JNM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in JNM
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Stabin, M. G.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stabin, M. G.
Journal of Nuclear Medicine Vol. 49 No. 9 1555-1563
© 2008 by Society of Nuclear Medicine
doi: 10.2967/jnumed.108.052241

Special Contribution

Radiopharmaceuticals for Nuclear Cardiology: Radiation Dosimetry, Uncertainties, and Risk

Michael G. Stabin

Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee

Correspondence: For correspondence or reprints contact: Michael G. Stabin, Department of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Ave. South, Nashville, TN 37232-2675. E-mail: michael.g.stabin{at}vanderbilt.edu

The technical basis for the dose estimates for several radiopharmaceuticals used in nuclear cardiology is reviewed, and cases in which uncertainty has been encountered in the dosimetry of an agent are discussed. Also discussed is the issue of uncertainties in radiation dose estimates and how to compare the relative risks of studies. Methods: Radiation dose estimates (organ absorbed doses and effective doses) from different literature sources were directly compared. Typical values for administered activity per study were used to compare doses that are to be expected in clinical applications. Results: The effective doses for all agents varied from 2 to 15 mSv per study, with the lowest values being seen for 13N-NH3 and 15O-H2O studies and the highest values being seen for 201Tl-chloride studies. The effective doses for 99mTc- and 201Tl-labeled agents differed by about a factor of 2, a factor that is comparable to the uncertainty in individual values. This uncertainty results from the application of standard anthropomorphic and biokinetic models, presumably representative of the exposed population, to individual patients. Conclusion: Considerations such as diagnostic accuracy, ease of use, image quality, and patient comfort and convenience should generally dictate the choice of a radiopharmaceutical, with radiation dose being only a secondary or even tertiary consideration. Counseling of nuclear medicine patients who may be concerned about exposure should include a reasonable estimate of the median dose for the type of examination and administered activity of the radiopharmaceutical; in addition, it should be explained that the theoretic risks of the procedure are orders of magnitude lower than the actual benefits of the examination. Providing numeric estimates of risks from studies to individual patients is inappropriate, given the uncertainties in the dose estimates and the limited predictive power of current dose–risk models in the low-dose (i.e., diagnostic) range.

Key Words: radiation dosimetry • nuclear cardiology • uncertainty • risk

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.


Related articles in JNM:

This Month in JNM

JNM 2008 49: 11A-12A. [Full Text]  





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY THE JOURNAL OF NUCLEAR MEDICINE
Copyright © 2008 by the Society of Nuclear Medicine.