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Abstract Bone regeneration is crucial for repairing bone tissue following various injuries. Research techniques that enable the study of metabolic changes in bone tissue under different conditions are important for understanding bone repair and remodeling. This study used bone scintigraphy to evaluate osteogenesis secondary to osteotomy in a preclinical model of New Zealand rabbits. For this purpose, we conducted a longitudinal, prospective, case-control study in which scintigraphic variables were measured in both the right forearm (case-operated) and the left forearm (control - non-operated). The study sample consisted of 10 rabbits subjected to osteotomy, followed by a 12-week postoperative evaluation period, divided into six imaging stages at 1, 2, 3, 4, 8, and 12 weeks. We observed that the operated forearm showed significantly higher external radiation than the control side, using the pinhole collimator, denoting an increase in the biodistribution and tropism of the radiopharmaceutical to the operated forearm. Among the three evaluated time points, osteoblastic activity was highest in the second week and presented a significant decline in the 8th and 12th weeks, denoting regeneration and resolution of the surgical injury; the control forearm was also influenced by the inactivity imposed by the operated forearm. This fact was notably evidenced by the reduction in the metabolic activity of osteoblasts in the left forearm. Our study suggested that bone scintigraphy was sensitive enough to semi-quantitatively differentiate the metabolic activity of osteoblasts in the operated forearm in the three temporal landmarks evaluated in the study.
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Introducción: la Medicina Nuclear es una especialidad médica que trata o diagnostica diferentes afecciones mediante imágenes de tipo funcional-molecular, a partir del empleo de fuentes no selladas. Un aspecto importante en el desempeño profesional es la adecuada gestión de sustancias que puedan resultar nocivas. Objetivo: fundamentar la estructura conceptual de la competencia gestión de desechos radiactivos. Métodos: se realizó una revisión bibliográfica con un análisis crítico reflexivo, se consideraron documentos normativos de la actividad en Medicina Nuclear, tesis, artículos y libros, publicados a partir del 2018 en español e inglés. La búsqueda fue realizada en las bases de datos SciELO durante el periodo comprendido de enero a mayo del 2023. Las palabras clave utilizadas fueron: competencias, gestión y desechos radiactivos. Fueron revisados 73 textos y se seleccionaron 20 para conformar el texto final. Resultados: se delimitaron cuatro núcleos temáticos: pertinencia de formar competencias profesionales, base teórico-metodológica, base legal y riesgos e implicaciones. Resulta evidente el insuficiente tratamiento teórico-metodológico a la gestión de desechos como actividad de los tecnólogos de Medicina Nuclear. Se propone la definición de la competencia, los problemas contextuales que aborda, ejes procesuales, criterio de desempeño y evidencias requeridas. Conclusiones: el estudio de las competencias profesionales en los tecnólogos de la salud es un campo de notable vigencia encaminado a desarrollar su profesionalización. La evidente relación establecida entre la competencia gestión de desechos radiactivos y la reducción de riesgos y accidentes, conlleva la responsabilidad de formar profesionales preparados para desempeñarse con éxito en la Medicina Nuclear.
Introduction: Nuclear Medicine is a medical specialty that treats or diagnoses different conditions through functional-molecular images, using unsealed sources. An important aspect in professional performance is the proper management of substances that may be harmful. Objective: to support the conceptual structure of the radioactive waste management competence. Methods: a bibliographic review was carried out with a reflective critical analysis, normative documents of the activity in Nuclear Medicine, theses, articles, and books, published since 2018 in Spanish and English, were considered. The search was carried out in the SciELO databases from January to May 2023. The keywords used were competencies, management and radioactive waste. 73 texts were reviewed and 20 were selected to make up the final text. Results: four topic cores were defined: relevance of training professional competencies, theoretical-methodological base, legal base and risks and implications. The insufficient theoretical-methodological treatment of waste management as an activity of Nuclear Medicine technologists is evident. The definition of the competence, the contextual problems it addresses, procedural axes, performance criteria and required evidence are proposed. Conclusions: the study of professional competencies in health technologists is a field of notable validity aimed at developing their professionalization. The evident relationship established between radioactive waste management competence and the reduction of risks and accidents entails the responsibility of training professionals prepared to perform successfully in Nuclear Medicine.
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Nuclear Medicine , Organization and Administration , Professional Competence , Education, MedicalABSTRACT
Abstract Objective: To measure the potential radiation dose emitted by patients who have recently undergone diagnostic nuclear medicine procedures, in order to establish optimal radiation safety measures for such procedures. Materials and Methods: We evaluated the radiation doses emitted by 175 adult patients in whom technetium-99m, iodine-131, and fluorine-18 radionuclides were administered for bone, kidney, heart, brain, and whole-body scans, as measured with a radiation detector. Those values served as the basis for evaluating whole-body radiopharmaceutical clearance, as well as the risk for the exposure of others to radiation, depending on the time elapsed since administration of the radiopharmaceutical. Results: The mean time to clearance of the radiopharmaceuticals administered, expressed as the effective half-life, ranged from 1.18 ± 0.30 h to 11.41 ± 0.02 h, and the mean maximum cumulative radiation dose at 1.0 m from the patients was 149.74 ± 56.72 µSv. Even at a distance of 0.5 m, the cumulative dose was found to be only half and one tenth of the limits established for exposure of the general public and family members/caregivers (1.0 mSv and 5.0 mSv per episode, respectively). Conclusion: Cumulative radiation doses emitted by patients immediately after diagnostic nuclear medicine procedures are considerably lower than the limits established by the International Commission on Radiological Protection and the International Atomic Energy Agency, and precautionary measures to avoid radiation exposure are therefore not required after such procedures.
Resumo Objetivo: O objetivo deste trabalho foi levantar o potencial de dose de radiação emitida por pacientes em procedimentos diagnósticos, visando a estabelecer cuidados de radioproteção mais otimizados. Materiais e Métodos: Taxas de dose de radiação emitidas por 175 pacientes administrados com os radionuclídeos 99mTc, 131I e 18F para cintilografias óssea, renal, cardíaca, cerebral e corpo inteiro, foram mensuradas com um detector de radiação, servindo para avaliar o clareamento do radiofármaco no organismo e risco de exposição após administração dos radiofármacos. Resultados: O clareamento, representado pela meia-vida efetiva, variou de 1,18 ± 0,30 h até 11,41 ± 0,02 h e a dose de radiação máxima acumulada oferecida pelos pacientes a 1,0 m foi de 149,74 ± 56,72 µSv. Mesmo para distâncias de 0,5 m, as doses estimadas foram, respectivamente, duas e dez vezes inferiores ao nível de restrição para o público geral (1,0 mSv) e exposição médica (5,0 mSv/episódio). Conclusão: Doses de radiação oferecidas por pacientes em procedimentos diagnósticos são inferiores aos níveis de restrição recomendados pela International Commission on Radiological Protection e International Atomic Energy Agency, e assim, cuidados de radioproteção são geralmente desnecessários.
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With the rapid development of nuclear medicine, the number of nuclear medical staff has increased a lot in the past few years in China. Close-range operations, such as preparation and injections of radiopharmaceuticals, are usually carried out in nuclear medicine department. And the use of unsealed radionuclides may also create internal exposure risk. So, occupational exposure of nuclear medical staff is a main issue of occupational health management in China. In this paper, the occupational exposure level and requirements for radiation protection of nuclear medical staff are introduced to provide references for the related work that radiological health technical institutions carry out.
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Humans , Radiation Protection , China , Medical Staff , Occupational Exposure/prevention & control , Occupational HealthABSTRACT
Objective To determine the current status of occupational internal exposure to 131I in the thyroid of nuclear medicine workers, to explore the influencing factors for internal exposure, and to provide a basis for the radiation safety management of nuclear medicine. Methods The cluster sampling method was used to select 162 workers practicing 131I treatment in 24 hospitals in Hubei Province, China. Thyroid 131I activity levels were measured in vitro using a portable γ-spectrometer, and the committed effective dose was estimated. Results The thyroid 131I activity detected in 13 (54.17%) hospitals was above the lower limit of detection of the instrument. Two hospitals had the highest detection rates, 62.50% and 61.90%; the difference was significant compared with the remaining 11 hospitals (P < 0.0001). Thyroid 131I was detected in 34 workers in total, with a detection rate of 20.99% and a mean activity of 179.09 ± 138.71 (6.02-589.74) Bq. The highest detection rates were found in cleaners and nurses, which were 35.71% and 33.33%, respectively, with no significant difference in detection rate between positions (least P > 0.08). The mean value of the committed effective dose was 0.68 ± 0.52 (0.02-2.22) mSv/a in the 34 workers. Conclusion The 131I consumption and workplace ventilation may be important factors affecting the level of internal exposure. It is important to strengthen the training of nuclear medicine workers on radioprotection and workflow management, as well as the regular monitoring of occupational internal exposure for 131I treatment-related workers.
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Objective To determine the responses of radioactivity meter at different positions in the vertical direction of the ionization chamber by measuring different radioactive sources. Methods The radiation of cesium-137, cobalt-60, and americium-241 nuclides was measured at different positions in the vertical direction of the ionization chamber with commonly used clinical radioactivity meters. The measured values were fitted to obtain three trend lines. The maximum deviation of the measured values was estimated according to the trend line, and the deviation was estimated at different syringe needle heights. Results According to the trend lines, the maximum deviation of the radioactivity meter CRC-55tR in measuring cesium-137, cobalt-60, and americium-241 nuclides was 5.15%, 5.98%, and 6.25% respectively. The radioactivity meter RM-905a was used to measure three nuclides at different syringe needle heights, and the maximum deviations were −4.33%, −9.9%, and −12.65%, respectively. Conclusion The three nuclides showed different change patterns in measurement with CRC-55tR and RM-905a but similar change patterns in measurement with the same radioactivity meter. The values measured with the same radioactivity meter showed significant deviations at different positions in the vertical direction of the ionization chamber. It is recommended to make position correction for commonly used nuclides. Reducing measurement error and improving measurement accuracy of nuclides are of great significance for radiation protection.
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ObjectiveTo tentatively understand the status of radioactive contamination in nuclear medicine personnel. MethodsA total of 34 radiation staff engaged in nuclear medicine diagnosis and treatment were selected from two hospitals in Shanghai as the survey subjects.Among the 34 medical staff， 8 were nuclear medicine doctors， 14 were nuclear medicine technicians and 12 were nuclear medicine nurses. After surface contamination monitoring was first carried out to confirm that they had no surface radioactivity contamination， whole body scanning was performed with a whole body counter to determine whether they were internally contaminated with artificial radionuclides. ResultsThe α surface contamination was not detected in the nuclear medical staff. The β surface contamination of the nuclear medicine doctors， technicians and nurses was （13.8±0.8）， （14.1±0.8） and （14.0±0.7） times per second， respectively. There were 2， 2， and 4 nuclear medicine doctors who were contaminated with 18F， 99mTc and 131I， 3， 5， and 2 nuclear medicine technicians who were contaminated with 18F， 99mTc and 131I， and 6， 8， and 5 nuclear medicine nurses who were contaminated with 18F， 99mTc and 131I， respectively. The 18F activity of nuclear medicine technicians was 1 997‒9 401 Bq， and the 99mTc activity of nuclear medicine technicians and nurses was 3 699‒18 692 and 652‒388 22 Bq， respectively. One nuclear medicine nurse had a 99mTc activity of 35 389 Bq. According to the preliminary estimation of 131I internal irradiation dose， the maximum committed effective dose of nuclear medicine doctors， technicians and nurses could reach 0.370， 0.018 and 0.584 mSv， respectively. ConclusionThe nuclear medicine staff are exposed to radioactive contamination， and it is important to monitor and evaluate their internal radiation doses.
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@#The combination of conventional single-photon emission computed tomography (SPECT) and computed tomography (CT) may display the morphological changes of lesions and distribution of imaging agents, which is effective to improve the imaging sensitivity and specificity of tumors and non-tumor diseases. SPECT/CT is feasible to analyze the anatomical structure and metabolic status through displaying multi-site lesions with single imaging, thereby improving differential diagnosis and diagnostic accuracy of diseases. In addition, the novel mixed SPECT/CT device shortens the duration of image acquisition and provides precise attenuation correction and fusion imaging, which provides a scientific basis for rational selection of treatment regimens in clinical practice. This review describes the advances in clinical application of SPECT/CT.
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Objective:To analyze the application and funding status of various projects of nuclear medicine and molecular imaging supported by the National Natural Science Foundation of China (NSFC) from 2013 to 2022, and explore the challenges faced by basic research and clinical transformation in this field.Methods:From 2013 to 2022, application and funding information of nuclear medicine and molecular imaging projects (secondary code H2704, H2706) from five departments of Medical Science Department of NSFC were retrospectively collected. The number of applications, number of funding, funding direction, funding intensity, distribution of supporting units and research hotspots of various projects in this field were analyzed.Results:From 2013 to 2022, the total number of applications of various projects in the field of nuclear medicine and molecular imaging reached 5 387, and the total number of grants reached 899. The number of applications and grants showed a steady growth trend. The overall funding intensity increased from 48.935 0 million yuan in 2013 to 59.495 4 million yuan in 2022, with the increase of 21.58%. Among all supporting units, Shanghai Jiao Tong University topped the list for both the number of applications (440) and the number of grants (82), Xiamen University ranked the first in terms of overall funding rate (25.42%, 30/118), and Peking University ranked the first in terms of total funding intensity (41.897 1 million yuan). Research hotspots focused on the construction of tumor targeted molecular probes and precise imaging of tumor internal molecular components.Conclusion:In the past decade, the number of related projects and total funding of nuclear medicine and molecular imaging supported by NSFC have steadily increased, and the types of funded projects are diverse and interdisciplinary, promoting the innovative development of nuclear medicine and molecular imaging disciplines in China.
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Prostate cancer is the most common malignancy of the male genitourinary system. In 2022, the European Association of Urology (EAU) published an update of the guidelines for prostate cancer, following the updating of evidence. The clinical application of nuclear medicine diagnostic and therapeutic techniques in the staging and grading, screening and assessment of prostate cancer, especially metastatic castration-resistant prostate cancer, is becoming more and more valuable. This article aims to introduce the application of nuclear medicine recommended in the 2022 edition of EAU guidelines for prostate cancer based on the latest clinical evidence.
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The quality control of nuclear medicine imaging equipment is essential to ensure the quality and safety of nuclear medicine imaging. Phantoms are indispensable tools in quality control, performance comparison, and multicenter clinical trials of nuclear medicine imaging equipment. The structure of phantoms is developed from a simple form to a complicated form which can simulate real clinical conditions, and they are provided in various forms in combination with modern technologies. Different types of phantoms have their unique advantages and application situations. This article investigated and summarizes common phantoms and their performance evaluation indicators used in nuclear medicine imaging to provide a reference for the quality control of nuclear medicine equipment and selection of phantoms for clinical research.
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Objective:To investigate the basic situation of clinical nuclear medicine resources and their application in medical institutions of Jiangsu province, in order to grasp their distribution characteristics and make an evaluation briefly on distribution eaquity of nuclear medicine resources and application.Methods:In the form of online questionnaire, the basic information in the medical institutions conducting clinical nuclear medicine diagnosis and treatment in the provice was collected, including the number and model of nuclear medicine equipment, the number of protection devices, the number of nuclear medicine employees and the application frequency of nuclear medicine.Results:In 2020 in Jiangsu province, there were 67 nuclear medicine institutions, 727 employees and 95 nuclear medicine tomography equipment including 38 positron emission tomography (PET) equipment and 54 single photon emission computed tomography (SPECT) equipment. The frequencies of imaging and treatment in the medical institutions were 259, 686 and 12 186, with average frequency of 3.21 expressed per 1 000 population. The Gini coefficients of nuclear medicine equipment, employees and application based on population distribution in Jangsu province were 0.25, 0.30 and 0.34, respectively. The related Theil indices were 0.044 9, 0.062 6 and 0.085 2, respectively.Conclusions:The nuclear medicine developed quickly in Jiangsu province in the past ten years. The distribution of all kinds of nuclear medicine resources and application on the basis of continuous increase showed a certain degree of imbalance, and correlation with the level of regional economic development.
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Due to the limitations professional status and training channels, the training of pediatric imaging talents in China is seriously insufficient. Pediatric imaging doctors are concentrated in children's hospitals. Pediatric imaging knowledge and talents in primary medical institutions are scarce, which is not conducive to the construction of hierarchical diagnosis and treatment system. Large-scale telemedicine and online medical treatment based on mobile Internet have become the mainstream platforms for medical consultation and teaching, providing a good opportunity for remote teaching of pediatric imaging, and are expected to become a powerful tool for training pediatric imaging talents. The analysis of literature, mobile phone application market software and cost-effectiveness shows that the current large-scale telemedicine construction cycle is long, the construction and maintenance costs are high, and it is vulnerable to geographical and environmental constraints. It is still a long way to go for remote teaching in hospitals below the county level. The use of mobile terminals and mobile Internet is very convenient. It is an excellent choice to realize the remote teaching of pediatric imaging. It is expected to solve the problem of pediatric imaging talent training and skill dissemination.
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In order to help the standardized residency training of nuclear medicine residents, the standardized residency training base of nuclear medicine residents in Peking University People's Hospital, combined with forty-five nuclear medicine departments of teaching hospital, established the WeChat official account of "Standardized Residency Training of Nuclear Medicine" and submitted one teaching case per week. The appearance of the WeChat official account of "Standardized Residency Training of Nuclear Medicine" has made up for the shortcomings of insufficient teaching cases in a single training base, strengthened the training of residents' imaging diagnostic thinking, and promoted mutual learning among the bases. By writing teaching cases, instructors and residents have opened up ideas, increased knowledge, improved self-learning ability, and cultivated imaging diagnostic thinking. With the flexible and practical features of the WeChat official account, the consciousness and sustainability of residents' learning have been enhanced.
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Kummel's disease is a crush fracture of a vertebral body caused by a minor trauma, with the most accepted etiology being avascular necrosis. It is more frequent in individuals with risk factors such as osteoporosis or prolonged treatment with corticosteroids. Initially, it usually has normal radiological tests and an asymptomatic period, followed by a progressive onset of pain along with probable kyphosis and a sign of void or fluid abscess on radiological tests, which may create nerve/spinal involvement. The case is presented of a 76-year-old man, who was admitted to this center for the differential diagnosis of a single vertebral lesion. After imaging tests and biopsy, the definitive diagnosis of Kummel's disease was reached. The confirmatory diagnosis was reached by vertebral biopsy, but given its invasive nature, imaging techniques can play a significant role. As regards metabolic imaging tests, bone scintigraphy has shown to be one of the most sensitive tools to detect ischemia in earlier stages or to determine if it affects other locations. The whole body scan with diphosphonates shows an increase in activity in relation to bone remodeling activity in this condition. The 3-phase study makes it possible to differentiate whether it is an acute/subacute or chronic process, and can influence the therapeutic decision. Knowledge of this disease is important to make a differential diagnosis with tumour or infectious pathology, with emphasis on performing imaging tests in the event of persistent pain with a normal initial plaque.
La enfermedad de Kummel es una fractura-aplastamiento de un cuerpo vertebral precedida por un traumatismo menor, cuya etiología más aceptada es la necrosis avascular. Es más frecuente en individuos con factores de riesgo como osteoporosis o tratamiento prolongado con corticoides. Inicialmente, suele presentar pruebas radiológicas normales y un periodo asintomático, con aparición progresiva del dolor junto a probable cifosis y signo del vacío o absceso líquido en las pruebas radiológicas, pudiendo llegar a crear compromiso nervioso/medular. Presentamos el caso de un varón de 76 arios que ingresa en nuestro centro para el diagnóstico diferencial de una lesión única vertebral; tras la realización de las pruebas de imagen y biopsia se llega al diagnóstico definitivo de enfermedad de Kummel. El diagnóstico de confirmación de esta enfermedad se alcanza mediante la biopsia vertebral, pero dada su naturaleza invasiva, las técnicas de imagen toman un papel relevante. En relación con las pruebas de imagen metabólicas, la gammagrafía ósea ha demostrado ser una de las herramientas más sensibles para detectar isquemia en fases más tempranas o para conocer si afecta a otras localizaciones. El rastreo corporal de cuerpo completo con difosfonatos muestra un aumento de actividad en relación con la actividad ósea remodelativa en este cuadro. El estudio de tres fases permite diferenciar si se trata de un proceso agudo/subagudo o crónico, lo que influye en la decisión terapéutica. Es importante el conocimiento de esta enfermedad para realizar diagnóstico diferencial con patología tumoral o infecciosa e insistir en la realización de pruebas de imagen ante la persistencia del dolor con una placa inicial normal.
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Humans , Male , Aged , Bone Diseases , Radionuclide Imaging , Musculoskeletal Diseases , Embryophyta , Diagnostic Techniques and Procedures , Carum , Diagnosis , Eukaryota , Femur Head NecrosisABSTRACT
Abstract Objective: To evaluate the maximum and mean standardized uptake values, together with the metabolic tumor value and the total lesion glycolysis, at the primary tumor site, as determined by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG-PET/CT), performed before and after neoadjuvant chemoradiotherapy (nCRT), as predictors of residual disease (RD) in patients with esophageal cancer. Materials and Methods: The standardized uptake values and the volumetric parameters (metabolic tumor value and total lesion glycolysis) were determined by 18F-FDG-PET/CT to identify RD in 39 patients before and after nCRT for esophageal carcinoma. We used receiver operating characteristic curves to analyze the diagnostic performance of 18F-FDG-PET/CT parameters in the definition of RD. The standard of reference was histopathological analysis of the surgical specimen. Results: Eighteen patients (46%) presented RD after nCRT. Statistically significant areas under the curve (approximately 0.72) for predicting RD were obtained for all four of the variables evaluated after nCRT. Considering the presence of visually detectable uptake (higher than the background level) at the primary tumor site after nCRT as a positive result, we achieved a sensitivity of 94% and a specificity of 48% for the detection of RD. Conclusion: The use of 18F-FDG-PET/CT can facilitate the detection of RD after nCRT in patients with esophageal cancer.
Resumo Objetivo: Avaliar os valores máximo e médio de captação padronizada, o valor metabólico do tumor e a glicólise total da lesão do local do tumor primário, medidos no estudo de 18F-FDG-PET/CT realizado antes e depois da quimiorradioterapia neoadjuvante (nQRT) em pacientes com câncer de esôfago, como preditores de doença residual (DR). Materiais e Métodos: Os valores máximo e médio de captação padronizada e os parâmetros volumétricos (valor metabólico do tumor e glicólise total da lesão) da 18F-FDG-PET/CT realizada em 39 pacientes antes e após a nQRT para carcinoma de esôfago foram avaliados para RD. Usamos curvas receiver operating characteristic (ROC) para analisar o desempenho diagnóstico dos parâmetros 18F-FDG-PET/CT na definição de RD. O estudo anatomopatológico foi utilizado como padrão ouro. Resultados: Dezoito pacientes (46%) apresentaram DR após a nQRT. Áreas estatisticamente significativas sob a curva ROC para predizer DR foram obtidas para as quatro variáveis nos estudos realizados após a nQRT, com áreas sob a curva ROC semelhantes em torno de 0,72. Considerando a presença de captação visualmente detectável (captação maior que o background) no local da lesão primária após a nQRT como resultado positivo, teríamos uma sensibilidade de 94% e uma especificidade de 48% para detecção de DR. Conclusão: A 18F-FDG-PET/CT pode ser útil para detectar a presença de doença neoplásica residual no câncer de esôfago após a nQRT.
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Introducción: la técnica de imagen híbrida de SPECT-CT combina la imagen de la tomografía por emisión de fotón único (SPECT) con el estudio de tomografía computada (TC), obteniendo información funcional y anatómica en un mismo estudio. La dosis efectiva total de radiación ionizante recibida en los estudios SPECT-CT puede ser estimada a partir de la dosis efectiva atribuible a la actividad administrada del radiofármaco y la dosis efectiva del componente de tomografía computada (TC). Objetivos: estimar la dosis efectiva total en los protocolos SPECT-CT utilizados en población adulta y determinar el aporte adicional del estudio TC sobre la dosis efectiva total. Método: se evaluaron 258 estudios SPECT-CT para estimar la dosis efectiva total aportada por la administración de los radiofármacos y los estudios de TC de baja dosis. Para estimar el aporte de ambos componentes se utilizaron factores de conversión específicos de cada radiofármaco y región explorada mediante TC. Resultados: la dosis efectiva total (media ± DS) en los estudios SPECT-CT fueron: 12,4 ± 1,44 mSv en el estudio de perfusión miocárdica, 1,14 ± 0,25 mSv en ganglio centinela de mama, 8,6 ± 0,6 mSv paratiroides, 1,48 ± 1,02 mSv tiroides y los estudios óseos de las regiones de cuello 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdomen y pelvis 6,1 ± 0,3 mSv. La dosis de radiación aportada por el estudio TC se encuentra entre 0,46 mSv para la región del tórax en el estudio de ganglio centinela de mama y 2,3 mSv para el SPECT-CT óseo en la región de abdomen y pelvis. Conclusión: se logró estimar la dosis efectiva en los protocolos SPECT-CT de uso clínico más frecuente en población adulta y el aporte de los estudios TC a la dosis efectiva total siendo relativamente baja comparado con la dosis aportada por los radiofármacos administrados con la excepción del estudio de ganglio centinela donde la contribución del componente TC es aproximadamente la mitad de la dosis efectiva total.
Introduction: SPECT-CT Hybrid image technique combines the SPECT (single-photon emission computed tomography) image with the CT (computerized tomography) image to obtain both functional and anatomical images in the same study. The total effective ionizing radiation dose received in SPECT-CT studies may be estimated based on the effective dose from the radiopharmaceutical administered and the effective dose from the CT (computerized tomography) component. Objectives: the study aims to estimate the total effective dose in SPECT-CT protocols applied for the adult population, and to determine the additional contribution from the CT component to the total effective dose. Method: 258 SPECT-CT studies were evaluated to estimate the total effective dose from the administration of radiopharmaceuticals and low dose CT studies. Specific conversion factors for each radiopharmaceutical and area of the body explored with the CT were used to estimate radiation doses from both components. Results: total effective dose (average ± SD) in the SPECT-CT studies was: 12.4 ± 1.44 mSv in the myocardial perfusion study, 1.14 ± 0.25 mSv in the breast sentinel lymph node study, 8.6 ± 0.6 mSv in the parathyroid study, 1.48 ± 1.02 mSv in the thyroid study. As to bone studies, doses found were: 4.5 ± 0.3, in neck studies, 6.07 ± 0.3 mSv in thoracic studies and 6.1 ± 0.3 mSv in abdominal and pelvic studies. The radiation dose from the CT study ranges from 0.46 mSv for the thoracic region on the breast sentinel lymph node study to 2.3 mSv for the bone SPECT-CT study of the abdominal and pelvic region. Conclusions: we managed to estimate the effective dose in the the most frequently used SPECT-CT protocols for the adult population and the contribution of CT studies to the total effective dose. It was found to be relatively low when compared to the dose contributed by the radiopharmaceuticals administered, with the exception of the sentinel lymph node study for which the contribution from the CT study is approximately half the total effective dose.
Introdução: a técnica de imagem híbrida SPECT-CT combina a imagem de tomografia por emissão de fóton único (SPECT) com o estudo de tomografia computadorizada (TC), obtendo informações funcionais e anatômicas no mesmo estudo. A dose efetiva total de radiação ionizante recebida em estudos SPECT-CT pode ser estimada a partir da dose efetiva atribuível à atividade administrada do radiofármaco e da dose efetiva do componente de tomografia computadorizada (TC). Objetivos: estimar a dose efetiva total nos protocolos SPECT-CT utilizados na população adulta e determinar a contribuição adicional do estudo de TC na dose efetiva total. Método : 258 estudos SPECT-CT foram avaliados para estimar a dose efetiva total fornecida pela administração de radiofármacos e estudos de TC de baixa dose. Para estimar a contribuição de ambos os componentes, foram utilizados fatores de conversão específicos para cada radiofármaco e região explorada pela TC. â Resultados: a dose efetiva total (média ± DP) nos estudos SPECT-CT foi: 12,4 ± 1,44 mSv no estudo de perfusão miocárdica, 1,14 ± 0,25 mSv no linfonodo sentinela mamário, 8,6 ± 0,6 mSv paratireoide, 1,48 ± 1,02 mSv estudos de tireoide e ossos das regiões do pescoço 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdômen e pelve 6,1 ±0,3mSv. A dose de radiação fornecida pelo estudo de TC está entre 0,46 mSv para a região do tórax no estudo do linfonodo sentinela da mama e 2,3 mSv para o SPECT-CT ósseo na região do abdome e pelve. Conclusão: foi possível estimar a dose efetiva nos protocolos de SPECT-CT mais utilizados clinicamente na população adulta e a contribuição dos estudos de TC para a dose efetiva total, sendo relativamente baixa em relação à dose fornecida pelos radiofármacos administrados com a exceção do estudo do linfonodo sentinela onde a contribuição do componente TC é aproximadamente metade da dose efetiva total.
Subject(s)
Radiation Protection/standards , Single Photon Emission Computed Tomography Computed Tomography/standards , Guidelines as Topic , Nuclear MedicineABSTRACT
Objective:To investigate 131I activity in thyroid of workers at the place of radioiodine therapy and its main influencing factors. Methods:In terms of the types of hospitals, six hospitals that performed radioiodine therapy procedure were selected by quota sampling in the provinces of Shandong and Shanxi. 131I activity in thyroids of 76 workers at the place of radioiodine therapy was measured directly, and their internal doses were estimated. Results:131I activity in thyroids was found to be above the detection limit for 29 subjects (38.16%) in five hospitals. The maximum value of 131I activity was 2 468.45 Bq for a doctor who was responsible for manual distribution of radioisotopes. In general 131I activities in thyroid of workers at the place of radioiodine therapy of six hospitals were not significantly different ( P>0.05). But the measurement result in the hospitals where radioiodine was distributed manually were significantly higher than that in the hospitals where radioiodine was distributed automatically ( Z=1.75, P<0.01). Thyroid measurement result of 12 workers in two hospitals where radioiodine was distributed manually were all above the detection limit, with medians of 324.59 Bq and 331.98 Bq, respectively. The medians of 131I activities in thyroid of 12 staff in the remaining 4 hospitals were all below the detection limit. The detection frequencies of 131I above dose limit were 32.61%, 25.00%, 10.00% and 0. The measurement result for the doctors who participated in distributing 131I and the relevent cleaners were significantly higher than for the doctors who did not participate in distributing 131I at the same hospital ( Z=2.44, 2.12, P<0.05). Conclusions:There was a significant difference in the internal exposure level among workers at the different places of radioiodine therapy. Using automatic loading device could reduce the internal exposure level of the workers at the place of radioiodine therapy. It is necessary to strengthen the radiological protection for workers at the control area of the place of radioiodine therapy.
ABSTRACT
Objective:To explore the application effect of massive online open course (MOOC) + case-based learning (CBL) in SPECT/CT practice teaching of nuclear medicine.Methods:Twenty-nine interns of nuclear medicine SPECT/CT in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2020 to October 2020 were selected as the research group and received MOOC + CBL teaching. Taking 31 interns from January 2019 to October 2019 as the control group, and the traditional teaching method was conducted. At the end of the internship, the students' theoretical and operational skills were assessed. Their learning motivation and thinking ability were evaluated by using the study process questionnaire (SPQ) and the Chinese version of California critical thinking disposition inventory (CTDI-CV), and the two groups' satisfaction with teaching was compared. SPSS 22.0 was used for Chi-square test and t-test. Results:The results of theoretical knowledge, PET/CT case analysis and image diagnosis in the study group were higher than those in the control group ( P<0.05). The total scores of surface motivation, deep motivation and SPQ in the study group were higher than those in the control group ( P<0.05). The self-confidence scores of open mind, analytical ability, systematization ability, and critical thinking and CTDI-CV total scores of the study group were higher than those of the control group ( P<0.05). The study group was more satisfied with the teaching and the enhancement of self-study ability than the control group ( P<0.05). Conclusion:MOOC + CBL teaching for nuclear medicine SPECT/CT interns can improve their examination results, learning motivation and thinking ability, and also enhance their self-study ability.