Gamma-Ray Protection Properties of Bismuth-Silicate Glasses against Some Diagnostic Nuclear Medicine Radioisotopes: A Comprehensive Study

This study aimed to perform an investigation for the potential implementation of bismuth silicate glasses as novel shield equipment instead of ordinary shields in nuclear medicine facilities. Accordingly, a group of Bi2O3 reinforced silicate glass system were investigated and compared with ordinary shields in terms of their gamma-ray attenuation properties in diagnostic nuclear medicine radioisotope energies emitted from 99mTc, 111In, 67Ga, 123I, 131I, 81mKr, 201Tl, 133Xe. Mass attenuation coefficient (μm) results for glass samples were calculated comparatively with the XCOM program and MCNPX code. The gamma-ray attenuation parameters such as half value layer (HVL), tenth value layer (TVL), mean free path (MFP), effective atomic number (Zeff) were obtained in the diagnostic gamma ray energy range from 75 to 336 keV. To confirm the attenuation performance of superior sample, obtained results were extensively compared with ordinary shielding materials. According to the results obtained, BISI6 glass sample with the highest Bi2O3 additive has an excellent gamma-ray protection.

Cumulative radiation doses due to nuclear medicine examinations: a systematic review

Objectives: To systematically review the published data regarding the cumulative exposure to radiation in selected cohorts of adults or paediatric patients due to diagnostic nuclear medicine examinations. Methods: We conducted PubMed/Medline searches of peer-reviewed papers on cumulated effective dose (CED) from diagnostic nuclear medicine procedures published between 01 January 2010 until 31 January 2021. Studies were considered eligible if the contribution of nuclear medicine examinations to total CED was >10%. Studies reporting cumulative doses in a single episode of care or in a limited time (≤1 year) were excluded. The main outcomes for which data were sought were the CED accrued by patients, the period in which the CED was accrued, the percentage of patients with CED > 100 mSv and the percentage contribution due to nuclear medicine procedures to the overall CED. Results: The studies included in the synthesis were 18 which enrolled a total of 1,76,371 patients. Eleven (1,757 patients), three (1,74,079 patients) and four (535 patients) were related to oncological, cardiologic and transplanted patients, respectively. All the studies were retrospective; some of the source materials referred to small number of patients and some of the patients were followed for a short time. Not many studies accurately quantified the contribution of nuclear medicine procedures to the overall radiation exposure due to medical imaging. Finally, most of the studies covered an observation period which extended mainly in the 2000–2010 decade. Conclusions: There is a need of prospective, multicentric studies enrolling a greater number of patients, followed for longer period in selected groups of patients to fully capture the cumulative exposure to radiation in these settings Advances in knowledge: This systematic review allows to identify selected group of patients with a specific health status in which the cumulated exposure to radiation may be of concern and where the contribution of nuclear medicine procedures to the total CED is significant.

Clinical Perspectives of Theranostics

Theranostics is a precision medicine which integrates diagnostic nuclear medicine and radionuclide therapy for various cancers throughout body using suitable tracers and treatment that target specific biological pathways or receptors. This review covers traditional theranostics for thyroid cancer and pheochromocytoma with radioiodine compounds. In addition, recent theranostics of radioimmunotherapy for non-Hodgkin lymphoma, and treatment of bone metastasis using bone seeking radiopharmaceuticals are described. Furthermore, new radiopharmaceuticals for prostatic cancer and pancreatic cancer have been added. Of particular, F-18 Fluoro-2-Deoxyglucose (FDG) Positron Emission Tomography (PET) is often used for treatment monitoring and estimating patient outcome. A recent clinical study highlighted the ability of alpha-radiotherapy with high linear energy transfer (LET) to overcome treatment resistance to beta--particle therapy. Theranostics will become an ever-increasing part of clinical nuclear medicine.

Recent advances in the synthesis of (99mTechnetium) based radio-pharmaceuticals

Technetium radionuclide (99mTc) has excellent extent of disintegration properties and occupies a special place in the field of nuclear medicinal chemistry and other health disciplines. Current review describes recent approaches of synthesis in detailed ways for radio-pharmaceuticals of technetium which have been developed to treat and diagnose the biotic disorders. These technetium labeled radio-pharmaceuticals have been established to apply in the field of diagnostic nuclear medicine especially for imaging of different body parts such as brain, heart, kidney, bones and so on, through single photon emission computed tomography (SPECT) that is thought to be difficult to image such organs by using common X-ray and MRI (Magnetic Resonance Imaging) techniques. This review highlights and accounts an inclusive study on the various synthetic routes of technetium labeled radio-pharmaceuticals using ligands with various donor atoms such as carbon, nitrogen, sulphur, phosphorus etc. These compounds can be utilized as next generation radio-pharmaceuticals.

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

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.

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

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.