Development of a model for registration and notification of accidents and incidents in nuclear medicine.

Nuclear medicine (NM) is a medical speciality that uses unsealed radioactive sources involving several handling procedures with some critical points before, during, and after the examination and therapies performed, requiring special attention to the occurrence of a possible accident or incident over the course of the clinical routine. The accidents and incidents in NM can involve actors such as workers, patients, the public or caregivers, and even the environment. Although expected, the number of occurrences and their nature are not well understood due to the absence of a Brazilian reporting tool for incidents or accidents. This paper aims to develop a web-based NM incident and accident notification system named SINMED (NM Notification System). Specific forms were developed in an offline system inhtml5language with an online system interface according to the Google Forms platform. The developed forms were based on existing international notification templates from the the perspective of NM services in operation applying Brazilian regulations.

SPECT performance evaluation on image of Yttrium 90 - Bremsstrahlung using Monte Carlo simulation.

Yttrium-90 (90Y) is one of the most widely used radionuclides in Nuclear Medicine practice. However, characteristic energy of this beta emitter constitutes a difficulty for dose planning using SPECT imaging. This work aimed to study bremsstrahlung X-rays effects produced by 90Y beta particles during SPECT image acquisition using Monte Carlo code MCNPX. Several simulations were carried out to evaluate different aspects that could affect SPECT image quality, such as: collimator type, source-collimator distance and composition of each interacting material. Two configurations of 90Y sources were simulated: a point source in several spheres of different materials (soft tissue, water, articular cartilage, and bone) and dimensions with radius ranging from 1 to 20 mm; and a uniformly distributed source in a Lucite cylindrical phantom filled with water. It was evaluated the bremsstrahlung photon emission generated inside different materials; for this was considered the number photons that passing through every different sphere's surface for each radii and material. In case of cylindrical phantom filled with water, in order to obtain the energy deposited over NaI (Tl) crystal detector; there was considered Median Energy General Purpose (MEGP) and Low Energy High Resolution (LEHR) collimators. Moreover, using TMESH routine available in the MCNPX Monte Carlo code, energy distribution images according to the collimator type and the source-collimator distance were obtained. The simulation was validated by comparing with the spectral distribution of the 90Y bremsstrahlung X-rays obtained experimentally from an acrylic cylindrical phantom. Results corroborated the importance of Monte Carlo simulation method to evaluate a performance of SPECT image acquisition with 90Y. The best resolution was obtained with MEGP collimator independent of source-collimator distance.

A cost-effective way to reduce the equivalent eye lens dose fromYttrium-90 radiopharmaceuticals.

PURPOSE: We analyzed the effect of the use of Eye Protective Equipment (EPE) and the best position to use individual dosimeters to estimate the eye lens radiation dose to a medical staff that works with yttrium-90. METHODS: Three Alderson-Head-Phantoms were exposed to 58MBq of 90Y for 24h, in two different experiments: (1) at different dosimeter placements and (2) with and without the use of EPE. The measurements were carried on by thermoluminescent technique. RESULTS: Doses received by dosimeters on both lenses were more closely represented by the ones placed between the eyes than those on the temples, which underestimated the doses by a factor of 3. Also, the transmission factors showed that the EPE was able to reduce the Hp(3) values from about 78% to 92%. CONCLUSIONS: This study demonstrated that the use of EPE can optimize the 90Y eye lens dose. An individual dosimeter should be worn between the eyes for an appropriate estimate of this equivalent dose.

Individual dose planning in radiosynoviorthesis treatment: Step by step.

Radiosynoviorthesis (RSO) is a minimally invasive treatment aiming for the necrosis of the pannus tissue by the use of radionuclide. The method suggested here starts with the segmentation of the joint effusion, synovial thickness, and area of the synovial membrane using the 3D Slicer software. The last step is the estimated value of the activity to be injected without considering the leakage of the radiopharmaceutical into the articular cavity. It includes the S-values obtained by Monte Carlo simulation coupled with the calculated therapeutic distance (ST90).

Outpatient treatment for haemophilic arthropathy with radiosynovectomy: Radiation dose to family members.

One of the key features of good practice in medicine is the doctor-patient communication. Radiation protection standards for radiosynovectomy (RS) is limited. Yttrium-90 is a beta-emitting radioisotope used in RS to treat joint pain from haemophilic arthritis. ICRP 94 states that if a patient is treated with up to 200 MBq, there is no need for further precautions when it comes to public exposure, however, activities can go up to 370 MBq in RS for the knee. This study analysed 119 family members' safety (16.7% pregnant women). The ambient dose equivalent rate was measured within four distances. A survey was carried analysing risk groups and time spent next to patients. Results showed that family members should be advised to remain at 1.0 m from the patient to decrease accumulated dose by 97.6%. The dose per activity factors estimated in this study is also a useful tool during the risk assessment and doctor/patient communication. Pamphlets were distributed with radiation protection recommendations. Ambient dose equivalent was low enough to show that RS is a safe procedure for family members, which is essential to promote adherence to RS in countries where it is needed but not performed due to lack of information on radiation safety.

Genotoxic and cytotoxic effects of testosterone cypionate (deposteron(®)).

The indiscriminate use of anabolic androgenic steroids (AAS) has motivated researchers to investigate the mutagenic action of these substances. The present study, using the mouse bone marrow micronucleus test, evaluates the genotoxic potential of testosterone cypionate (deposteron). Male Swiss mice received intramuscular injections of deposteron at three doses. The animals were sacrificed 24, 48, or 72h after treatment and bone marrow was removed immediately, followed by scoring to count the micronuclei in 2000 polychromatic erythrocytes (PCE). Two hundred erythrocytes/animal were analyzed to determine the PCE-NCE (normochromatic erythrocyte) relationship and to determine the cytotoxic effects. The animals treated with deposteron at the highest dose presented greater numbers of micronuclei. The highest dose caused a decrease in the PCE/NCE relationship, indicating a cytotoxic effect. We conclude that deposteron is genotoxic and cytotoxic in mice.