Objectives: The aim of this study was to determine occupational dose levels in interventional radiology and cardiology procedures. Methods: The study covered a sample of 25 procedures and monitored occupational dose for all laboratory personnel. Each individual wore eight thermoluminescent dosemeters next to the eyes, wrists, fingers and legs during each procedure. Radiation protection shields used in each procedure were recorded. Results: The highest doses per procedure were recorded for interventionists at the left wrist (average 485 mSv, maximum 5239 mSv) and left finger (average 324 mSv, maximum 2877 mSv), whereas lower doses were recorded for the legs (average 124 mSv, maximum 1959 mSv) and the eyes (average 64 mSv, maximum 1129 mSv). Doses to the assisting nurses during the intervention were considerably lower; the highest doses were recorded at the wrists (average 26 mSv, maximum 41 mSv) and legs (average 18 mSv, maximum 22 mSv), whereas doses to the eyes were minimal (average 4 mSv, maximum 16 mSv). Occupational doses normalised to kerma area product (KAP) ranged from 11.9 to 117.3 mSv/1000 cGy cm 2 and KAP was poorly correlated to the interventionists' extremity doses. Conclusion: Calculation of the dose burden for interventionists considering the actual number of procedures performed annually revealed that dose limits for the extremities and the lenses of the eyes were not exceeded. However, there are cases in which high doses have been recorded and this can lead to exceeding the dose limits when bad practices are followed and the radiation protection tools are not properly used.
Rhenium-188 (Re-188) is a high energy β-emitting radioisotope obtained from the tungsten-188/rhenium-188 (W-188/Re-188) generator, which has shown utility for a variety of therapeutic applications in nuclear medicine, oncology, and interventional radiology/cardiology. Re-188 decay is accompanied by a 155 keV predominant energy γ-emission, which could be detected by γ-cameras, for imaging, biodistribution, or absorbed radiation dose studies. Its attractive physical properties and its potential low cost associated with a long-lived parent make it an interesting option for clinical use. The setup and daily use of W-188/Re-188 generator in hospital nuclear medicine departments are discussed in detail. The clinical efficacy, for several therapeutic applications, of a variety of Re-188-labeled agents is demonstrated. The high energy of the β-emission of Re-188 is particularly well suited for effective penetration in solid tumours. Its total radiation dose delivered to tissues is comparable to other radionuclides used in therapy. Furthermore, radiation safety and shielding requirements are an important subject of matter. In the case of bone metastases treatment, therapeutic ratios are presented in order to describe the efficacy of Re-188 usage.
Rhenium-186 (Re-186) is a β-emitting radionuclide. Emitted β-particles have ranges up to 4.5 mm in tissue, capable of delivering high doses to skeletal regions of high Re-186 concentrations while sparing adjacent radiosensitive regions and thus making the irradiation well tolerated for the patient. Along with the β-emissions, γ-rays are emitted having an adequate energy for imaging during therapy and biodistribution assessment for patient-specific dosimetry calculations. The relatively short physical half-life combined with the β-emissions allows the delivery of relatively high activity rate for a short period of time in areas of concentration. This study is a short review concerning the palliative treatment of skeletal metastases using 186Re-HEDP. After presenting the dominant ways of 186Re production, special emphasis is given to dosimetry issues while the effect of palliation therapy can be evaluated through the comparison of the absorbed dose in metastatic lesion relatively to the normal bone region. Accurate dose estimation is required taking into account the anatomic individual difference of each patient. For this purpose a patient specific dosimetric model considering metastatic lesions as spherical nodules is introduced. In order to quantify in a representative way the results of palliation treatment, the concept of therapeutic ratios is analyzed.
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