Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Evaluating Estimated Dose outside the Patients Undergoing Myocardial Perfusion Imaging with 99mTc-MIBI

Document Type : Original Paper

Authors
amir reza khorasanchi 1
Esmat Ramezanzadeh 2
Azam eskandari 2
Erfan saatchian 2
mahmoodreza yahyaei 3
1 Assistant Professor, Department of Nuclear Medicine, Shahrood University of Medical Sciences, Semnan, Iran
2 PhD Student of Medical Physics, Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 MSc Student in Nuclear Physics, Shahrood University of Technology, Semnan, Iran
10.22038/ijmp.2022.60736.2023
Abstract
Introduction: It is important that estimated doses from patients administered radiopharmaceuticals in nuclear medicine by hospital staff but other people in connection to patients need radiation protection. The purpose of this study was to measure the dose rate with increasing distance from patients to estimate the average effective dose in hospital staff and companions of patients.
Material and Methods: Myocardial perfusion scanning was performed using Technetium 99m-methoxy isobutyl isonitrile (99mTc-MIBI) (in 2 groups of stress and rest). We measured the external dose rate for 48 patients (23 men and 25 women) at 4 distances and 5 times. Doses are estimated for a range of scenarios, in hospital staff, public transportation, and family contacts. Finally, the obtained data were compared to the trigger level introduced by the International Commission on Radiological Protection 53 and 62 (ICRP). Data analysis was performed using SPSS version 24.
Results: The distance of the times when patients need family or hospital staff to be with them was divided into 4 categories (injection to scanning, using public transport, emergency patients during injection to scanning, and emergency patients after finishing medical procedures). 
Conclusion: In all scenarios, effective doses were obtained at less than 100 µSv according to ICRP guidelines. Due to the significant increase of the uptake in the heart and skeleton, after injection, the dose rate per MBq in the stress rate before 1hr decreases more slowly than the rest test, and the effective dose of hospital staff in stress procedure is more than rest procedure.
Keywords
Technetium Tc 99m Sestamibi
Radiation Exposure
Radiation Dosage
Radiation Protection
Subjects
  1. Anderson CJ, Ling X, Schlyer DJ, Cutler CS. A short history of nuclear medicine. Radiopharmaceutical Chemistry; Springer International Publishing: Cham, Switzerland. 2019:11-26.
  2. Hyafil F, Gimelli A, Slart RH, Georgoulias P, Rischpler C, Lubberink M, et al. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. European Journal of Hybrid Imaging. 2019;3(1):1-27.
  3. Askari D, Bakhshandeh M, Amoui M, Mirzaee H, Malekzadeh M. Investigate Change Cardiac Perfusion Pattern Following By Hypo-fractionated and Conventional Radiation Therapy Schedule in Patients with Left-Sided Breast Cancer. Iranian Journal of Medical Physics. 2018;15(Special Issue-12th. Iranian Congress of Medical Physics):341-.
  4. Bartlett ML. Estimated dose from diagnostic nuclear medicine patients to people outside the Nuclear Medicine department. Radiation protection dosimetry. 2013;157(1):44-52.
  5. Hansson SO. ALARA: What is reasonably achievable? Radioactivity in the Environment. 19: Elsevier. 2013; 143-55.
  6. Strauss HW, Miller DD, Wittry MD, Cerqueira MD, Garcia EV, Iskandrian AS, et al. Procedure guideline for myocardial perfusion imaging. Journal of Nuclear Medicine. 1998;39(5):918-23.
  7. Strauss HW, Miller DD, Wittry MD, Cerqueira MD, Garcia EV, Iskandrian AS, et al. Procedure guideline for myocardial perfusion imaging 3.3. Journal of Nuclear Medicine Technology. 2008;36(3):155-61.
  8. Travin MI, editor Pitfalls and limitations of radionuclide and hybrid cardiac imaging. Seminars in nuclear medicine; 2015: Elsevier.
  9. Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P, et al. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. European journal of nuclear medicine and molecular imaging. 2015;42(12):1929-40.
  10. Ohiduzzaman M, Khatun R, Reza S, Khan K, Akter S, Uddin M, et al. Study of exposure rates from various nuclear medicine scan at INMAS, Dhaka. IJARIIE. 2019;5(3):208-18.
  11. GÖKBULUT M. Examination of 99mTc-mdp radioactivity after ınjection according to time and distance. Cumhuriyet Science Journal.42(2):389-96.
  12. Husain SS. Myocardial perfusion imaging protocols: is there an ideal protocol? Journal of nuclear medicine technology. 2007;35(1):3-9.
  13. Oswald WM, Herold TJ, Wilson ME, Hung JC. Dose calibrator linearity testing using an improved attenuator system. Journal of nuclear medicine technology. 1992;20(3):169-72.
  14. SATARI A, Dadashzadeh S, Nasiroghli G, Firoozabadi H. Radiation dose to the nuclear medicine nurses. 2004.
  15. Mattsson S, Johansson L, Leide Svegborn S, Liniecki J, Noßke D, Riklund K, et al. ICRP publication 128: radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances. Annals of the ICRP. 2015;44(2_suppl):7-321.
  16. Saeed M, Almalki Y. Assessment of the occupational dose and radiogenic risk in diagnostic radiology and nuclear medicine examinations. International Journal of Radiation Research. 2021;19(2):365-72.
  17. Joseph SR, Kim J. Radiological Dose Assessment to Members of the Public Using Consumer Products Containing Naturally Occurring Radioactive Materials in Korea. International journal of environmental research and public health. 2021;18(14):7337.
  18. Stenstad L-I, Pedersen GA, Landmark AD, Brattheim B. Nuclear radiation dose to the surroundings from patients who are undergoing nuclear medicine examinations. Radiography Open. 2014;1(1):7-.
  19. Yen Y-C, Tien H-Y, Guo Z-H, Wang T-H, Tsai S-C, Pan L-F, et al. Biokinetic Model of Tc-99m Mibi for Eight Patients Undergone Myocardial Perfusion Examination Via Gamma Camera and Matlab Program: An In-Vivo Study. Journal of Mechanics in Medicine and Biology. 2019;19(07):1940042.
  20. Valentin J. Radiation dose to patients from radiopharmaceuticals:(Addendum 2 to ICRP Publication 53) ICRP Publication 80 Approved by the Commission in September 1997. Annals of the ICRP. 1998;28(3):1-.
  21. Bayram T, Yilmaz AH, Demir M, Sonmez B. Radiation dose to technologists per nuclear medicine examination and estimation of annual dose. Journal of nuclear medicine technology. 2011;39(1):55-9.
  22. Sattari A, Dadashzadeh S, Nasiroghli G, Firoozabadi H. Absorbed radiation to the nuclear medicine nurses from patients administered 201 Tl and 99m Tc-MIBI. 2010.

 

 

 

  1. Anderson CJ, Ling X, Schlyer DJ, Cutler CS. A short history of nuclear medicine. Radiopharmaceutical Chemistry; Springer International Publishing: Cham, Switzerland. 2019:11-26.
  2. Hyafil F, Gimelli A, Slart RH, Georgoulias P, Rischpler C, Lubberink M, et al. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. European Journal of Hybrid Imaging. 2019;3(1):1-27.
  3. Askari D, Bakhshandeh M, Amoui M, Mirzaee H, Malekzadeh M. Investigate Change Cardiac Perfusion Pattern Following By Hypo-fractionated and Conventional Radiation Therapy Schedule in Patients with Left-Sided Breast Cancer. Iranian Journal of Medical Physics. 2018;15(Special Issue-12th. Iranian Congress of Medical Physics):341-.
  4. Bartlett ML. Estimated dose from diagnostic nuclear medicine patients to people outside the Nuclear Medicine department. Radiation protection dosimetry. 2013;157(1):44-52.
  5. Hansson SO. ALARA: What is reasonably achievable? Radioactivity in the Environment. 19: Elsevier. 2013; 143-55.
  6. Strauss HW, Miller DD, Wittry MD, Cerqueira MD, Garcia EV, Iskandrian AS, et al. Procedure guideline for myocardial perfusion imaging. Journal of Nuclear Medicine. 1998;39(5):918-23.
  7. Strauss HW, Miller DD, Wittry MD, Cerqueira MD, Garcia EV, Iskandrian AS, et al. Procedure guideline for myocardial perfusion imaging 3.3. Journal of Nuclear Medicine Technology. 2008;36(3):155-61.
  8. Travin MI, editor Pitfalls and limitations of radionuclide and hybrid cardiac imaging. Seminars in nuclear medicine; 2015: Elsevier.
  9. Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P, et al. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. European journal of nuclear medicine and molecular imaging. 2015;42(12):1929-40.
  10. Ohiduzzaman M, Khatun R, Reza S, Khan K, Akter S, Uddin M, et al. Study of exposure rates from various nuclear medicine scan at INMAS, Dhaka. IJARIIE. 2019;5(3):208-18.
  11. GÖKBULUT M. Examination of 99mTc-mdp radioactivity after ınjection according to time and distance. Cumhuriyet Science Journal.42(2):389-96.
  12. Husain SS. Myocardial perfusion imaging protocols: is there an ideal protocol? Journal of nuclear medicine technology. 2007;35(1):3-9.
  13. Oswald WM, Herold TJ, Wilson ME, Hung JC. Dose calibrator linearity testing using an improved attenuator system. Journal of nuclear medicine technology. 1992;20(3):169-72.
  14. SATARI A, Dadashzadeh S, Nasiroghli G, Firoozabadi H. Radiation dose to the nuclear medicine nurses. 2004.
  15. Mattsson S, Johansson L, Leide Svegborn S, Liniecki J, Noßke D, Riklund K, et al. ICRP publication 128: radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances. Annals of the ICRP. 2015;44(2_suppl):7-321.
  16. Saeed M, Almalki Y. Assessment of the occupational dose and radiogenic risk in diagnostic radiology and nuclear medicine examinations. International Journal of Radiation Research. 2021;19(2):365-72.
  17. Joseph SR, Kim J. Radiological Dose Assessment to Members of the Public Using Consumer Products Containing Naturally Occurring Radioactive Materials in Korea. International journal of environmental research and public health. 2021;18(14):7337.
  18. Stenstad L-I, Pedersen GA, Landmark AD, Brattheim B. Nuclear radiation dose to the surroundings from patients who are undergoing nuclear medicine examinations. Radiography Open. 2014;1(1):7-.
  19. Yen Y-C, Tien H-Y, Guo Z-H, Wang T-H, Tsai S-C, Pan L-F, et al. Biokinetic Model of Tc-99m Mibi for Eight Patients Undergone Myocardial Perfusion Examination Via Gamma Camera and Matlab Program: An In-Vivo Study. Journal of Mechanics in Medicine and Biology. 2019;19(07):1940042.
  20. Valentin J. Radiation dose to patients from radiopharmaceuticals:(Addendum 2 to ICRP Publication 53) ICRP Publication 80 Approved by the Commission in September 1997. Annals of the ICRP. 1998;28(3):1-.
  21. Bayram T, Yilmaz AH, Demir M, Sonmez B. Radiation dose to technologists per nuclear medicine examination and estimation of annual dose. Journal of nuclear medicine technology. 2011;39(1):55-9.
  22. Sattari A, Dadashzadeh S, Nasiroghli G, Firoozabadi H. Absorbed radiation to the nuclear medicine nurses from patients administered 201 Tl and 99m Tc-MIBI. 2010.

 

 

 

 

 

 

 

 

Iranian Journal of Medical Physics
Volume 20, Issue 2
March and April 2023
Pages 87-93

  • Receive Date 04 October 2021
  • Revise Date 28 February 2022
  • Accept Date 30 May 2022