Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine II. Somatically Effective Dose Equivalents to the Patients and Assessment of Risk

R. Poppitz

doi:10.1055/s-0037-1620558

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1982; 21(03): 92-98
DOI: 10.1055/s-0037-1620558

Originalarbeiten – Original Articles

Schattauer GmbH

Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine II. Somatically Effective Dose Equivalents to the Patients and Assessment of Risk

Strahlenbelastung der Patienten und Strahlenrisiko durch nuklearmedizinische Diagnostik in Bulgarien. II. Somatisch effektive Äquivalentdosen für die Patienten und Abschätzung des Strahlenrisikos

R. Poppitz

Abstract

Es wird über die somatisch effektiven Äquivalentdosen bei den häufigst verwendeten nuklearmedizinischen diagnostischen Applikationen in Bulgarien 1980 berichtet. Unter Verwendung der ICRP Risikofaktoren für stochastische somatische Wirkungen wurde der Erwartungswert strahleninduzierter maligner Neubildungen mit tödlichem Ausgang in der Zukunft, bedingt durch diese medizinische Bestrahlungsart, berechnet. Dieser Wert (ca. 10 Neubildungen) ist verhältnismäßig klein im Vergleich zu der Gesamtzahl der offiziell registrierten Malignome in Bulgarien. Ein Vergleich der traditionell verwendeten Bevölkerungsdosen (z.B. GSD, LSD) für Bulgarien und für andere Länder wurde ebenfalls durchgeführt. Es wird empfohlen, durch eine verminderte Anwendung von ¹³¹J-Jodid in der in vivo Schilddrüsendiagnostik eine Herabsetzung der Strahlenbelastung der Patienten zu erreichen.

Somatically effective dose equivalents from some frequently employed diagnostic radiopharmaceutical applications in Bulgaria are reported for 1980. Using ICRP risk factors for stochastic somatic effects, the excess number of expected fatal malignancies in the future resulting from this medical radiation source was calculated. This number (approx. 10) is relatively small in comparison with the total number of officially registered malignancies in Bulgaria. A comparison of the traditionally used population doses (e.g. GSD, LSD) in Bulgaria and other countries is also included. It is recommended to reduce the use of ¹³¹I-iodide in thyroid in vivo diagnostics in order to lower radiation exposure of patients.

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References

References
1 Clarke R. H, Smith H. Calculation of the Incidence of Stochastic Health Effects in Irradiated Populations. NRPB Report 102, National Radiological Protection Board, Harwell (UK), June. 1980
2 Curatolo M, Dobici e F. Indagini conoscitive e iniziative per la riduzione delia dose al paziente in medicina nucleare. In: La Radioprotezione del Paziente in Diagnostica Medica (Convegno Nazionale, Piacenza, 26–27 Aprile 1979), Parte seconda Relazioni e Comunicazioni. 19-28 1979
3 Guskova A. K, Burenin P. I. Review (in Russian) of the publication from L.-E. Holm “Incidence of Malignant Thyroid Tumors in Man …” Stockholm, 1980. Med. Radiol 1981; 26: 84
4 Hashizume T. et al. Estimation of population doses from medical uses of radiopharmaceuticals in Japan, 1977. 2. Estimation of genetically significant dose, per caput mean bone marrow dose and leukaemia significant dose. Nippon Acta Radiol 39: 747-760 1979;
5 Holm L.-E. Incidence of Malignant Thyroid Tumors in Man after Diagnostic and Therapeutic Doses of Iodine-131. Epidemiologic and Histopathologic Study. Radiumhemmet, Karolinska Hospital, Stockholm. 1980
6 ICRP: Protection of the Patient in Radionuclide Investigations. Publication. Pergamon Press; Oxford: 1971: 17
7 ICRP: Radiation Protection. Publication. Pergamon Press; Oxford: 1977: 26
8 ICRP: Problems Involved in Developing an Index of Harm. Publication. Pergamon Press; Oxford: 1979: 27
9 ICRU: Methods of Assessment of Absorbed Dose in Clinical Use of Radionuclides. Report No ICRU; Washington, D.C.: 1980: 32
10 Kaul A, Henrichs K, Roedler H. D. Radionuclide biokinetics and internal dosimetry in nuclear medicine. Ric. Clin. Lab 10: 629-660 1980;
11 Kaul A, Roedler H. D. Dosimetric In: Nuklearmedizin. Funktionsdiagnostik und Therapie. Emrich D. Hrsg. 2. Aufl., 107–119 G. Thieme Verlag, Stuttgart; 480-498 1979
12 Keam D. W. Genetic and Mean Bone-Marrow Doses from Medical Use of Unsealed Radioisotopes. Report NARL/TR-023 - Australian Radiation Laboratory, Melbourne, June. 1980
13 Keeling D. H. Side Effects Associated with the Use of Radiopharmaceuticals. In: Drug Toxicity. Ed. Gorrod J. W. Taylor and Francis, London: 285-295 1979
14 Keeling D. H. Radiopharmaceuticals. In: Drug Safety. Ed. Inman W. H. W. M. T. P. Press; Lancaster: 277-283 1980
15 Kereiakes J. G, Rosenstein M. Handbook of Radiation Doses in Nuclear Medicine and Diagnostic X-Rays. CRC Press, Inc.; Boca Raton: 1980
16 Loevinger R, Berman M. A Revised Scheme for Calculation of the Absorbed Dose from Biologically Distributed Radionuclides (MIRD Pamphlet No. 1, revised). Society of Nuclear Medicine; New York: 1976
17 Maxon H. R. et al. Ionizing irradiation and the induction of clinically significant disease in the human thyroid gland. Amer. J. Med 63: 967-978 1977;
18 Nosslin B. Dose to Patients from Radiopharmaceuticals. Report at the 15^th International Congress of Radiology (ICR-81), Brussels, 24 June-1 July. 1981
19 Persson B. R. R. Medical Irradiation and the Use of the “Effective Dose Equivalent” Concept – In 5^th Internat. Congress of the Internat. Radiat. Protection Association (Jerusalem, March, 9–14, 1980), Book of Papers I: 155-162. Pergamon Press, Oxford 1980;
20 Persson B. R. R. Effective Dose Equivalent Concept in Radiopharmaceutical Dosimetry. In: Third Internat. Radiopharmaceutical Dosimetry Symposium (Proceedings), HHS Publication FDA 81–8166, US Dept. of Health. 616-624 1981
21 Poppitz R, Pentschev VI. Dosimetrische Betrachtungen zur Strahlenbelastung der Patienten bei nuklear-medizinischen und röntgenologischen Untersuchungen. Radiobiol. Radiother 18: 239-243 1977;
22 Popov V. I, Korsunsky V. N. Radiation burden in the use of radiopharmaceutical agents (in Russian) – Med. Radiol 26: 66-75 1981;
23 Roedler H. D, Kaul A, Hine G. J. Internal Radiation Dose in Diagnostic Nuclear Medicine. H. Hoffmann; Berlin (West): 1978
24 Roedler H. D, Kaul A. Strahlenrisiko für den Patienten durch nuklearmedizinische Diagnostik. In: Das Strahlenrisiko im Vergleich zu chemischen und biologischen Risiken. Glöbel B. Hrsg. G. Thieme Verlag, Stuttgart; 1981
25 UNSCEAR: Source and Effects of Ionizing Radiation. Report to the General Assembly, with annexes. United Nations; New York: 1977
26 Webb G. A. M. Radiation Exposure of the Public — The Current Levels in the United Kingdom. Report 24, National Radiological Protection Board, Harwell, May. 1974
27 World Health Organization: Use of Ionizing Radiation and Radionuclides on Human Beings for Medical Research, Training, and Nonmedical Purposes. Technical Report Series No 611. WHO, Geneva; 1977