Generic placeholder image

Current Radiopharmaceuticals


ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Research Article

Re-Evaluation of Patient-Sourced Radiation Doses in PET/CT

Author(s): Ahmet Murat Şenışık*, Handan Tanyıldızı Kökkülünk and Mahmut Yüksel

Volume 16, Issue 2, 2023

Published on: 11 January, 2023

Page: [163 - 169] Pages: 7

DOI: 10.2174/1874471016666230102122554

Price: $65


Background: New generation PET/CT devices provide quality images using low radiopharmaceutical activities. Dose monitoring is carried out for nuclear medicine personnel, other health personnel, and companions by determining the radiation dose emitted from low-activity patients to the environment. In particular, it is necessary to revise the working conditions of the personnel according to the radiation dose exposed.

Aim: It was aimed to reevaluate the radiation dose rate transmitted to the environment from patients injected with 18F-FDG.

Materials and Methods: A total of 31 patients (14F, 17M) who underwent 18F-FDG PET/CT imaging were included. The mean 18F-FDG activity of 7.26 ± 1.29 mCi was used for injection. After injection, radiation dose rates (mR/h) were measured at distances of 25, 50, 100, 150, and 200cm for 3 different periods from the level of the head, thorax, abdomen, and pelvis by using a GM counter. Additionally, biological samples such as urine and sweat were taken during 3 different periods. The activity amounts (μCi) in the samples were measured with a well-type counter.

Results: Strong correlations were calculated between normalized dose rates obtained by all regions and time. Considering the nuclear medicine staff handling time with a PET/CT patient, the average dose received by staff was calculated between a range of 0.002-0.004 mSv/pt. The radiation dose exposed to the porter and nurse was calculated as 0.049 mSv/pt for the 2nd hour and 0.001-0.007 mSv/pt for the 4th hour, respectively. The companion was exposed to a dose between 0.073-0.147 mSv and 0.024-0.048 mSv for public transport and private car transportation after 4-6 hours of injection (for 30-60 min of travel duration), respectively. For inpatients, the received dose for porters, serving 20min from a distance of 30cm for the 2nd and 4th hours after the PET/CT scan, was 0.049 mSv/pt and 0.048 mSv/pt, respectively. And for nurses serving from a 50cm distance between 1-5 minutes, these values were found to be 0.001-0.007mSv/pt, 0.001-0.007mSv/pt, and 0.001-0.006mSv/pt, respectively.

Conclusion: The radiation dose of nuclear medicine staff, porters, nurses, and companions are found to be below the recommended dose limit by the ICRP. According to our results, there is no need for any restrictions for patients, companions, or healthcare personnel in PET/CT units.

Keywords: PET/CT, radiation, dose rate, 18F-FDG, exposure, radiopharmaceutical.

Graphical Abstract
Hegi, F.; Atwood, T.; Keall, P.; Loo, B.W. 34 - Technical requirements for lung cancer radiotherapy. In: IASLC Thoracic Oncology, 2nd ed; Pass,, H.T.; Ball, , D.; Scagliotti,, G.V., Eds.; Elsevier: Philadelphia, 2018; pp. 318-329.e2.
Chawla, M.; Kumar, R.; Agarwala, S.; Bakhshi, S.; Gupta, D.K.; Malhotra, A. Role of positron emission tomography-computed tomography in staging and early chemotherapy response evaluation in children with neuroblastoma. Indian J. Nucl. Med., 2010, 25(4), 147-155.
[] [PMID: 21713223]
Vasundhara, B.; Hemalatha, P.; Raju, P.S.S.K. Role of PET-CT (Positron Emission Tomography-Computed Tomography) in Cancer Evaluation and Treatment. World J. Nucl. Sci. and Technology, 2022, 12(1), 11-20.
Günay, O.; Abamor, E. Environmental radiation dose rate arising from patients of PET/CT. Int. J. Environ. Sci. Technol., 2019, 16(9), 5177-5184.
Zhang-Yin, J.; Dirand, A.S.; Sasanelli, M.; Corrégé, G.; Peudon, A.; Kiffel, T.; Nataf, V.; Clerc, J.; Montravers, F.; Talbot, J.N. Equivalent Dose Rate 1 Meter From Neuroendocrine Tumor Patients Exiting The Nuclear Medicine Department After Undergoing Imaging. J. Nucl. Med., 2017, 58(8), 1230-1235.
[] [PMID: 28209907]
Berberoglu, K. External radiation exposure rate after 18F-FDG PET/CT examination. Radioprotection, 2019, 54(2), 113-116.
Alauddin, M.M. Positron emission tomography (PET) imaging with (18)F-based radiotracers. Am. J. Nucl. Med. Mol. Imaging, 2012, 2(1), 55-76.
[PMID: 23133802]
Kaushik, A.; Jaimini, A.; Tripathi, M.; D’Souza, M.; Sharma, R.; Mondal, A.; Mishra, A.K.; Dwarakanath, B.S. Estimation of radiation dose to patients from (18) FDG whole body PET/CT investigations using dynamic PET scan protocol. Indian J. Med. Res., 2015, 142(6), 721-731.
[] [PMID: 26831421]
Biersack, H-J.; Yüksel, M.; Palmedo, H.; Roland, R.; Reinhardt, M.; Ursula, J. Multimodal imaging with PET-CT in oncology. Trakya Univ. Fak. Derg., 2006.
National Research CouncilEvaluation of Guidelines for Exposures to Technologically Enhanced Naturally Occurring Radioactive Materials; The National Academies Press: Washington, DC, 1999.
Şenışık, A.M.; İçhedef, Ç.; Kılçar, A.Y.; Uçar, E.; Arı, K.; Göksoy, D.; Parlak, Y.; Sayıt Bilgin, B.E.; Teksöz, S. One-step conjugation of glycylglycine with [18F]FDG and a pilot PET imaging study. J. Radioanal. Nucl. Chem., 2018, 316(2), 457-463.
Witney, T.H.; Carroll, L.; Alam, I.S.; Chandrashekran, A.; Nguyen, Q.D.; Sala, R.; Harris, R.; DeBerardinis, R.J.; Agarwal, R.; Aboagye, E.O. A novel radiotracer to image glycogen metabolism in tumors by positron emission tomography. Cancer Res., 2014, 74(5), 1319-1328.
[] [PMID: 24590807]
Brix, G. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J. Nucl. Med., 2005, 46(4), 608-613.
Yonekura, Y.; Mattsson, S.; Flux, G.; Bolch, W.E.; Dauer, L.T.; Fisher, D.R.; Lassmann, M.; Palm, S.; Hosono, M.; Doruff, M.; Divgi, C.; Zanzonico, P. ICRP Publication 140: Radiological protection in therapy with radiopharmaceuticals. Ann. ICRP, 2019, 48(1), 5-95.
[] [PMID: 31565950]
Bach-Gansmo, T.; Dybvik, J.; Adamsen, T.; Naum, A. Variation in urinary excretion of FDG, yet another uncertainty in quantitative PET. Acta Radiol Short Rep, 2012, 1(8) arsr.2012.120038
Rangarajan, V.; Puranik, A.D.; Purandare, N.C.; Agrawal, A.; Shah, S. Incidentally detected grade 3 cystocele on FDG PET/CT in a case of suspected malignancy. Indian J. Nucl. Med., 2012, 27(4), 264-265.
[] [PMID: 24019662]
Garbarino, S.; Caviglia, G.; Brignone, M.; Massollo, M.; Sambuceti, G.; Piana, M. Estimate of FDG excretion by means of compartmental analysis and ant colony optimization of nuclear medicine data. Comput. Math. Methods Med., 2013, 2013, 1-10.
[] [PMID: 24191175]
Gül, S.S.; Esen, M. Effect of urinary excretion on radiation dose in patients having PET/CT scans. Eur. Respir. J., 2019.
Demir, M.; Demir, B.; Sayman, H.; Sager, S.; Sabbir, A.; Uslu, I. Radiation protection for accompanying person and radiation workers in PET/CT. Radiat. Prot. Dosimetry, 2011, 147(4), 528-532.
[] [PMID: 21183551]
Demir, M. Radiation doses to technologists working with 18F-FDG in a PET center with high patient capacity. Nukleonika, 2010, 55, 107-112.
1990 Recommendations of the International Commission on Radiological Protection. Ann. ICRP, 1991, 21(1-3), 1-201.
[PMID: 2053748]
Saleh, E.E.; Al-esaei, A.M.; Khalil, M.M.; El Shazly, R.M.; Kany, A.M.I.; Elmaghraby, S. Assessment of radiation exposure dose for nuclear medicine workers from 18F-FDG, 99mTc MDP and 99mTc. Curr. Radiopharm., 2022, 15(4), 320-326.
[] [PMID: 35422232]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy