Joint EURADOS-EANM initiative for an advanced computational framework for the assessment of external dose rates from nuclear medicine patients.

BACKGROUND: In order to ensure adequate radiation protection of critical groups such as staff, caregivers and the general public coming into proximity of nuclear medicine (NM) patients, it is necessary to consider the impact of the radiation emitted by the patients during their stay at the hospital or after leaving the hospital. Current risk assessments are based on ambient dose rate measurements in a single position at a specified distance from the patient and carried out at several time points after administration of the radiopharmaceutical to estimate the whole-body retention. The limitations of such an approach are addressed in this study by developing and validating a more advanced computational dosimetry approach using Monte Carlo (MC) simulations in combination with flexible and realistic computational phantoms and time activity distribution curves from reference biokinetic models. RESULTS: Measurements of the ambient dose rate equivalent H*(10) at 1 m from the NM patient have been successfully compared against MC simulations with 5 different codes using the ICRP adult reference computational voxel phantoms, for typical clinical procedures with 99mTc-HDP/MDP, 18FDG and Na131I. All measurement data fall in the 95% confidence intervals, determined for the average simulated results. Moreover, the different MC codes (MCNP-X, PHITS, GATE, GEANT4, TRIPOLI-4®) have been compared for a more realistic scenario where the effective dose rate E of an exposed individual was determined in positions facing and aside the patient model at 30 cm, 50 cm and 100 cm. The variation between codes was lower than 8% for all the radiopharmaceuticals at 1 m, and varied from 5 to 16% for the face-to face and side-by-side configuration at 30 cm and 50 cm. A sensitivity study on the influence of patient model morphology demonstrated that the relative standard deviation of H*(10) at 1 m for the range of included patient models remained under 16% for time points up to 120 min post administration. CONCLUSIONS: The validated computational approach will be further used for the evaluation of effective dose rates per unit administered activity for a variety of close-contact configurations and a range of radiopharmaceuticals as part of risk assessment studies. Together with the choice of appropriate dose constraints this would facilitate the setting of release criteria and patient restrictions.

Development of a dosimetric model for in vitro labelled cells with ß + emitters in PET tracking studies.

Positron emission tomography (PET) offers an effective method for tracking ß + emitters-labeled cells in vivo. However, in vitro high labelling activities used may cause cell damage or death. Our understanding of the impact of such procedure remains limited by the fact that the biological effects are usually linked to the activity per cell rather than the absorbed dose. To assess the dose delivered to the cells during the radiolabelling, a multi-cellular dosimetry computational tool was developed, allowing the study of two key parameters: the cell density and the labelling efficiency. Through a hybrid method based on Monte Carlo simulations (MCNP6 code) and an analytical approach implemented in Python, the mean absorbed dose received by a target cell was calculated for distributions with a very large number of cells-up to hundreds of millions. An advanced investigation of in vitro cell labelling with ß-emitting radionuclides was carried out via (i) a systematic study of the effects of the labelling parameters on the cell absorbed dose for 18F, 64Cu and 68Ga, and (ii) a quantitative comparison between cellular and conventional dosimetry. The results provided a thorough analysis of how the dose (self, cross and extracellular medium dose contributions) varies with the initial labelling parameters selected and highlighted the conditions where the cellular dosimetry is required over the conventional dosimetry. The dosimetric model was finally applied to real conditions of 18F-FDG labelling on the basis of eight reported studies. The results showed that similar activity per cell can lead to significantly different absorbed dose and pointed out differences between cellular and conventional dosimetry up to a factor of 5.

Examples of Mesh and NURBS modelling for in vivo lung counting studies.

Realistic calibration coefficients for in vivo counting installations are assessed using voxel phantoms and Monte Carlo calculations. However, voxel phantoms construction is time consuming and their flexibility extremely limited. This paper involves Mesh and non-uniform rational B-splines graphical formats, of greater flexibility, to optimise the calibration of in vivo counting installations. Two studies validating the use of such phantoms and involving geometry deformation and modelling were carried out to study the morphologic effect on lung counting efficiency. The created 3D models fitted with the reference ones, with volumetric differences of <5 %. Moreover, it was found that counting efficiency varies with the inverse of lungs' volume and that the latter primes when compared with chest wall thickness. Finally, a series of different thoracic female phantoms of various cup sizes, chest girths and internal organs' volumes were created starting from the International Commission on Radiological Protection (ICRP) adult female reference computational phantom to give correction factors for the lung monitoring of female workers.

Creation and use of adjustable 3D phantoms: application for the lung monitoring of female workers.

In vivo counting measurements, used for the monitoring of workers with internal contamination risks, are based on the use of calibration physical phantoms. However, such phantoms do not exist for female subjects. Computational calibration using numerical representations, Mesh and non-uniform rational basis spline (NURBS) geometries, was thus considered. The study presented here is focused on the creation of different female thoracic phantoms with various breast sizes and chest girths. These 3D models are used to estimate the radiation attenuation with morphology and the resulting variation of the calibration coefficient of a typical 4-germanium in vivo counting system. A basic Mesh female thoracic phantom was created from the International Commission on Radiological Protection Adult Female Reference Computational Phantom. Using this basic phantom, different chest girths (85, 90, 100, 110, and 120) and cup sizes (A to F) were created representing the most common thoracic female morphologies, as recommended by the available and relevant literature. Variation of breast tissue composition and internal organ volumes with morphology were also considered. As a result, 34 thoracic female phantoms were created combining different cup sizes and chest girths. For the 85 chest girth, at very low energies (15 keV), a relative counting efficiency variation of about 85% was observed between the A and E cups. As a result of this study, breast size dependent calibration coefficients, between 15 keV and 1.4 MeV, were obtained and tabulated for a typical lung counting germanium system.

Study of the influence of radionuclide biokinetics on the efficiency of in vivo counting using Monte Carlo simulation.

To improve calibration methods of in vivo counting, our laboratory has developed a computer tool to model internal contamination and assess in vivo activity and corresponding organ absorbed doses. The aim of the recent work was to define a more realistic source based on biokinetic models. The influence of the biokinetic parameters on the in vivo counting was studied through the simulation of an acute inhalation intake of (241)Am. The tissue distribution of activity predicted by the biokinetic model was visualized. Two equivalent methods for determination of the efficiency related to the total activity distributed in the body were used. The comparison between the efficiency taking the biokinetics into account and the classically estimated efficiency quantifies the influence of the activity distribution in the body and provides conversion factors for correcting the classical efficiency to account for biokinetics.