Tout Deborah, Davidson Gillian, Hurley Caroline, Bartley Michelle, Arumugam Parthiban, Bradley Andy
Nuclear Medicine Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Nucl Med Commun. 2014 Oct;35(10):1032-7. doi: 10.1097/MNM.0000000000000160.
Rubidium-82 (Rb-82) PET myocardial perfusion imaging (MPI) has superior diagnostic accuracy, at least similar prognostic value, and lower patient radiation exposure when compared with technetium-99m single-photon emission computed tomography (Tc-99m SPECT) MPI. The aim of this study was to compare occupational radiation exposure from the two modalities and show that improvements for the patient do not come at a cost to staff.
Electronic personal dosimeters were worn by staff involved in the administration and imaging of routine clinical Tc-99m SPECT and Rb-82 PET MPI, and during tracer production and QC. To estimate dose to the staff in the event of a medical emergency, a survey meter was placed in close contact with the patient during Rb-82 infusion and imaging, and immediately after administration for Tc-99m SPECT.
Mean (SD) whole-body effective dose to staff during a single MPI procedure was 0.4 (0.4) μSv for Rb-82 PET (1110 MBq) and 3.3 (1.7) μSv for Tc-99m SPECT (350 MBq). Staff effective dose during tracer production and QC was low (<0.2 μSv/patient) and comparable between tracers. An additional effective dose was measured at close contact to the patient during, and immediately after, tracer administration, although this will not pose a significant radiation risk to staff with either technique as long as this is not routine practice.
There is a significant reduction in effective dose during Rb-82 PET when compared with Tc-99m SPECT MPI because of the short half-life of Rb-82 and reduced patient contact.
与锝-99m单光子发射计算机断层扫描（Tc-99m SPECT）心肌灌注成像（MPI）相比，82铷（Rb-82）PET心肌灌注成像具有更高的诊断准确性、至少相似的预后价值，且患者辐射暴露更低。本研究的目的是比较这两种检查方式对工作人员的职业辐射暴露，并表明对患者的改善不会以牺牲工作人员为代价。
参与常规临床Tc-99m SPECT和Rb-82 PET MPI给药及成像的工作人员，以及在示踪剂生产和质量控制期间佩戴电子个人剂量计。为了估计医疗紧急情况下工作人员的剂量，在Rb-82输注和成像期间以及Tc-99m SPECT给药后立即将测量仪与患者密切接触放置。
单次MPI检查过程中，工作人员全身平均有效剂量，Rb-82 PET（1110 MBq）为0.4（0.4）μSv，Tc-99m SPECT（350 MBq）为3.3（1.7）μSv。示踪剂生产和质量控制期间工作人员的有效剂量较低（<0.2 μSv/患者），且两种示踪剂之间相当。在示踪剂给药期间及给药后立即与患者密切接触时测量到额外的有效剂量，不过只要这不是常规操作，这两种技术对工作人员都不会构成重大辐射风险。
与Tc-99m SPECT MPI相比，Rb-82 PET期间的有效剂量显著降低，这是由于Rb-82的半衰期短以及患者接触减少。
