DTC清甲治疗后诊断性^(131)I SPECT/CT全身显像中的辐射剂量分析  

Analysis of radiation dose of diagnostic^(131)I SPECT/CT whole-body imaging in patients with differentiated thyroid cancer after iodine remnant ablation

作　　者：任庆余 张延华 孟庆乐 吴兴 Ren Qingyu;Zhang Yanhua;Meng Qingle;Wu Xing(Department of Nuclear Medicine,the 980th Hospital of Joint Logistics Support Force of PLA,Shijiazhuang 050082,China;Department of Pharmacy,Hebei Provincial Corps Hospital of Chinese People's Armed Police Forces,Shijiazhuang 050081,China)

机构地区：[1]联勤保障部队第九八〇医院核医学科,石家庄050082 [2]武警河北省总队医院药剂科,石家庄050081

出　　处：《国际放射医学核医学杂志》2023年第12期733-737,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨分化型甲状腺癌(DTC)清甲治疗后诊断性^(131)I SPECT/CT全身显像中,患者服^(131)I后对周围的辐射剂量及其变化规律,为辐射安全评价和职业防护研究提供依据。方法采用方便抽样方法,回顾性分析2021年6至12月在联勤保障部队第九八〇医院行诊断性^(131)I SPECT/CT全身显像的20例患者[男性5例、女性15例,年龄(45.7±11.7)岁,范围24.0~65.0岁]。采用X、γ剂量率仪分别测量患者服^(131)I后胸前体表不同时间(2、24、48、72、96 h)、距离胸前体表不同距离(1.0、2.0、3.0 m)的辐射剂量率,采用热释光探测器分别测量患者服^(131)I后第1~4天的辐射当量剂量。结果患者服^(131)I后2 h,胸前体表的辐射剂量率最高[186.12(135.52~201.01)μSv/h],且随着服^(131)I后时间的延长和距胸前体表距离的增加,辐射剂量率均明显下降;服^(131)I后96 h以上胸前体表的辐射剂量率,以及任何时间距离胸前体表3.0 m处的辐射剂量率均可达到本底辐射水平。患者服^(131)I后,第1天对周围的辐射当量剂量为(1.19±0.28)mSv(范围为0.90~1.66 mSv),从第2天开始及之后均较前1天不再明显增加。结论清甲治疗后行诊断性^(131)I SPECT/CT全身显像的DTC患者对周围的辐射剂量较低,且衰减较快,无需进行隔离;但是在服^(131)I的早期,患者体表辐射剂量较高,应避免长时间近距离接触他人,并做好内照射的防护。Objective To explore the radiation dose and its variation patterns of diagnostic^(131)I SPECT/CT whole-body imaging in patients with differentiated thyroid cancer after iodine remnant ablation to provide a basis for radiation safety evaluation and occupational protection research.Methods Using convenience sampling,retrospective analysis was conducted on 20 patients(including 5 males and 15 females,aged(45.7±11.7)years,ranging from 24.0 to 65.0 years old)who underwent diagnostic^(131)I SPECT/CT whole-body imaging at the 980th Hospital of the Joint Logistics Support Force of PLA from June to December 2021.An X-γdose rate meter was used to measure the radiation dose rate on the chest surface of patients at different time periods(2,24,48,72,and 96 h)and at different distances(1.0,2.0,and 3.0 m)after taking^(131)I.The effective dose equivalent of patients was measured on the first to fourth day by using a thermoluminescent dosimeter after taking^(131)I.Results After 2 h of taking^(131)I,the highest radiation dose rate was observed on the chest surface of patients(186.12(135.52–201.01)μSv/h),and the radiation dose rate significantly decreases with the prolongation of time after taking^(131)I and with the increase of distance from the chest surface.The radiation dose rate on the chest surface above 96 h after taking^(131)I,as well as the radiation dose rate at any time 3.0 m away from the body surface,can reach the background radiation level.After taking^(131)I,the radiation equivalent dose on the chest surface of patients was(1.19±0.28)mSv(ranging from 0.90 to 1.66 mSv)on the first day,and no significant increase was found from the second day onwards compared with the previous day.Conclusions The radiation dose rate of patients with differentiated thyroid cancer who underwent diagnostic^(131)I SPECT/CT whole-body imaging after iodine remnant ablation was low,and it decreased rapidly.Therefore,quarantine is not required for patients,but the radiation dose on the body surface is relatively high in the early stages

关 键 词：分化型甲状腺癌 甲状腺清除 碘放射性同位素 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 全身显像 辐射剂量 

分 类 号：R736.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]