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Radiation Protection and Medical Internal Dosimetry 輻射防護及醫用體內輻射劑量. 高雄醫學大學附設中和紀念醫院 核子醫學科 陳 毓 雯 主任. Pattern of Radiation Effect. Exposure Contamination. Units of Radiation Dose. Activity (A) Bq Radiation exposure C/kg Air kerama
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Radiation Protection and Medical Internal Dosimetry 輻射防護及醫用體內輻射劑量 高雄醫學大學附設中和紀念醫院 核子醫學科陳 毓 雯 主任
Pattern of Radiation Effect • Exposure • Contamination
Units of Radiation Dose • Activity (A) Bq • Radiation exposure C/kg • Air kerama • Absorbed dose (D) gray • Equivalent dose (H) sievert LET (linear energy transfer) • Effective dose (E)
Threshold Doses for Determininstic Effects in The More Radiosensitive Tissues and Organs
Biological Effects of Exposure • Nonstochastic effects • Stochastic effects
Internal Dosimetry • The method of calculating absorbed dose delivered internally has been developed over many years by the Medical Internal Radiation Dose (MIRD) committee of the American Society of Nuclear Medicine. • The aim of committee was to develop a dosimetry system (MIRD schema) for diagnostic nuclear medicine. However, the methods have also been applied in radionuclide therapy and in internal contamination.
MIRD Schema • Source Organs vs Target Organs Dt s = A s St s • Cumulated activity, Asthe total number of radioactive disintegrations which occur in the sourve organ, and depends on: the activity administered; the uptake of , retention by, and excretion from the organ; and thte physical decay of the radionuclide. • S-factors have been tabulated for a variety of radionuclides and for different source/target configurations in both standard man and children.
S- Factors • St s = 1/ mi Δi i Δiequilibrium absorbed dose constant iabsorbed fraction specific absorbed fraction (Monte Carlo calculations)
Example • Calculated the absorbed dose to the liver of an adult patient who receives 3mCi (111MBq) Tc99m-sulfur colloid for a liver scan, assuming 85% liver uptake with no excretion. • Answer Weight of liver = 1700 g (for a standard man) A0 in the liver = 3000 x 0.85 = 2550 u Ci (86.7 MBq) T e = 6 hr Δi i = 0.0806 • D = 1.44 x (2550/1700) x 6 x 0.0806 = 1.04 rad
The limitations of the MIRD Methods Tabulated doses do not apply to all patients In the MIRD schema it is assumed that the shape, size and position of the organs are s prepresented by the standard, 70kg, hermaphrodite human phantom. Disease organs can result in both increased or decreased uptake of activiity and changes in the residence time compared with standard values so these factors sholud also be considered when assessing the dose to patients. The MIRD schema claculates each dose to the target organs as an average, without permitting the determination of a maximum or minimum dose.