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MIRD Pamphlet No. 14 Revised: A Dynamic Urinary Bladder Model for Radiation Dose Calculations

Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
Oak Ridge Associated Universities, Oak Ridge, Tennessee
University of Chicago, Chicago, Illinois

Correspondence: For correspondence contact: Stephen R. Thomas, PhD, E560 Medical Sciences Building, University of Cincinnati, College of Medicine, Cincinnati, OH 45267-0579.

Correspondence: For reprints contact: Evelyn E. Watson, MS, Chair, MIRD Committee, 104 New Bedford Lane, Oak Ridge, TN 37830.

ABSTRACT

The constant-volume urinary bladder model in the standard MIRD Pamphlet No. 5 (Revised) phantom has recognized limitations. Various investigators have developed detailed models incorporating more physiologically realistic features, such as expanding bladder contents and residual volume, and variable urinary input rate, initial volume and first void time. We have reviewed these published models and have developed a new model for calculation of radiation absorbed dose to the urinary bladder wall incorporating these aspects. Methods: The model consists of a spherical source with variable volume to simulate the bladder contents and a wall represented by a spherical shell of constant volume. The wall thickness varies as the source expands or contracts. The model provides for variable urine entry rate (three different hydration states), initial bladder contents volume, residual volume and first void time. The voiding schedule includes an extended nighttime gap during which the urine entry rate is reduced to one-half the daytime rate. Results: Radiation-absorbed dose estimates have been calculated for the bladder wall surface including photon and electron components) and at several depths in the wall (electron component) for 2-¹⁸F-fluoro-2-deoxy-D-glucose, ^99mTc-diethylenetriaminepentaacetic acid (DTPA), ^99m-HEDP, ^99mTc-pertechnetate, ^99mTc-red blood cells (RBCs), ^99mTc-glucobeptonate, ^99mTc-mercaptoacetyltriglicine chelator (MAG3), ^99mTc-methylene diphosphonate (MDP), ^99mTc-hexamethylpropylene amine oxime (HMPAO), ^99mTc-human serum albumin (HSA), ^99mTc-MIBI (rest and stress), ¹²³I-/¹²⁴I-/¹³¹I-OIH, ¹²³I/¹³¹I-Nal, ¹²⁵I-iothalamate, ¹¹¹In-DTPA and ⁸⁹Sr-SrCl. Conclusion: The new model tends to give a higher radiation absorbed dose to the bladder wall surface than the previous models. Large initial bladder volumes and higher rates of urine flow into the bladder result in lower bladder wall dose. The optimal first voiding time is from 40 min to 3 hr postadministration, depending on radiopharmaceutical. The data as presented in tabular and graphic form for each compound provide guidance for establishing radiation absorbed dose reduction protocols.

Key Words: dosimetry • urinary bladder radiation absorbed dose • dynamic bladder • MIRD dose calculation

FOOTNOTES

This is the last in a series of MIRD Special Contributions.

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