Nuclear medicine: workplace monitoring and internal occupational exposure during a ventilation/perfusion single-photon emission tomography.

The administration of 99mTc-HDP to diagnose pulmonary thromboembolisms leads to the presence of 99mTc in the environment of a nuclear medicine department, which could pose a potential risk of internal contamination to medical staff. Therefore, air samples from the administration room, gamma camera room and corridor of such a department were taken for the purpose of performing a workplace monitoring program of the medical centre under study, with maximum activity values of 640 ± 30 kBq/m3, 1.5 ± 0.1 kBq/m3 and 54 ± 3 kBq/m3, respectively, being obtained. These results correspond to committed effective doses received by exposed employees, via inhalation, when one ventilation/perfusion single-photon emission tomography study was performed, of 0.7 µSv, 0.004 µSv and 0.2 µSv, respectively. As inhalation is the employees' main exposure pathway to radio-aerosols, the internal dose of the nuclear medicine department's medical staff was also evaluated via urine bioassay measurements. Nuclear medicine nurses showed the highest 99mTc activity in 24-h urine samples (2100 ± 130 Bq/day), resulting in a committed effective dose of 21 µSv for each diagnostic study performed. Even so, the performance of ventilation/perfusion diagnostic studies did not constitute a substantial radiological risk since the annual dose limit for exposed employees was not exceeded.

A method for accurate zero calibration of asymmetric jaws in single-isocenter half-beam techniques.

PURPOSE: To present a practical method for calibrating the zero position of asymmetric jaws that provides higher accuracy at the central axis and improves dose homogeneity in the abutting region of half-beams. METHODS: Junction doses were measured for each asymmetric jaw using the double-exposure technique and electronic portal imaging devices. The junction dose was determined as a function of jaw position. The shift in the zero jaw position (or in its corresponding potentiometer readout) required to correct for the measured junction dose could thus be obtained. The jaw calibration was then modified to introduce the calculated shift and therefore achieve an accurate zero position in order to provide a relative junction dose that was as close to zero as possible. RESULTS: All the asymmetric jaws from four medical linear accelerators were calibrated with the new calibration procedure. Measured relative junction doses at gantry 0° were reduced from a maximum of ±40% to a maximum of ±8% for all the jaws in the four considered accelerators. These results were valid for 6 MV and 18 MV photon beams and for any combination of asymmetric jaws set to zero. The calibration was stable over a long period of time; therefore, the need for recalibrating is seldom necessary. CONCLUSIONS: Accurate calibration of the zero position of the jaws is feasible in current medical linear accelerators. The proposed procedure is fast and it improves dose homogeneity at the junction of half-beams, thus, allowing a more accurate and safer use of these techniques.

Cosmetic outcome of breast conservative treatment for early stage breast cancer.

PURPOSE: To evaluate the cosmetic outcome of breast conservative therapy and to examine the degree of agreement between the patients' and oncologists' ratings. We also analyze the influence of several factors on cosmesis. METHODS AND MATERIALS: We retrospectively evaluated 145 patients with primary breast cancer treated by local excision and radiotherapy between January 2000 and May 2001. Cosmetic outcome was evaluated by doctors and patients and was scored as excellent, good, fair or poor. RESULTS: 73% of patients rated cosmesis as excellent or good while the percentage was 71% when rated by radiation oncologists. The degree of cosmesis concordance evaluated by oncologists and patients was low (kappa = 0.3). In our study the variables which significantly influence on the cosmetic outcome were concomitant adjuvant chemotherapy (p = 0.04) and radiation therapy boost, either by electron beam or brachytherapy (p = 0.013). CONCLUSION: The cosmetic outcome of breast conserving therapy was good. There was a similar rating by the patient and radiation oncologist, but the level of concordance between patients and doctors was low. Factors that significantly influence the cosmesis appear to be concomitant adjuvant chemotherapy and radiation therapy boost.