Method for verification of dose during medical administration of open radioactive nuclides

FIELD: medicine, namely, medicinal use of radiation, possible use for determining dose really received by pathologic focus having absorbed open radioactive nuclide.

SUBSTANCE: method for verification of dose during medicinal usage of open radioactive nuclides includes measuring intensiveness of radiation, with consideration of changes in radiation source activity in time, during that, by means of tissue-equivalent phantom, original intensiveness of radiation of open radionuclide is measured immediately prior to injecting it into organism of patient as well as average intensiveness of radiation from focuses having absorbed radionuclide, and after that individual relative dose of open radionuclide injected into pathologic focuses is computed using formula

where Dn/o - value of relative dose in %, Io - original intensiveness of radiation at the moment of injection of radionuclide, In - average intensiveness of radiation from focuses at day or hour of measurement of n, B0 and Bn - background values of radiation intensiveness at the moment of injection of radionuclide and at the day of measurement, respectively, k - coefficient of daily or hourly decomposition of radionuclide, n - number of days or hours having passed since the moment of injection of radionuclide.

EFFECT: invention allows verification of relative dose in most precise and individual manner.

3 ex

 

The invention relates to medicine, namely to the nuclear-medical use, and is designed to define the dose that actually received a pathological focus, absorbed outdoor radionuclide introduced into the patient in the form of a radiopharmaceutical for diagnostic or therapeutic purposes.

Measurement of the absolute value of the dose is known in the medical use of radioactive radiation. To measure the dose absorbed from the hearth (or multiple lesions) radionuclide with gamma radiation, requires the use of sensitive recording equipment, and determining the mass of the target organs and the calculation of the corresponding absorbed fractions [1, 2].

At the same time is a major problem of the measurement of the absorbed dose introduced into the body beta-emitting radionuclides, beta radiation which has a short run in biological tissues and is therefore unavailable for direct external registration. Recently in the literature [2] presents the opportunity for external radiometry beta emitters included in pathological lesions, brake gamma radiation, which is generated by beta particles when they are slow in the tissues.

However, these known methods of dosimetry of ionizing radiation in medical unsealed radionuclides, vnedreny is in pathological lesions, have a number of significant drawbacks. These methods involve the calculation of the values of the internal exposure dose from the total given as the geometric and mass parameters of pathological foci obtained by dynamically repetitive use of medical imaging (e.g., radiography or scintigraphy), and a number of mathematical expressions involving nuclear-physical characteristics of the radionuclide. These methods differ on the negative side, first, a long multi-day conduct of the calculation procedure, and secondly, a prerequisite step-determine the dose characteristics of internal exposure. With each step accompanied by a measure of uncertainty of measurements or calculations, which generally creates a very large total error in the determination of the absorbed dose.

In addition, measurement of the absolute focal, organ and total dose of irradiation, moreover, exacerbated by low precision, largely serves the task of accounting for and control dose within the radiation safety and does not take into account the characteristics of metabolic processes enable open radionuclide in pathological lesions, strictly individual for each particular patient. However, the latter have n the highest clinical value.

The aim of the invention is the verification of the most accurate and individual relative dose embedded in pathological lesions open radionuclide.

This goal is achieved by the fact that determine is not absolute absorbed dose in the centers, and the relative dose-dependent, on the one hand, from the source is introduced into the body activity open the radionuclide and on the other hand, from its accumulation in pathological lesions, which, in turn, caused by metabolic processes in the organism of a particular individual. This is measured through a tissue-equivalent phantom source radiation intensity just before the introduction of the radionuclide in the body of the patient and the average intensity from the centers across the radionuclide, activity changes the radiation source in time and calculate the relative dose according to the formula

where Dn/o- the value of the relative dose in %,

Andaboutis the initial radiation intensity at the moment of injection of the radionuclide,

Andn- the average radiation intensity from lesions in the day (or hour) of dimension n

Faboutand fn- background values of the radiation intensity at the moment of injection of the radionuclide and on the day of measurement, respectively,

k - coefficient of the daily (hourly) the dissolution of the Radion is klida,

n - number of days (hours)elapsed since the introduction of the radionuclide.

Taken into account that the change of the radiation intensity in direct proportion depends on the daily (hourly) activity of radionuclide.

The mentioned combination and sequence of distinctive actions are not known and are not derived explicitly from the current level of science and technology, therefore, the inventive method corresponds to inventive step.

The method is as follows. Measure the intensity of radiation in the room where you spend the measurement (fabout). Then through a tissue-equivalent phantom perform the measurement of the intensity of radiation of the open radionuclide that will be entered into the patient in the form of a radiopharmaceutical for diagnostic or therapeutic purposes (Andabout). After injection of the radiopharmaceutical in necessary to measure the day or hour (n), since the injection, the same measuring instrument register the radiation intensity at location (fn), then measure the intensity of the patient above the hearths, nachevski radionuclide, and calculate its average value (Andn). Then calculate the relative dose of the radionuclide actually accumulated in the pathological lesions of the patient in relation to the original introduced in his body is orale

where Dn/o- the value of the relative dose in %,

Andaboutis the initial radiation intensity at the moment of injection of the radionuclide,

Andn- the average radiation intensity from lesions in the day (or hour) of dimension n

Faboutand fn- background values of the radiation intensity at the moment of injection of the radionuclide and on the day of measurement, respectively,

k - coefficient of the daily (hourly) decay of the radionuclide,

n - number of days (hours)elapsed since the introduction of the radionuclide.

Verification of the dose of the proposed method, we conducted in 7 patients with curative intent was injected outdoor radionuclide in the form of a solution of strontium chloride. The determination of the relative dose allowed all of these patients individually to assess the duration and degree of accumulation of the radionuclide in the pathological lesions, the relative magnitude of the actual radiation doses and associated clinical effect that influenced the tactics of the further treatment.

Here are clinical examples of the use of the method.

Example 1. Patient D., aged 57, clinical diagnosis: Cancer of the prostate, the generalization process with metastatic Th6, Th12, L1 vertebrae, sternum, 3-5 ribs on the left, right Ilium, the expressed painful syndrome. The purpose of system radiation therapy bol is the resultant was produced by intravenous injection of 148 MBq of radionuclide strontium-89 chloride. Immediately before injection, the registered radiation intensity of the radiopharmaceutical through the tissue-equivalent phantom, which was 1175 pulse/sec/cm2; the average intensity from the centers identified in the 5-, 7-, 12-th day since the introduction of the radionuclide and by the present method are calculated relative dose, which was 38,14; 26,13; and 16.7%, respectively. As a result of this systemic effect of the radionuclide was estimated as relatively satisfactory, requiring additional use of pharmacotherapy. At the control examination after 3 months the patient's condition is satisfactory, pain is absent.

Example 2. Patient A., aged 47, a clinical diagnosis of breast Cancer with multiple metastases in the bones of the pelvis, right scapula, left humerus, 6-7 ribs on the left pain. The measured radiation intensity of the radionuclide strontium-89 just before the introduction of the radiopharmaceutical and over bone lesions the patient at 2-, 6-, 10-, and 14 days after injection. The value of the relative dose in those days were, respectively, 80,25; 90,16; 53,38; to 20.28%, which allowed us to assess the systemic radial action of the radiopharmaceutical as satisfactory. Pain completely stopped after 7 days. At the control examination the patient's condition is satisfactory, Bo the eve syndrome is absent.

Example 3. Patient K., 56 years, clinical diagnosis of Peripheral cancer of the upper lobe of the left lung, post operative treatment of multiple metastases in Th5-Th8 vertebrae, the expressed painful syndrome. A systematic radiation therapy by intravenous injection of 148 MBq of strontium-89 chloride. The radiation intensity of strontium-89 immediately before injection was 1180 pulse/sec/cm2. The relative dose of the inventive method is defined at the 2-, 5-, 9-th day after injection of the radiopharmaceutical and was 18,36; 20,3; 16,48%, respectively. The action of the radiopharmaceutical is assessed as unsatisfactory, pain equally remained until the 9th day, even with the additional use of medicinal analgesics, which required exposure the most painful Th5-Th7 vertebrae through remote gamma-therapy; pain partially cropped.

Thus, the inventive method allows the verification of the most accurate and individual relative dose embedded in pathological lesions open radionuclide.

Literature

1. Gorlachev G. Measurement of absolute doses in radiation therapy // Honey. physics. - 2000. No. 7. - S-92.

2. Narkevich BJ, Kostylev, VA, S.V. Shiryaev Dosimetry to ensure radionuclide therapy // the III Congress of the NGO "Society of nuclear medicine", User Siska scientific-practical conference "Topical issues of nuclear medicine and radiopharmaceutical". School "Selected questions of nuclear medicine: Abstracts. Dubna, 2004. - P.64-71.

Method of verification dose in medical unsealed radionuclides by measuring the intensity of radiation to reflect changes in the activity of the radiation source in time, characterized in that measure through tissue-equivalent phantom source intensity is open radionuclide directly before introduction into the patient and the average intensity from the centers across the radionuclide, and then calculate the individual relative dose introduced in pathological lesions open radionuclide by the formula

where Dn/0- the value of the relative dose, %;

And0is the initial radiation intensity at the moment of injection of the radionuclide;

Andn- the average radiation intensity from lesions in the day or the hour of dimension n;

F0and fn- background values of the radiation intensity at the time of introduction

radionuclide and on the day of measurement, respectively;

k - coefficient of daily or hourly decay of the radionuclide;

n is the number of days or hours that have passed since the introduction of the radionuclide.



 

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