Abstracts ASN Report 2019

The installation of semi-conductor cameras (CZT –Cadmium Zinc Telluride), which have very high detection sensitivity, is continuing to develop, particularly in health care centres performing a large number of examinations of the myocardial function. These cameras effectively provide for faster and more comfortable scintigraphic imaging and give a more reliable diagnosis. Research in this area is continuing with the installation ļŁ ӅӃӄӋׇłĹ Ĵ " ӆ ĴŁķ ŊĻłĿĸ ĵłķŌ ĺĴŀŀĴіĶĴŀĸŅĴ ĴĿĿłŊļŁĺ spatial viewing of the entire body. According to the survey conducted with the nuclear medicine ňŁļŇņ ļŁ ӅӃӄӋё ŇĻĸ ļŁņŇĴĿĿĸķ ŃłłĿ łĹ ĴŁķ " ĶĴŀĸŅĴņ comprises: Ҋ ӇӅӆׇ ĶĴŀĸŅĴņё łĹ ŊĻļĶĻ ӊӃՌ ĴŅĸ ĶłňŃĿĸķ Ňł Ĵ ĶłŀŃňŇĸķ ŇłŀłĺŅĴŃĻŌ Ҏ ҏ ņĶĴŁŁĸŅё ĴĶĶłňŁŇļŁĺ ĹłŅ ӌӅӇёӃӃӃׇŃŅłĶĸķňŅĸņ per year; Ҋ ӈӄׇņĸŀļіĶłŁķňĶŇłŅ ĶĴŀĸŅĴņ Ҏ " ҏё łĹ ŊĻļĶĻ ӊׇĴŅĸ ĶłňŃĿĸķ Ňł Ĵ ņĶĴŁŁĸŅё ĴĶĶłňŁŇļŁĺ ĹłŅ ӄӅӈёӃӃӃׇŃŅłĶĸķňŅĸņ ŃĸŅ ŌĸĴŅє The installed pool of PET cameras comprises: Ҋ ӄӈӋׇ ĶĴŀĸŅĴņё ĴĿĿ ĶłňŃĿĸķ Ňł Ĵ ņĶĴŁŁĸŅё ĴĶĶłňŁŇļŁĺ ĹłŅ ӇӋӉёӃӃӃׇŃŅłĶĸķňŅĸņ ŃĸŅ ŌĸĴŅђ Ҋ Ӈׇ ĶĴŀĸŅĴņ ĶłňŃĿĸķ Ňł ĴŁ ņŌņŇĸŀё ĴĶĶłňŁŇļŁĺ ĹłŅ ӅёӃӄӉׇŃŅłĶĸķňŅĸ ŃĸŅ ŌĸĴŅє ג ِ׏ِ ڙ א In vitro ƳǣƏǕȇȒɀǣɀ This is a medical biology technique that enables certain compounds contained in biological fluid samples taken from the patient, such as hormones or tumoral markers, to be assayed, without administering radionuclides to the patient. This technique uses assaying methods based on immunological reactions (reactions between antigens and antibodies marked with iodine-125), hence the name Radio Immunology Assay or radioimmunoassay –RIA). The activities contained in the analysis kits designed for a series of assays do not exceed a few thousand becquerels (kBq). Radioimmunology is currently challenged by techniques which make no use of radioactivity, such as immuno- ĸŁōŌŀłĿłĺŌ ĴŁķ ĶĻĸŀļĿňŀļŁĸņĶĸŁĶĸє ĹĸŊ ŇĸĶĻŁļńňĸņ ňņĸ łŇĻĸŅ radionuclides such as tritium or carbon-14. Here again the activity levels involved are of the order of the kilobecquerel. ג ِ׏ِ ב XȇɎƺȸȇƏǼ ɎƏȸǕƺɎƺƳ ȸƏƳǣȒɎǝƺȸƏȵɵ Used for therapeutic purposes, the aim of the administered RPDs is to deliver a high dose of ionising radiation to a target organ for curative or palliative purposes. Two areas of therapeutic application of nuclear medicine can be identified: oncology and non-oncological conditions (treatment of forms of hyperthyroidism, synoviorthesis). ĸʼnĸŅĴĿ ŇŌŃĸņ łĹ ĶĴŁĶĸŅ ŇŅĸĴŇŀĸŁŇ ĶĴŁ ĵĸ ļķĸŁŇļĹļĸķѓ Ҋ treatments administered by nonspecific systemic route (thyroid cancer by iodine-131, non-Hodgkin lymphoma by ŀłŁłĶĿłŁĴĿ ĴŁŇļĵłķļĸņ ŀĴŅľĸķ ŊļŇĻ ŌŇŇŅļňŀіӌӃё ŃŅłņŇĴŇĸ cancer which has spread to the bones by radium-223, treatment !X(««0 ي Ə ɎȒȒǼ ǔȒȸ ɀɎɖƳɵǣȇǕ Ɏǝƺ ƳȒɀǣȅƺɎȸǣƬ ǣȅȵƏƬɎ ɎǝƏɎ ȸƏƳǣȒȇɖƬǼǣƳƺ ƳǣɀƬǝƏȸǕƺɀ ǝƏɮƺ Ȓȇ ɀƺɯƏǕƺ ȇƺɎɯȒȸǸ ɯȒȸǸƺȸɀ Xȇ hɖȇƺ א ׎׏ ח ً X«³z ȵɖɎ Ȓȇ Ǽǣȇƺ Ə ȇƺɯ ƬƏǼƬɖǼƏɎǣȒȇ ɎȒȒǼ ǔȒȸ ƺɀɎǣȅƏɎǣȇǕ Ɏǝƺ ƳȒɀƺɀ ǼǣǸƺǼɵ ɎȒ ƫƺ ȸƺƬƺǣɮƺƳ ƫɵ ɀƺɯƏǕƺ ȇƺɎɯȒȸǸ ƏȇƳ ɯƏɀɎƺɯƏɎƺȸ ɎȸƺƏɎȅƺȇɎ ȵǼƏȇɎ ȵƺȸɀȒȇȇƺǼ ɯǝȒ ƬƏȇ ƬȒȅƺ ǣȇɎȒ ƬȒȇɎƏƬɎ ɯǣɎǝ ȸƏƳǣȒƏƬɎǣɮƺ ƺǔǔǼɖƺȇɎɀ ƳǣɀƬǝƏȸǕƺƳ ƫɵ ȅƺƳǣƬƏǼ ǼƏƫȒȸƏɎȒȸǣƺɀ Ȓȸ ȇɖƬǼƺƏȸ ȅƺƳǣƬǣȇƺ ƳƺȵƏȸɎȅƺȇɎɀِ This digital model called CIDRRE (French acronym for “Calculation of the impact of radioactive discharges into drainage networks”), provides an estimation of the impact of radionuclide discharges on the sewage system workers and workers spreading sludge from wastewater treatment. Áǝƺ ƬɖǼȅǣȇƏɎǣȒȇ Ȓǔ Ə ȵȸȒǴƺƬɎ ǼƏɖȇƬǝƺƳ ǣȇ א ׎׏ ژא Ȓȇ Ɏǝƺ initiative of ASN, CIDRRE is accessible to all the stakeholders (network managers, persons/entities responsible for nuclear activities) under the discharge ƏɖɎǝȒȸǣɀƏɎǣȒȇɀ ȵȸȒɮǣƳƺƳ ǔȒȸ ǣȇ ȸɎǣƬǼƺ nِ ژ ׏ בב ׏ ٮ ׏׎ ژ Ȓǔ Ɏǝƺ Public Health Code. The calculation provides dose estimates at the different work stations concerned, based on conservative assumptions. In practice, a nuclear medicine department shall run the calculation using, for example, the total administered activities of the various radionuclides over one year as the input data. These results can be taken ǣȇɎȒ ژ ƬȒȇɀǣƳƺȸƏɎǣȒȇ ƫɵ Ɏǝƺ ƺȅȵǼȒɵƺȸɀ Ȓǔ ɀƺɯƏǕƺ ȇƺɎɯȒȸǸ personnel in their procedure for assessing the risk ȅƺȇɎǣȒȇƺƳ ǣȇ ȸɎǣƬǼƺ «ِ דגגژ ׏ ٮ ׏ ژג Ȓǔ Ɏǝƺ nƏƫȒɖȸ !ȒƳƺِ The regulations set the exposure limit of the personnel ƏɎ ژ ׏ ژ ȅ³ɮٖɵƺƏȸ ɀȒ ɎǝƏɎ Ɏǝƺɵ ƳȒ ȇȒɎ ƺȇɎƺȸ ǣȇɎȒ Ɏǝƺ ƬƏɎƺǕȒȸǣƺɀ of specially monitored workers. The estimates calculated during the CIDRRE test phases gave exposures that were ƏǼɯƏɵɀ ƫƺǼȒɯ Ɏǝƺ ׏ ژ ȅ³ɮ ǼǣȅǣɎِ TABLE 3 Main radionuclides used in diverse in vivo nuclear medicine explorations TYPE OF EXAMINATION RADIONUCLIDES USED Thyroidmetabolism Iodine-123, technetium-99m Myocardial perfusion Thallium-201, technetium-99m, rubidium-82 Lung perfusion Technetium-99m Lung ventilation Technetium-99m, krypton-81m Osteoarticular process Technetium-99m, fluorine-18 Renal exploration Technetium-99m Oncology – search for metastases Technetium-99m, fluorine-18, gallium-68 Neurology Technetium-99m, fluorine-18 214 ASN Report on the state of nuclear safety and radiation protection in France in 2019 ׎ ٲ ו MEDICAL USES OF IONISING RADIATION