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I-131 ve LU-177 PSMA Tedavisi Sonrası Hastaların Kurşun İzolasyonlu Odalarının Süpürme Testi ile Kontaminasyon Ölçümleri

Year 2018, , 431 - 438, 29.06.2018

Tuğba Demirbay , Kübra Harman Mustafa Demir

https://doi.org/10.17776/csj.359939

Abstract

I-131 ve Lu-177 PSMA radyonüklidleri, uzun yıllardır nükleer tıp
alanında tiroid kanseri tedavisinde yaygın şekilde kullanılmaktadır. Tedavi
süresince, doz hızı ölçümleri 3 mR / saat'in altında olan hastalar genellikle
hastaneye kaldırıldıkları odadan taburcu edilirler. Bu çalışmanın amacı
hastanın kurşun izolasyonlu odalarının I-131 ve LU-177 PSMA tedavisinden sonra
kontaminasyon ölçümlerini değerlendirmek ve radyasyon güvenliğini sağlamaktır.
Süpürme testi, Lu-177 PSMA ile tedavi edilen üç hasta ve I-131 radyonüklid ile
tedavi edilen dört hastaya ev sahipliği yapan odanın belirlenmiş alanlarından
numuneler almak için 10x10 cm2 ebatlı Whatman kağıtları kullanılarak
gerçekleştirildi. Numunelerin alınması için kullanılan Whatman kağıtları, dış
kontaminasyonu önlemek için farklı tüplerin içine yerleştirildi. Daha sonra,
tüplerin sayım işlemi hem Lu-177 hem de I-131 radyonüklidleri için farklı
kalibrasyon faktörlerine sahip olan gama sayacı kullanılarak bir dakika boyunca
yapıldı. Background
çıkarma amacıyla,  kullanılmayan
temiz Whatman kağıtlarından birine bir dakikalık sayım testi uygulanmıştır. Bu
testten sonra I-131 ve Lu-177 PSMA ile tedavi edilen hastaların sonuçları
değerlendirildi. İstatistiksel olarak sırasıyla I-131 ve Lu-177 PSMA
radyonüklidleri ile tedavi edilen hastalar için en yüksek kontaminasyonun bir
tuvalet seramik yüzeyinde gözlendiği anlaşıldı. Sonuç olarak, yeni hastaların
tedavisinden önce olası kontaminasyonların önüne geçmek için radyonüklidler ile
tedavi edilen hastaların odalarında havalandırma, kirlenmiş bölgelerin
titizlikle temizlenmesi ve süpürme testi gibi işlemler yapılmalıdır.

Keywords

Süpürme Testi Lu-177 Tadyonüklid I-131 Radyonüklid Yüzey Kontaminasyonu Radyasyon Kontaminasyonu

References

  • [1]. Ahmadzadehfar H., Eppard E., Kurpig S., Fimmers R., Yordanova A., Schlenkhoff C.D., Gartner F., Rogenhofer S. and Essler M., Therapeutic Response and Side Effects of Repeated Radioligand Therapy with 177 Lu-PSMA-DKFZ-617 of Castrate-Resistant Metastatic Prostate Cancer, Oncotarget 7 (2016) 12477-12488.
  • [2]. Rahbar K., Schmidt M., Heinzel A., Eppard E., Bode A., Yordanova A., Claesener M. and Ahmadzadehfar H., Response and Tolerability of a Single Dose of 177 Lu-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer: a Multicenter Retrospective Analysis, J. Nucl. Med. 57 (2016) 1334–1339.
  • [3]. Yeyin N., Akyel R., Abuqbeitah M., Çavdar İ., Sönmezoğlu K. and Demir M., The Evaluation of Dose Rate Measurements and Discharge Time After Radionuclide Therapy, J Ist Faculty Med 80 (2017) 1-6.
  • [4]. Daniels G. H., Radioactive Iodine: A Slice of History, Thyroid 23 (2013) 253-258.
  • [5]. Demir M., Radiobiological Effects, Protection of the Patient, Protection of Caregivers, Protection of Those Around the Patient and the Environment, Nuclear Medicine Seminars 1 (2015) 3171-3190.
  • [6]. Casara D., Rubello D., Saladini G., Piotto A., Peiizzo M.R., Girelli M.E., Busnardo B., Pregnancy After High Therapeutic Doses of Iodine-131 in Differentiated Thyroid Cancer: Potential Risks and Recommendations, Eur J Nucl Med Mol Imaging 20 (1993) 192–194.
  • [7]. Lakshmanan M., Schaffer A., Robbins J., Reynolds J. and Norton J., A Simplified Low Iodine Diet in I-131 Scanning and Therapy of Thyroid Cancer, Clin Nucl Med 13(1988) 866-880.
  • [8]. Demir M., Nükleer Tıp Fiziği ve Klinik Uygulamaları, 3rd ed. Turkey, Chap 2.
  • [9]. Willegaignon J., Sapienza M., Ono C., Watanabe T., Guimarâes M. I., Gutterres R., Marechal, M. H., Buchpiguel C., Outpatient Radioiodine Therapy for Thyroid Cancer: a Safe Nuclear Medicine Procedure, Clin Nucl Med 36 (2011) 440-445.
  • [10]. Sabbır A.S.M., Demir M., Yasar D., Uslu I., Quantification of Absorbed Doses to Urine Bladder Depending on Drinking Water During Radioiodine Therapy to Thyroid Cancer Patients: a Clinical Study Using MIRDOSE3, Nucl Med Commun 24 (2003) 749-754.
  • [11]. Özdoğan Ö., Töre G., Özkılıç H., Kır M., Yüksel D., TSNM, Procedure Guideline for I-131 Treatment of Hyperthyroidism 2.0., Nuclear Medicine Seminars 1 (2015) 44-90.
  • [12]. Driver I., Packer S., Radioactive Waste Discharge Quantities for Patients Undergoing Radioactive Iodine, Nucl Med Commun 22 (2001) 1129-1132.
  • [13]. Schneider, A. B., Radiation and Thyroid Cancer. In: Braverman L.E. (Ed.) Diseases of the Thyroid. 2nd ed. Berlin: Springer, pp (2003) 239-262.

Contamination Measurements of Patient’s Lead-Insulated Rooms After I-131 and LU-177 PSMA Treatment via Sweeping Test

Year 2018, , 431 - 438, 29.06.2018

Tuğba Demirbay , Kübra Harman Mustafa Demir

https://doi.org/10.17776/csj.359939

Abstract

I-131 and Lu-177 PSMA radionuclides have been widely
used in the field of nuclear medicine to treat thyroid cancer for many years.
In this treatment, the patients whose dose rate measurements are less than 3
mR/h are generally discharged from the lead-insulated rooms where they are
hospitalized. The aim of our study is to evaluate the contamination
measurements of these rooms after I-131 and LU-177 PSMA treatment and to ensure
radiation safety. A sweeping test was carried out by using Whatman papers
(10x10 cm2 in size) to take samples from designated areas of these rooms in
which three patients were treated with Lu-177 PSMA and four patients were
treated with the I-131 radionuclide. Whatman papers are placed inside different
tubes to prevent external contamination. Afterward, counting procedure was
taken to the tubes for one minute by using the gamma counter which has
different calibration factors both for Lu-177 and I-131 radionuclides. For the
background extraction, one-minute counting test was applied to one of the
Whatman papers that were not used for sweeping and background value was then
obtained. It was statistically understood that the highest contamination rate
was observed on the surface of toilet potteries in each room. As a result,
ventilation of the room, meticulous cleaning of contaminated areas and the sweeping
test must be implemented in each room where the patients are treated with
radionuclides before the treatment of other patients.

Keywords

Sweeping test Lu-177 radionuclide I-131 radionuclide Surface contamination radiation contamination

References

  • [1]. Ahmadzadehfar H., Eppard E., Kurpig S., Fimmers R., Yordanova A., Schlenkhoff C.D., Gartner F., Rogenhofer S. and Essler M., Therapeutic Response and Side Effects of Repeated Radioligand Therapy with 177 Lu-PSMA-DKFZ-617 of Castrate-Resistant Metastatic Prostate Cancer, Oncotarget 7 (2016) 12477-12488.
  • [2]. Rahbar K., Schmidt M., Heinzel A., Eppard E., Bode A., Yordanova A., Claesener M. and Ahmadzadehfar H., Response and Tolerability of a Single Dose of 177 Lu-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer: a Multicenter Retrospective Analysis, J. Nucl. Med. 57 (2016) 1334–1339.
  • [3]. Yeyin N., Akyel R., Abuqbeitah M., Çavdar İ., Sönmezoğlu K. and Demir M., The Evaluation of Dose Rate Measurements and Discharge Time After Radionuclide Therapy, J Ist Faculty Med 80 (2017) 1-6.
  • [4]. Daniels G. H., Radioactive Iodine: A Slice of History, Thyroid 23 (2013) 253-258.
  • [5]. Demir M., Radiobiological Effects, Protection of the Patient, Protection of Caregivers, Protection of Those Around the Patient and the Environment, Nuclear Medicine Seminars 1 (2015) 3171-3190.
  • [6]. Casara D., Rubello D., Saladini G., Piotto A., Peiizzo M.R., Girelli M.E., Busnardo B., Pregnancy After High Therapeutic Doses of Iodine-131 in Differentiated Thyroid Cancer: Potential Risks and Recommendations, Eur J Nucl Med Mol Imaging 20 (1993) 192–194.
  • [7]. Lakshmanan M., Schaffer A., Robbins J., Reynolds J. and Norton J., A Simplified Low Iodine Diet in I-131 Scanning and Therapy of Thyroid Cancer, Clin Nucl Med 13(1988) 866-880.
  • [8]. Demir M., Nükleer Tıp Fiziği ve Klinik Uygulamaları, 3rd ed. Turkey, Chap 2.
  • [9]. Willegaignon J., Sapienza M., Ono C., Watanabe T., Guimarâes M. I., Gutterres R., Marechal, M. H., Buchpiguel C., Outpatient Radioiodine Therapy for Thyroid Cancer: a Safe Nuclear Medicine Procedure, Clin Nucl Med 36 (2011) 440-445.
  • [10]. Sabbır A.S.M., Demir M., Yasar D., Uslu I., Quantification of Absorbed Doses to Urine Bladder Depending on Drinking Water During Radioiodine Therapy to Thyroid Cancer Patients: a Clinical Study Using MIRDOSE3, Nucl Med Commun 24 (2003) 749-754.
  • [11]. Özdoğan Ö., Töre G., Özkılıç H., Kır M., Yüksel D., TSNM, Procedure Guideline for I-131 Treatment of Hyperthyroidism 2.0., Nuclear Medicine Seminars 1 (2015) 44-90.
  • [12]. Driver I., Packer S., Radioactive Waste Discharge Quantities for Patients Undergoing Radioactive Iodine, Nucl Med Commun 22 (2001) 1129-1132.
  • [13]. Schneider, A. B., Radiation and Thyroid Cancer. In: Braverman L.E. (Ed.) Diseases of the Thyroid. 2nd ed. Berlin: Springer, pp (2003) 239-262.
There are 13 citations in total.

Details

Primary Language English
Journal Section Natural Sciences
Authors

Tuğba Demirbay

Kübra Harman

Mustafa Demir

Publication Date June 29, 2018
Submission Date November 30, 2017
Acceptance Date April 5, 2018
Published in Issue Year 2018

Cite

APA Demirbay, T., Harman, K., & Demir, M. (2018). Contamination Measurements of Patient’s Lead-Insulated Rooms After I-131 and LU-177 PSMA Treatment via Sweeping Test. Cumhuriyet Science Journal, 39(2), 431-438. https://doi.org/10.17776/csj.359939