Radiation Protection and Regulations for the Nuclear Medicine Physician
This article is intended to serve as a condensed guide for NM physicians who are in the process of applying for a radioactive materials license, establishing a new radiation protection program, or want to ensure continued compliance and maintenance of safety and security of licensed materials in the clinical or research settings. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Man Yu Chen Source Type: research
Quantitative Benefit-Risk Analysis of Medical Radiation Exposures
While it is commonly said that the benefits of the use of radiation in the healing arts far outweigh any potential risks, there has not been to date an attempt to quantify the numerical benefits of uses of medical radiation. Using the 'Linear, No-Threshold' (LNT) model of radiation carcinogenesis, many have provided numerical estimates of the risks of radiation exposure, sometimes in irresponsible ways. In this work, we show, through several selected examples, how the numerical benefits of medical radiation exposures indeed far outweigh any theoretical cancer risks. Choosing more invasive measures, there are known rates of...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Pat Zanzonico, Michael G. Stabin Source Type: research
Pediatric Nuclear Medicine and Radiation Dose
Nuclear medicine is a unique and valuable method that contributes to the diagnosis and assessment of many diseases in children. Radiation exposures in children undergoing diagnostic nuclear medicine studies are low. Although in the past there has been a rather large variation of pediatric radiopharmaceutical administered activities, adhering to recent standards for pediatric radiopharmaceutical administered doses can help assure that the lowest administered activity are employed and that the diagnostic value of the studies is preserved. Radiation exposures in children can be reduced further by optimizing routine protocols,...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: S. Ted Treves, Anthony E. Falone, Frederic H. Fahey Source Type: research
Dose Optimization in Nuclear Medicine
This article discusses these issues, particularly in the context of cardiovascular nuclear medicine and hybrid imaging including PET/CT and SPECT/CT. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Frederic Fahey, Michael Stabin Source Type: research
Radiation Risk in Nuclear Medicine
Given the central roles that anatomical and functional imaging now play in medical practice, there have been concerns about the increasing levels of radiation exposure and their potential hazards. Despite incomplete quantitative knowledge of the risks, it is prudent to think of radiation, even at low doses, as a potential, albeit weak, carcinogen. Thus, we are obliged to minimize its dose and optimize its benefits. Hopefully, time will clarify our estimates of the dangers. Until then, we should educate and assure our patients, their families, and colleagues that the risks have been taken into account and are well balanced ...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: S. James Adelstein Source Type: research
Advances in Radiation Biology: Effect on Nuclear Medicine
Over the past 15 years and more, extensive research has been conducted on the responses of biological systems to radiation delivered at a low dose or low dose rate. This research has demonstrated that the molecular-, cellular-, and tissue-level responses are different following low doses than those observed after a single short-term high-dose radiation exposure. Following low-dose exposure, 3 unique responses were observed, these included bystander effects, adaptive protective responses, and genomic instability. Research on the mechanisms of action for each of these observations demonstrates that the molecular and cellular...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Antone L. Brooks, Lawrence T. Dauer Source Type: research
Dosimetry for Radiopharmaceutical Therapy
Radiopharmaceutical therapy (RPT) involves the use of radionuclides that are either conjugated to tumor-targeting agents (e.g., nanoscale constructs, antibodies, peptides, and small molecules) or concentrated in tissue through natural physiological mechanisms that occur predominantly in neoplastic or otherwise targeted cells (e.g., Graves disease). The ability to collect pharmacokinetic data by imaging and use this to perform dosimetry calculations for treatment planning distinguishes RPT from other systemic treatment modalities such as chemotherapy, wherein imaging is not generally used. Treatment planning has not been wi...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: George Sgouros, Robert F. Hobbs Source Type: research
Basic Principles in the Radiation Dosimetry of Nuclear Medicine
Abstract: The basic principles of the use of radiation dosimetry in nuclear medicine are reviewed. The basic structure of the main mathematical equations are given and formal dosimetry systems are discussed. An extensive overview of the history and current status of anthropomorphic models (phantoms) is given. The sources and magnitudes of uncertainties in calculated internal dose estimates are reviewed. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Michael Stabin, Xie George Xu Source Type: research
Guest Editorial
This issue of Seminars in Nuclear Medicine provides 8 articles that discuss the current practice of radiation dosimetry in nuclear medicine and relate calculated dose estimates to the associated risks. In any use of ionizing radiation, consideration of the benefits of the exposures to possible risks is a central concern, for the physician and patient. Currently, much attention is being paid to reducing doses to patients, particularly pediatric patients, owing to concerns about the rapid increase in collective dose seen in recent decades in patients receiving radiation doses as part of their medical care, as significant inc...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Frederic H. Fahey, Michael G. Stabin Source Type: research
Letter from the Editors
It has been 6 years since the editors have devoted an issue of Seminars to the subject of radiation dosimetry and exposure risk. At that time, one of our current guest editors, Dr Michael Stabin teamed with his Vanderbilt colleague, Dr Randy Brill, to present a current status report appropriate for that time. Since then, there has been considerable interest and concern about the ever-increasing use of all radiologic procedures, including radionuclide studies. Many articles have appeared in both the medical and lay media that have dealt with this realistic concern. A recent editorial in the New York Times written by 2 West ...
Source: Seminars in Nuclear Medicine - May 1, 2014 Category: Radiology Authors: Leonard M. Freeman, M. Donald Blaufox Source Type: research
Computer-Assisted Diagnosis in Renal Nuclear Medicine: Rationale, Methodology, and Interpretative Criteria for Diuretic Renography
The goal of artificial intelligence, expert systems, decision support systems, and computer-assisted diagnosis (CAD) in imaging is the development and implementation of software to assist in the detection and evaluation of abnormalities, to alert physicians to cognitive biases, to reduce intraobserver and interobserver variability, and to facilitate the interpretation of studies at a faster rate and with a higher level of accuracy. These developments are needed to meet the challenges resulting from a rapid increase in the volume of diagnostic imaging studies coupled with a concurrent increase in the number and complexity o...
Source: Seminars in Nuclear Medicine - February 3, 2014 Category: Radiology Authors: Andrew T. Taylor, Ernest V. Garcia Source Type: research
Transplanted Kidney Function Evaluation
The best option for the treatment of end-stage renal disease is kidney transplantation. Prompt diagnosis and management of early posttransplantation complications is of utmost importance for graft survival. Biochemical markers, allograft biopsies, and imaging modalities are used for the timely recognition and management of graft dysfunction. Among several other factors, improvements in imaging modalities have been regarded as one of the factors contributing to increased short-term graft survival. Each imaging procedure has its own unique contribution to the evaluation of renal transplant dysfunction. In the era of multimod...
Source: Seminars in Nuclear Medicine - February 3, 2014 Category: Radiology Authors: Ayşe Aktaş Source Type: research
Febrile Urinary Tract Infections: Clinical and Laboratory Diagnosis, Imaging, and Prognosis
According to the literature, febrile urinary tract infections (UTIs) are among the most common severe bacterial infections occurring in childhood, with potential serious long-term consequences. In recent years, there have been significant developments in our understanding of the pathophysiology and clinical and laboratory issues of febrile UTIs. Studies are focusing on the role of predisposing host factors related to genes regulating immune response, inflammation and fibrosis in the development of acute renal damage and subsequent processes leading to renal scars. All the available guidelines underline the importance of a ...
Source: Seminars in Nuclear Medicine - February 3, 2014 Category: Radiology Authors: Alberto Edefonti, Francesca Tel, Sara Testa, Diego De Palma Source Type: research
Clinical Problems in Renovascular Disease and the Role of Nuclear Medicine
Although renovascular disease remains defined as a stenosis of the main renal artery or its proximal branches (renal artery stenosis [RAS]), its clinical overview has changed dramatically over the last 15-20 years and its management is more controversial than ever before. The clinical problems, not only diagnosis and treatment but also the relative contribution of different pathophysiological mechanisms involved in the progression of kidney disease, have shifted dramatically. This presentation aims to emphasize the paradigm change revisiting the (recent) past focused on renovascular hypertension (RVH) to the current contex...
Source: Seminars in Nuclear Medicine - February 3, 2014 Category: Radiology Authors: Alain Prigent, Philippe Chaumet-Riffaud Source Type: research
Molecular Imaging of Urogenital Diseases
There is an expanding and exciting repertoire of PET imaging radiotracers for urogenital diseases, particularly in prostate cancer, renal cell cancer, and renal function. Prostate cancer is the most commonly diagnosed cancer in men. With growing therapeutic options for the treatment of metastatic and advanced prostate cancer, improved functional imaging of prostate cancer beyond the limitations of conventional CT and bone scan is becoming increasingly important for both clinical management and drug development. PET radiotracers, apart from 18F-FDG, for prostate cancer are 18F-sodium fluoride, 11C-choline, and 18F-fluorocho...
Source: Seminars in Nuclear Medicine - February 3, 2014 Category: Radiology Authors: Steve Y. Cho, Zsolt Szabo Source Type: research
