Часть 4

4

4.

Nuclear Medicine

4. * , . , , . .

4.

Nuclear Medicine

4. *

4.

4.

4.1.

4.

Nuclear Medicine

4. * (Na-22, Mn-54, -57, Co-60, s-137, Cd-109, I-129, Ba-133, Am-241). (Co-57, u-195). 1 -1. -1.

4.

Nuclear Medicine

4. *

4.

()

()

()

()

H-3

12.4

(-

0.016 (100%)

-

10

C-14

5730

(-

0.155 (100%)

-

0.5

Na-24

15

(-

1.39 (100%)

1.37 (100%)

2.75 (100%)

1

S-35

87.2

(-

0.17 (100%)

-

8

K-42

12.45

(-

2.0 (18%)

3.6 (82%)

1.52 (18%)

1

K-43

22

(-

0.47 (8%)

0.83 (87%)

1.24 (3.5%)

..

0.370 (85%)

0.390 (18%)

0.610 (81%)

..

1

Ca-45

163

(-

0.25 (100%)

-

0.8

Ca-47

4.5

(-

0.66 (83%)

0.480 (6%)

0.8

Cr-51

27.8

EC

(100%)

0.323 (8%)

5

Fe-59

45

(-

0.27 (46%)

0.46 (53%)

..

1.10 (56%)

1.29 (44%)

..

0.05

Co-57

270

EC

(100%)

0.122 (88%)

0.136 (10%)

0.3

Co-58

71

EC

(+

(85%)

0.47 (15%)

0.81 (101%)

0.51 (30%)

0.3

Cu-64

12.8

(-

(+

EC

0.57 (38%)

0.66 (19%)

(43%)

0.51 (38%)

..

20

Zn-65

64

EC,

(+

(98.5%)

0.33 (1.5%)

1.115 (51%)

0.5

Se-75

121

EC

(100%)

0.140 (54%)

0.270 (56%)

..

0.4

I-125

60

EC

(100%)

0.035 (8%)

X (138%)

5

Nuclear Medicine

4. *

4.

(max)

()

()

()

P-32

14.3

(-

1.71 (100%)

-

200

Sr-89

50.5

(-

1.46 (100%)

0.909 (1%)

150

Y-90

64.2

(-

2.27 (100%)

-

5000

I-131

8.04

(-

0.33 (9%)

0.61 (87%)

..

0.365 (80%)

0.640 (9%)

..

20000

Er-169

9.3

(-

0.03 (100%)

-

50

Re-186

90

(-

0.93 (23%)

1.07 (73%)

0.137 (10%)

0.122 (1%)

150

Au-198

2.7

(-

0.96 (99%)

..

0.412 (96%)

..

2000

Nuclear Medicine

4. *

4.

(max) ()

()

()

C-11

20.4

(+

0.39 ()

0.511 (A)

1000

O-15

2.2

(+

0.72 ()

0.511 (A)

3500

F-18

110

(+

0.25 ()

0.511 (A)

500

Ga-67

78.3

EC

(100%)

X (38%)

0.185 (24%)

0.300 (17%)

..

250

e-75

121

EC

(100%)

0.140 (54%)

0.270 (56%)

0.280 (23%)

..

10

Kr-81m

13

IT

-

0.191 (66%)

6000

Tc-99m

6

IT

-

0.140 (90%)

1000

In-111

2.8

EC

(100%)

0.171 (91%)

0.245 (94%)

200

In-113m

1.66

EC

(100%)

0.393 (64%)

20

I-123

13.2

EC

(100%)

X (86%)

0.159 (83%)

400

I-125

60

EC

(100%)

X (138%)

0.035 (7%)

10

I-131

8.04

(-

0.33 (9%)

0.61 (87%)

..

0.365 (80%)

0.640 (9%)

..

100

Xe-133

5.27

(-

0.34 (100%)

0.081 (35%)

500

Tl-201

73

EC

(100%)

X (95%)

0.167 (10%)

..

150

Nuclear Medicine

4. * A. , Am-241, Cf-252

B. , Na-22, Ca-45, Mn-54, Co-60, Sr-89, I-125, I-131 C. , C-14, F-18, P-32, Cr-51, Co-57, Ga-67, Se-75, Mo-99, In-111, I-123, Au-198, Tl-201

D. , H-3, C-11, N-13, O-15, Tc-99m, Xe-133

4.

Nuclear Medicine

4. * (); Tc-99m, In-111, Ga-67, I-123

(+) : F-18

, - : I-131, Sm-153

- : Sr-89, Y-90, Er-169

: At-211, Bi-213

4.

Nuclear Medicine

4. *99Mo-99mTc

99Mo87.6%99mTc 140 T = 6.02 99Tc- 292 T = 2*105 99Ru 12.4%- 442 739 T = 2.75

4.

Nuclear Medicine

4. *Mo-99 Tc-99m Tc-99 66 6 NaCl

AlO2

Mo-99+Tc-99m

Tc-99m

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

+ ,

Tc-99m + MAA

+ DTPA ( )

4.

Nuclear Medicine

4. * (), :

, : 131I- MIBG, 131I-, 201Tl-, 111In-DTPA 99mTc-MDP, 99mTc-MAA, 99mTc-HIDA, 111In- , : 99mTc-MAG3, 99mTc-MIBI, , ,

4.

Nuclear Medicine

4. * : (GMP)

:

() ( )

4.

4. 4.2.

4.

Nuclear Medicine

4. *

4.

Nuclear Medicine

4. *

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Nuclear Medicine

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Nuclear Medicine

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4. *

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4. *

4.

4. 4.3.

4.

Nuclear Medicine

4. * ()IV.13. , , :) , ; b) , , , , , ; c) .

4.

Nuclear Medicine

4. * -

4.

Nuclear Medicine

4. * 2.34: , , , " " (. 2.72.9),

4.

Nuclear Medicine

4. * ( , ) , , , ,

4.

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4. * ( )

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Nuclear Medicine

4. *,

4. 4.4.

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Nuclear Medicine

4. * ()2.35. ( ), , :a) , ;b) , ; c) .

4.

Nuclear Medicine

4. * : ?

4.

4. 4.5.

4.

Nuclear Medicine

4. * .

< 50 50-50000 >50000

4.

Nuclear Medicine

4. *

A75Se, 89Sr, 125I, 131I100B11C, 13N, 15O, 18F,51Cr, 67Ga, 99mTc,111In, 113mIn, 123I, 201Tl1.00

C3H, 14C, 81mKr127Xe, 133Xe0.01

4.

Nuclear Medicine

4. *

0.01

, ( ), , () 0.10

/, , ( ), , ( ) 1.00

10.0

4.

Nuclear Medicine

4. * 11 -131

, 100 , 1

1100

< 50 50-50000 >50000

4.

Nuclear Medicine

4. * , 400 Tc-99m

, 1 , 1

400

< 50 50-50000 >50000

4.

Nuclear Medicine

4. * , 8 , 400 Tc-99m

, 1 , 0.1

320

< 50 50-50000 >50000

4.

Nuclear Medicine

4. * ( )

, ()

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:

4.

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& &

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Nuclear Medicine

4. * sinkswashing facilitiespatient toilets

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4. *, : 4312 : 12 ; 359 / : 2001-10-18 : 07:45 : SC

Tc99m-Tc. : A2376 : 30 : 12 12:00 GMT

DateTimeActivityVolumeSignature1507.3022572 15 SC

4.

Nuclear Medicine

4. *?

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Nuclear Medicine

4. * 2 -. , , .., , .

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4. * . , ? ?

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4. * , Cr-51. ?

4.

Nuclear Medicine

4. * , 5. 8. . 10. 11. 12. IAEA, International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources Safety Series No.115, (1996) IAEA/WHO Manual on Radiation Protection in Hospital and General Practice, Volume 4, Nuclear Medicine. (draft) Saha GB, Fundamentals of Nuclear Pharmacy. 4th edition. Springer Verlag, 1998. ISBN 0-387-98341-4.

4.

Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThese are some examples of the sealed sources used in a nuclear medicine departmentPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is an example of classification of radionuclides according to their radiotoxicity Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineNote that there different types of generators. This illustrates a dry type with a separate container of saline solution that is changed every time a new elution will be made. In the wet type of generator there is a built in container with enough volume of saline solution for all elutionsPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineExample of a transport container for a Tc generatorPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis image shows that extra shielding of the generator should be used.as well as shielding of the elution vialPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is a closer look at the top of the generator with the needles where the elution vial and the saline solution vial are placedPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe shielded elution vialPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe image can be used for a short explanation of a radiopharmaceutical. The same radioactive substance can be used in labeling of different compunds resulting in radiopharmaceuticals with different propertiesPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis image and the follwing images are illustrations to the different types of work performed in nuclear medicine. They should be used to explain the need to have different requirements for different types of facilities.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThese images are examples of bad storage. The image to the left shows an equipment for ventilation studies that is stored in an officePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe image illustrates how the security of sources must be considered during their lifetime in the hospitalPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe main messages are already dealt with in part XIV of the MaterialPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is a central message - the lecturer should ensure the participants grasp its importance. The documentation must be verified and easily accessible for updates.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is to illustrate the concept of defense in depth. A source is contained in a shield to prevent from external exposure. If contamination occur it should be kept within the work area, the laboratory, the department or at least in the hospital.Weak points? Identify situations where the defense in depth will fail, meaning that we have to introduce a different safety concept or special requirements. Weak points are exhaust of volatile radionuclides through the fume hood directly out in the air and disposal of sources via the sewage system. Another weak point is the living source (patient) leaving the hospital.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is an introduction to the ICRP concept of categorization of hazard which should be used to define some basic building requirements. .. Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis is an example of a calculation of the weighted activity. In this case the room for administration of an iodine therapy is a high hazard roomPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThese are examples of categorization of hazard for different rooms in a typical nuclear medicine department handling quite large amounts of Tc99mPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis image should be used to illustrate that categorization of hazard and safety assessments not solely should used to determine the furnishing of a room but also its use.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe lecturer can ask the students if there is something wrong in the design of the lead shields although the image basically is an illustration of the possible need of reinforcement of the bench.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineRooms where work with unsealed sources are taken place should be under negative pressure to minimize the risk of airborne radionuclides to be spread, The sterile environment that might be necessary in preparation of radiopharmaceuticals is achieved in a laminar air flow bench.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineIf there are regulations about air pressure gradients they should be continously monitored and an alarm system introducedPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThis illustartion is from a Nuclear Medicine department in India. Does it follow the general rule to separate high activity areas from low activity areas and to separate working areas from patient areas?Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineIt is important that the radioactive waste be segregated at the point of origin. In a big nuclear medicine department this means that several types of waste containers must be available. In a small department it may be enough with one container for paper, gloves etc and one container for glass, needle and syringes.Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicineThe image of the gamma camera is to point out that without the collimator it can be used as a whole body counterPart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicinePart 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine*Part 4: Design of facilities. Safety of sourcesPart 4: Design of facilities. Safety of sourcesRadiation protection in nuclear medicine

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Часть 4