Aplicação dos princípios de radioproteção em medicina nuclear

The Nuclear Medicine is a medical specialty which uses different radioisotopes for diagnostic and therapeutic purposes. The isotopes are radioactive elements which are administered in vivo and present distribution to specific organs or cell types. The knowledge of radioactivity and notions related to ionizing radiation allow to contextualize the radiological protection measures to be taken in Nuclear Medicine. So it is possible to minimize unnecessary exposure to patients, the public, and individuals occupationally exposed and the environmental. For this it is necessary to relate the physical and technological bases apply to this mode with the standards established by regulatory agencies, including the CNEN (National Nuclear Energy Commission) and ANVISA (National Agency for Sanitary Vigilance). In this scenario, it is important that the theoretical endorse the activities which are periodically audited for verification of compliance with the standards that aim to radioprotection. One role of the Medical Physicist in these services is, therefore, act as Radiation Protection Supervisor exerting numerous activities and ensuring compliance with these standards. In this context the stage in the area of Nuclear Medicine was developed in many customers of the enterprise Rad Dimenstein & Associados LTDA, among them the hospitals Israelita Albert Einstein (HIAE), Nossa Senhora de Lourdes (HNSL), Santa Paula (HSP), Cruz Azul (CRAZ), Grupo Fleury, among other clinics. Following the routine and then carrying out various activities pertaining to the Medical Physicist in the area, it was noted that the measures and actions are extremely effective and fundamental in terms of radiological protection

Instrumentação em Medicina Nuclear

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Distribuição e dispersão dos níveis radiométricos do setor técnico de medicina nuclear do hospital das clínicas da faculdade de medicina de botucatu

Nuclear medicine uses non-sealed sources for exams and treatments, because the movement of these sources, source of patients injected or not, involve a wide range of environmental radiometric levels. To better control of these levels this study was aimed at monitoring points strategically distributed in all environments Sector Technical Nuclear Medicine, Hospital of the Botucatu Medical School, performing two measurements at random times daily for a period of three months, sampling the normal routine of the sector. The detector Geiger-Muller was used for the acquisition of exposure rates of the points, efficiency and reprodutibility test have shown good performance of this equipment for this purpose. The results allowed to make a projection of annual dose for each environment indicating higher risks for Occupationally Exposed Individuals as well as Public Individuals compared with the limits established by the National Commission of Nuclear Energy. Was developed a spatial map of dose that can be used as a visual warning to the regions with the highest exposure to ionizing radiation, enabling reduced risk of a potential exposure

Aplicações práticas de proteção radiológica nas áreas de medicina nuclear e radiodiagnóstico em instalações hospitalares

After the discovery of ionizing radiation, its applications in various fields of science began to take significant proportions. In the case of medicine, there are the application areas in radiotherapy, diagnostic radiology and nuclear medicine. It was then necessary to create the field of radiological protection to establish the conditions necessary for the safe use of such ionizing radiation. Apply knowledge obtained during the graduation stage and in the practice of radiological protection in the areas of nuclear medicine and diagnostic radiology. In the area of nuclear medicine, tests were made in the Geiger-Muller counters (GM) and the dose calibrator (curiometer), the monitoring tests of radiation, waste management, clean of the Therapeutic room and testing the quality control of gamma-chambers. In the area of radiology, were performed tests of quality control equipment for conventional X-ray equipment and x-ray fluoroscopy, all following the rules of the National Health Surveillance Agency (ANVISA), and reporting of tests. The routine developed in the fields of nuclear medicine in hospitals has proved very useful, since the quality control of GM counters contribute to the values of possible contamination are more reliable. The control of dose calibrator enables the patient not to receive different doses of the recommended amounts, which prevents the repetition of tests and unnecessary exposure to radiation. The management of waste following the rules and laws established and required for its management. Tests for quality control of gamma chambers help to evaluate its medical performance through image. In part of diagnostic radiology, tests for quality control are performed in order to verify that the equipment is acceptable for usage or if repairs are needed. The knowledge acquired at the internship consolidated the learning of graduation course

Gama Câmara CZT: alteração de paradigmas em aquisição de imagens de medicina nuclear

Nuclear medicine is a medical specialty related to imagery that deals with imaging techniques, diagnosis and therapy, allowing observing the physiological state of tissues noninvasively by marking the molecules participating of these physiological processes with radioactive isotopes, thus creating the called radionuclides. The image of a radionuclide is one of the most important applications of radioactivity in nuclear medicine. The equipment’s of nuclear medicine imaging use the principle of radiation detection, turning it into an electrical signal which, through specific algorithms, allows forming tomographic images that provide information about the functional status of organs. New detection systems have been developed for tomographic acquisitions using solid state detectors. These devices use crystals of cadmium zinc telluride (CdZnTe). Some of the advantages of this detector are a significant improvement of signal to noise ratio, the increased spectral and spatial resolution, which in sum, result in greater clarity of the images obtained, opening new perspectives for imaging protocols previously unattainable. In contrast, all other gamma-cameras equipped with vacuum tubes have remained relatively unchanged for nearly fifty years. In these gamma-cameras, the images are obtained using two steps significantly less efficient: the gamma rays are converted to light through a first device, and then the light is converted into an electrical signal through a second device. One of functions the Medical Physicist is related to the quality control of equipment. This control ensures that the information and images provided are true and thus credible to be used in medical reports. To perform this type of analysis the physicist must understand the performance characteristics and operation of all equipment of the department concerned; besides, in the absence of specific legislation, proposing...(Complete abstract click electronic access below)

Mapeamento do nível radiométrico e construção de mapa espacial em serviço de medicina nuclear

Nuclear Medicine is a medical modality of therapy and diagnostic imaging using unsealed radioactive sources for its purposes. This routine activity promotes the transit of radioactive sources for the area of installation, beyond the transit of patients injected with radioisotope, which also contribute to raising the radiometric level of environment. As a consequence, it has exposured workers and public individuals to the ionizing radiation. There are protective mechanisms of radiation exposure, personal protective equipments, and measurement planes established in standard measurement at certain points of the environment in order to identify any increase in radiometric levels and \ or contamination, but do not cover the entire space occupied by workers and patients. To accomplish with the individual dose limits established by the National Commission of Nuclear Energy, it is interesting if there is an individualized classification for each Nuclear Medicine service. This work aimed to promote an analysis of the radiometric level distribution across the extent of the Technical Nuclear Medicine Sector of Hospital of the Botucatu Medical School, and produce a spatial map to identify locations with higher exposure rate to the ionizing radiation, can be used as a risk map to assist the Occupationally Exposed Individuals (IOE). To perform the radiometric levels checking it was used a digital Geiger-Muller detector available in the sector, due to its practicality compared to other detectors. Measurements were carried out at four different times for all days of the week, at points strategically established to cover all the installation

Some effects of gamma-irradiated autologous sera on their donors

The present paper is a further step to elucidate the effect of γ-irradiated molecules and their action as immunogens. Rabbits were bled, the total serum was γ-irradiated and reinjected to the autologous donor. Bleeding and reinjection of non-irradiated serum do not produce any alteration hence the animal is able to recognize the autologous unmodified serum proteins as 'self'. Electrophoretic results demonstrate that as an effect of γ-irradiation, alteration of the normal migration properties are occurring. The obtained data are suggesting that due to the possible alteration of the molecular structure, resulting as the effect of γ-rays, the antibody forming system of the animal injected with irradiated autologous serum might recognize the substances as 'not self' what may be the possible reason of antibody formation. The presence of antibodies and probably their complexes with antigens are demonstrated by cutaneous sensibilization technics. The low level of the complement starting from the 7-9 days, the histological alteration of the kidney and the cardiac lesions are tempting to try an interpretation comparing these symptoms to those observed in serum sickness.

Quantificação da resoluçao do sistema SPECT-CZT através do uso da função de transferência modulada (MTF)

Pós-graduação em Biologia Geral e Aplicada - IBB

Proposta de metodologia para o gerenciamento de fonte radioativa e estimativa de dose efeiva em pacientes submetidos à terapia com iodeto de sódio I-131

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Análise do plano de radioproteção em radioterapia

Ionizing radiation is used nowadays in various sectors such as agriculture, industry and medicine. The main specialties of medicine which use radiation are the diagnostic radiology, nuclear medicine and radiotherapy. Radiotherapy is a therapeutic modality that is a well established feature for the treatment of malignant disease or not. However, the inadvertent use of ionizing radiation can produce deleterious effects that result in sequels that compromise the welfare of the people involved. The analysis of radiological protection emphasizes the importance of avoiding inappropriate exhibitions aimed at protecting the health of patients, the professionals involved and the general public. The basic principles of radioprotection are justification, optimization and restriction for individual dosage. The departments of radiotherapy are regulated in accordance with specific technical standards of the National Commission of Nuclear Energy (CNEN), which during the inspection for issue and renewal of the authorization of operation requires the submission of a radioprotection plan, this document that requires great demand of time, and has generated much debate among professionals in medical physics, given the difficulties encountered in their preparation. After examining the radioprotection plan of some radiotherapy services, as suggested in order to guide those responsible for drawing up these plans, especially beginners in the career of the physics of radiation, this paper presents a model plan that is in line radioprotection it requires the Technical Standards of CNEN and can easily be the reality of appropriate services

SPECT (Single photon emission tomography): Gama câmara, reconstrução tomográfica e características funcional

The SPECT (Single Photon Emission Computed Tomography) systems are part of a medical image acquisition technology which has been outstanding, because the resultant images are functional images complementary to those that give anatomic information, such as X-Ray CT, presenting a high diagnostic value. These equipments acquire, in a non-invasive way, images from the interior of the human body through tomographic mapping of radioactive material administered to the patient. The SPECT systems are based on the Gamma Camera detection system, and one of them being set on a rotational gantry is enough to obtain the necessary data for a tomographic image. The images obtained from the SPECT system consist in a group of flat images that describe the radioactive distribution on the patient. The trans-axial cuts are obtained from the tomographic reconstruction techniques. There are analytic and iterative methods to obtain the tomographic reconstruction. The analytic methods are based on the Fourier Cut Theorem (FCT), while the iterative methods search for numeric solutions to solve the equations from the projections. Within the analytic methods, the filtered backprojection (FBP) method maybe is the simplest of all the tomographic reconstruction techniques. This paper's goal is to present the operation of the SPECT system, the Gamma Camera detection system, some tomographic reconstruction techniques and the requisites for the implementation of this system in a Nuclear Medicine service

Sistema de cálculo computacional da unidade monitora para feixes de elétrons em radioterapia

In radiation theraphy with electron beam, the electrons are produced in linear accelerators, and energy the most used have between 4MeV and 20MeV. Generally, the treatments are done for superficial injuries, because the low penetration of these particles. In this work a system for calculation of monitor units (U.M.) for cases of treatments with electron beam was developed. The Excel program of Microsoft was used and is easily found in the operational system of the personal microcomputers. In the Excel has been inserted the pertinent data of the linear accelerator of Varian, model 2100C, used in the Service of radiation theraphy of the Hospital of the Clinics of the College of Medicine of the UNESP of Botucatu. For some values of the physical parameters, such as: factors field and factors calibration, not supplied in the tests of acceptance of the machine, still proceeded calculations from interpolation and extrapolation. The mathematical formulas for automatic search of these and others factors used in the calculations of the determination of the U.M had been developed in agreement available routines in Excel. For this the functions had been used the function IF (that it imposes search condition) and the PROCH (that looks a value in a column from determined line), beyond the basic functions of addition, multiplication and division. It is intended to optimize the routine of the Services of radiation theraphy that perform through eletrontheraphy procedures, speeding the calculations and minimizing the occurrence of errors and uncertainties deriving of the maken a mistake manipulation of the parameters gotten in tables of data of electron beams

Calibração do Modelo de TBC para cálculos de espectros de raios-X

As normas nacionais e internacionais prevêem que a manutenção dos níveis de radiação deve estar abaixo do permitido. Sendo assim, a ICRP [1] (International Commission on Radiological Protection) exige métodos de otimização para garantir que o público esteja exposto aos menores níveis de radiação possíveis. Como método de otimização, aproximações teóricas e semi-empiricas podem realizar uma determinação do espectro de raios-X, sendo fundamental para o diagnóstico de energia, estimando a dose de radiações em pacientes e formulando modelos de blindagem. Métodos adequados de radioproteção foram desenvolvidos na física médica como a medicina nuclear, a radioterapia e a radiologia diagnóstica. Um dos métodos semi-empiricos utilizados é o modelo de TBC que é capaz de reproduzir e calcular os espectros gerados pelo anodo de tungstênio. Com o modelo de TBC modificado é possível também obedecer às exigências das barreiras protetoras presentes na radiologia, levando em conta a forma de onda arbitrária e a filtração adicional na geração do espectro não presente no modelo original. Além disso, realiza-se a calibração do espectro gerado para que o modelo de TBC represente a quantidade e comportamento de radiações típicas. Dessa forma, realiza-se uma revisão do modelo de TBC implementando-o ao programa matemático Matlab e comparando-o com os resultados adquiridos pelo Código MCNP-5 no Método de Monte Carlo. Os resultados encontrados são bastante satisfatórios, tanto em termos quantitativos quanto qualitativos dos feixes. Para a calibração, desenvolve-se uma análise dos espectros gerados pelo TBC Modificado aplicado ao programa Mathcad e Matlab sob as mesmas condições. Os espectros gerados apresentam o mesmo comportamento, diferindo em até 12% nos valores encontrados para camadas semi-redutoras, coeficiente de homogeneidade e energia efetiva

Avaliação dos aspectos dosimétricos no tratamento de câncer de tireóide com Iodo-131

The 131I (radioactive iodine) is one of the most used radionuclides in nuclear medicine for diagnosis and treatment. The present study evaluates the dosimetric aspects related to radioiodine therapy after thyroidectomy in patients with thyroid cancer. The samples were studied with 50 patients undergoing treatment, by assessing the exposures of workers (nursing assistants, staff hygiene, medical and physical), the general public (accompanying and family members) and on the environment. To evaluate the workers, was made a survey of the environmental conditions of the room radioiodine and routines adopted by them during the treatment period. Estimating the dose equivalent per month for each employee, we observed that the maximum levels obtained for nursing assistants, the team of hygiene, medical and physicians were considered low in relation to the extent permitted by law. In order to assess the public, some situations have been suggested for the calculation of equivalent doses in which it was possible to verify the fundamental importance of isolating the patient in the 2 days first. Regarding the environment, the radioactive waste generated by patient had volume of 1.0 m3 and activity estimated at 0.91 mCi, taking a decay time for eliminating them about 75 days to reach the allowable value of 2 μCi / kg system of collecting garbage. Therefore, all radioactive waste removed from the patient's room should be sent to the warehouse for temporary storage of radioactive waste, located away from normal work areas

Revisão dos principais radiofármacos utilizados no Brasil e suas aplicações na detecção e terapia de patologias

Radiopharmaceuticals are substances marked with radionuclides that can be used for detection and treatment of cancer, infections and inflammatory diseases. They emit several types of radiation through different decay routes, each radioisotope with its specific properties and uses. They can usually be produced from several different materials, by bombardment with particle beams in a nuclear research reactor or cyclotron, depending on their characteristics. Brazil has four public institutions which produce - or import - and distribute radiopharmaceuticals to hospitals and clinics throughout its territory. The largest such institution, Ipen, distributes 97% of radiopharmaceuticals used in the country. Some radiopharmaceuticals decay very quickly, meaning they must be produced and quickly administered to the patient in the same location, presenting a logistical challenge. Nuclear medicine in Brazil is a promising field and has been steadily growing, although rigid laws and a lack of qualified work force hinder Research and Development efforts for new radiopharmaceuticals. The construction of a new nuclear research reactor, in 2016, should generate self-sufficiency and economy in radiopharmaceutical production and avoid a future crisis in the supply of technetium-99m, the most important radioisotope, used in over 80% of procedures with radiopharmaceuticals.