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      Radiation Exposure to the Personnel Performing Myocardial Blood Flow Quantification Study Using 13N-ammonia Positron Emission Tomography/Computed Tomography

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          Abstract

          Purpose:

          The present study aimed to evaluate radiation exposure to staff performing coronary flow reserve (CFR) measurement using 13N-ammonia.

          Materials and Methods:

          The radiation exposure rate during the administration of 13N-ammonia for the rest and stress part of the study was noted using an ionization chamber-based calibrated survey monitor. The radiation exposure to persons involved in dispensing radioactivity (D1), administering radioactivity (D2) and monitoring the patient during pharmacological stress (D3) were measured using an energy compensated Si-diode personal pocket dosimeter.

          Results:

          The average dose received by individuals with dosimeters D1, D2, and D3 was 1.28 ± 0.79 µSv, 1.56 ± 0.51 µSv, and 0.88 ± 0.97 µSv per injection, respectively, during the rest of study and 1.56 ± 0.96 µSv, 2.64 ± 1.22 µSv, and 2.2 ± 1.7 µSv per injection, respectively, during stress study. The average exposure rate during the administration of 13N-ammonia at 0.5 m and 1.5 m from the injection site was found to be 259 µSv/h and 53.4 µSv/h, respectively, during the rest study and 301 µSv/h and 67.25 µSv/h, respectively, during stress study.

          Conclusion:

          The exposure to the staff performing CFR study with 13N-ammonia was well within prescribed limits by the International Commission on Radiological Protection 103. The CFR measurement with 13N-ammonia positron emission tomography/computed tomography can be included in routine workups of cardiac patients without the fear of radiation exposure.

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          Most cited references22

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          Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations.

          We investigated radiation exposure of patients undergoing whole-body 18F-FDG PET/CT examinations at 4 hospitals equipped with different tomographs. Patient doses were estimated by using established dose coefficients for 18F-FDG and from thermoluminescent measurements performed on an anthropomorphic whole-body phantom. The most relevant difference between the protocols examined was the incorporation of CT as part of the combined PET/CT examination: Separate low-dose CT scans were acquired at 2 hospitals for attenuation correction of emission data in addition to a contrast-enhanced CT scan for diagnostic evaluation, whereas, at the other sites, contrast-enhanced CT scans were used for both purposes. Nevertheless, the effective dose per PET/CT examination was similar, about 25 mSv. The dosimetric concepts presented in this study provide a valuable tool for the optimization of whole-body 18F-FDG PET/CT protocols. Further reduction of patient exposure can be achieved by modifications to the existing hardware and software of PET/CT systems.
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            EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

            The use of cardiac PET, and in particular of quantitative myocardial perfusion PET, has been growing during the last years, because scanners are becoming widely available and because several studies have convincingly demonstrated the advantages of this imaging approach. Therefore, there is a need of determining the procedural modalities for performing high-quality studies and obtaining from this demanding technique the most in terms of both measurement reliability and clinical data. Although the field is rapidly evolving, with progresses in hardware and software, and the near perspective of new tracers, the EANM Cardiovascular Committee found it reasonable and useful to expose in an updated text the state of the art of quantitative myocardial perfusion PET, in order to establish an effective use of this modality and to help implementing it on a wider basis. Together with the many steps necessary for the correct execution of quantitative measurements, the importance of a multiparametric approach and of a comprehensive and clinically useful report have been stressed.
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              • Article: not found

              N-13 ammonia as an indicator of myocardial blood flow.

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                Author and article information

                Journal
                Indian J Nucl Med
                Indian J Nucl Med
                IJNM
                Indian J Nucl Med
                Indian Journal of Nuclear Medicine : IJNM : The Official Journal of the Society of Nuclear Medicine, India
                Wolters Kluwer - Medknow (India )
                0972-3919
                0974-0244
                Oct-Dec 2023
                20 December 2023
                : 38
                : 4
                : 362-365
                Affiliations
                [1] Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
                Author notes
                Address for correspondence: Dr. Rajender Kumar, Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, India. E-mail: drrajender2010@ 123456gmail.com
                Article
                IJNM-38-362
                10.4103/ijnm.ijnm_100_23
                10880844
                38390544
                720c4c92-02a1-4638-b7e8-e4b1be211db7
                Copyright: © 2023 Indian Journal of Nuclear Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 06 September 2023
                : 01 November 2023
                Categories
                Original Article

                Radiology & Imaging
                13n-ammonia,coronary flow reserve,myocardial blood flow,radiation exposure
                Radiology & Imaging
                13n-ammonia, coronary flow reserve, myocardial blood flow, radiation exposure

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