing the unborn child at increased risk. Prenatal doses from most properly done diagnostic procedures present no measurably increased risk of prenatal death, malformation, or impairment of mental development over the background incidence of these entities. Higher doses, such as those involved in therapeutic procedures, can result in significant fetal harm. The pregnant patient or worker has a right to know the magnitude and type of potential radiation effects that might result from in utero exposure. Almost always, if a diagnostic radiology examination is medically indicated, the risk to the mother of not doing the procedure is greater than is the risk of potential harm to the fetus. Most nuclear medicine procedures do not cause large fetal doses. However, some radiopharmaceuticals that are used in nuclear medicine can pose significant fetal risks. It is important to ascertain whether a female patient is pregnant prior to radiotherapy. In pregnant patients, cancers that are remote from the pelvis usually can be heated with radiotherapy. This however requires careful planning. Cancers in the pelvis cannot be adequately treated during pregnancy without severe or lethal consequences for the fetus. The basis for the control of the occupational exposure of women who are not pregnant is the same as that for men. However, if a woman is, or may be, pregnant, additional controls have to be considered to protect the unborn child. In many countries, radiation exposure of pregnant females in biomedical research is not specifically prohibited. However, their involvement in such research is very rare and should be discouraged. Termination of pregnancy is an individual decision affected by many factors. Fetal doses below 100 mGy should not be considered a reason for terminating a pregnancy. At fetal doses above this level, informed decisions should be made based upon individual circumstances.

scholarly journals Diagnostic nuclear medicine in pediatric oncology-what we should know before scanning?

2012 ◽  
Vol 20 (3-4) ◽  
pp. 139-142
Author(s):  
Marina Vlajkovic ◽  
Milovan Matovic
Keyword(s):  
Nuclear Medicine ◽  
Cause Of Death ◽  
Pediatric Oncology ◽  
Diagnostic Procedures ◽  
Malignant Diseases ◽  
High Quality ◽  
Oncology Patients ◽  
Diagnostic Nuclear Medicine ◽  
Tumour Spread

Cancer is second only to trauma as a cause of death in children, accounting for approximately 10% of all childhood deaths. The application of radioisotopes in the treatment of malignant diseases in children consists of detecting and estimating the degree of tumour spread by application of tumour-specific and non-specific radiopharmaceuticals, as well as the treatment of some malignant diseases. Paramount to any successful nuclear medicine examination is the establishment of acquisition protocols that allow high quality images to be obtained while ALARA principles are followed. Pediatric-specific issues should be anticipated and addressed in the planning of the studies to maximize the utility of the technique in this challenging group of patients, so the goal of this article is to summarize general prerequisites for the application of nuclear medicine diagnostic procedures in pediatric oncology patients.

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

Risk score – valuable tool for individual risk assessment?

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
B Osswald ◽  
G Thomas ◽  
U Tochtermann ◽  
V Gegouskov ◽  
D Badowski-Zyla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Risk Score ◽  
Individual Risk ◽  
Individual Risk Assessment

Radiation exposure in the environment of patients after application of radiopharmaceuticals

2008 ◽  
Vol 47 (06) ◽  
pp. 267-274 ◽  
Author(s):  
F. Boldt ◽  
C. Kobe ◽  
W. Eschner ◽  
H. Schicha ◽  
F. Sudbrock
Keyword(s):  
Nuclear Medicine ◽  
Radiation Exposure ◽  
Radioactive Source ◽  
Time Intervals ◽  
The Public ◽  
Dose Rates ◽  
Diagnostic Nuclear Medicine ◽  
Photon Dose ◽  
Order Of Magnitude ◽  
Study Dose

Summary Aim: After application of radiopharmaceuticals the patient becomes a radioactive source which leads to radiation exposure in the proximity. The photon dose rates after administration of different radiopharmaceuticals used in diagnostic nuclear medicine were measured at several distances and different time intervals. These data are of importance for estimating the exposure of technologists and members of the public. Patients, method: In this study dose rates were measured for 67 patients after application of the following radiopharmaceuticals: 99mTc-HDP as well as 99mTcpertechnetate, 18F-fluorodeoxyglucose, 111In-Octreotid and Zevalin® and 123I-mIBG in addition to 123I-NaI. The dose rates were measured immediately following application at six different distances to the patient. After two hours the measurements were repeated and – whenever possible – after 24 hours and seven days. Results: Immediately following application the highest dose rates were below 1 mSv / h: with a maximum at 780 μSv/h for 18F (370 MBq), 250 μSv/h for 99mTc (700 MBq), 150 μSv/h for 111In (185 MBq) and 132 μSv/ h for 123I (370 MBq). At a distance of 0.5 m the values decrease significantly by an order of magnitude. Two hours after application the values are diminished to 1/3 (99mTc, 18F), to nearly ½ (123I) but remain in the same order of magnitude for the longer-lived 111In radiopharmaceuticals. Conclusion: For greater distances the doses remain below the limits outlined in the national legislation.

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