Abstract:Objective To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.
[1] LI Y,TENG D,BA J,et al.Efficacy and safety of long-term universal salt iodization on thyroid disorders:epidemiological evidence from 31 provinces of mainland China[J].Thyroid,2020,30(4):568-579. [2] 冯珏. Graves甲状腺功能亢进症的正确诊断与规范化治疗[J].临床荟萃,2016,31(3):233-236. [3] 中华人民共和国国家卫生健康委员会.核医学放射防护要求:GBZ 120—2020[S].2020. [4] 郭佳娣,郦依华,俞顺飞,等.2011—2019年浙江省11家省级医院放射工作人员外照射个人剂量监测结果分析[J].预防医学,2021,33(9):948-950. [5] 章群,张丹丹,王爱红,等.数字X线检查北仑区成人体表照射剂量参考值研究[J].预防医学,2022,34(4):400-403. [6] 李亚明,王辉,马婷,等.核医学护士工作手册[M].北京:人民卫生出版社,2015:6-7. [7] 武含露,闫志华,李祥周,等.分化型甲状腺癌患者131I治疗后诊断性全身显像周围剂量当量率动态变化的研究[J].国际放射医学核医学杂志,2020,44(4):212-216. [8] GRANLUND C,THILANDER-KLANG A,YLHAN B,et al.Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations[J/OL].Br J Radiol,2016,89(1066)[2022-12-28].https://doi.org/10.1259/bjr.20151052. [9] 中华人民共和国卫生部,中国国家标准化管理委员会.临床核医学的患者防护与质量控制规范:GB 16361—2012[S].北京:中国标准出版社,2012. [10] 中华人民共和国国家质量监督检验检疫总局.电离辐射防护与辐射源安全基本标准:GB 18871—2002[S].2002. [11] MOUNTFORD P J.Estimation of close contact doses to young infants from surface dose rates on radioactive adults[J].Nucl Med Commun,1987,8(11):857-863.