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Radiobiology and Radiation Protection 25. MakrigiorgosGM, AdelsteinSJ, KassisAl. Limitationsof conventional Med 1983;24:l164—1175. internal dosimetry at the cellular level. JNuclMed i989;30:1856—1864. 30. FeinendegenLE.HighLET-emittersand their relativebiologicaleffective 26. FenechM, MorleyA. Measurementofmicronucleiin lymphocytes.Mzaat ness. In: SchubigerPA, Hasler PH, eds. Radionuclidesfor therapy. Pro Res l985;i47:29—36. ceedings ofthe 4th Bottstein colloquium; Villigen, Switzerland; June 13— 27. Aimassy Z, Krepinsky AB, Bianco A, Kotcies Gi. The present state and 14,1986:39—57. perspectives of micronucleus assay in radiation protection. A review. Appl 31. Cole J, ArIeti CF, Green MHL Ctal. Comparative human cellular mdi Radiat Isot l987;38:241—249. osensitivity. II. The survival following gamma-irradiation of unstimulated 28. Cole A. Absorptionof 20-eV to 50,000-eVelectronbeams in air and (G0) T-iymphocytes, T-lymphocyte lines, lymphoibiastoid cell lines and plastic. Radia: Res 1969;38:7—33. fibroblasts from normal donors@from ataxia-telangiectasia patients and 29. Kassis Al, Adeistein Si, Haydock C, Sastry KSR. Thallium-201: an exper from ataxia-telangiectasia heterozygotes. mt i Radiat Biol l988;54: imental and a theoretical radiobiological approach to dosimetry. I Nuci 929—943. SELF-STUDY TEST Radiobiology and Radiation Protection Questions are taken from the Nuclear Medicine Self-StudyProgramI, published by The Society of Nuclear Medicine DIRECTIONS The followingitems consist of a question or incomplete statement followedby fivelettered answers or completions. Select the one lettered answer or completion that is best in each case. Answers may be found on page 1182. Truestatements concerning radiation-induced thyroidcancer 17. The limitingtissueresponseoccursinthe bonemarrow. include: 18. Radiationnephritisoccursinabout5% ofpatients. I . Alltypesofthyroidcancerareincreasedinincidenceby 19. Cytogeneticchangesincirculatinglymphocytesaredirect radiation exposure. ly related to the blood dose. 2. Itis unlikelyto develop as a consequence ofadministra 20. Radiation-inducedvomitingoccurs inmore than 20% of tion of 1311in dosesusedin the diagnosisor therapyof patients. thyrotoxicosis. 3. Itcan be distinguishedfromthatoccurring spontaneously. Radiation-relatedeffectsfrom high-dose32@therapyof 4. Itismorelikelytoresultfromexposuretothethyroiddur ing adolescence than in early childhood. polycythemia vera include: 5. Itis more common followingexternalthan internalradia 21. thyroidcancer tion exposure. 22. leukemia 23. leukopenia True statements concerning probability of causation (PC) calculations for radiation-induced cancers include: Truestatements regarding radiationtherapy withradiolabeled 6. Theypertaintoaparticularcancerdiagnosedata particu lar timefollowinga particularradiationexposure. monoclonal antibodies include: 7. The PC is equal to the relativeriskfor radiation-induced 24. Itis effectiveprimarytherapy forseveral types ofcancer. cancerdividedbythesumofthatriskandthespontaneous 25. The radiation dose distributionwithina typical tumor is risk. sufficientlyuniformtoensureatumoricidaldosethrough 8. They may be applied to patients exposed to diagnostic out the tumorvolume. and therapeuticradiation. 26. The doseto normaltissues does notlimittheeffectiveness 9. Theyconsiderage,sex,andcigarettesmokinghabitsas of radiolabeled monoclonal antibodies as a sole method wellas radiation exposure. of treatment. 10. Theyare basedon the linear—quadraticmodelforall 27. Alpha-emittingradionuclides are preferred. cancers. For radiation protection purposes it is generally assumed that Iodine-131therapy forcarcinoma ofthe thyroidhas been shown a dose to a portion ofthe bone marrowcan be averaged over to cause the entire marrow. Concerning this concept, I I . excessdeathsfromcancerofthebladder. 28. a dose of 800 rads to 40% of the marrow is equivalent 12. excessdeathsfromleukemia. to 320 rads to the whole marrow. 13. increasedincidenceofmalignantsalivaryglandtumors. 29. the dose calculatedinthisfashionisthe same asthe mean 14. reducedfertility. marrow dose. I 5. overtevidenceofgeneticdamage. 30. the assumptionisconsistentwitha dose-response model incorporatingquadraticterms. 31. the assumptionappliesif partialbody doses are high True statements concerning 1311therapy for thyroid cancer enoughto killcells. Include: 32. the assumptionisthe basisofthe dose equivalentconcept. I 6. Radiationeffectsontheparathyroidglandsoccurinabout 10% of patients. (continued on page 1182) 1174 The Journal of Nuclear Medicine•Vol.33 •No. 6 •June 1992 REFERENCES 1989;l73:469—475. 6. HashimotoY, StassenJM,LcclefB,ct al.Thrombosisimagingwithan I- I. Hui KY, Haber E, Matsuda GR. Monoclonalantibodies to a synthetic 123-labeled F(ab'h fragment ofan antihuman fibrin monoclonal antibody fibrin-like peptide bind to human fibrin, but no fibrinogen. Science in a rabbit model. Radiology 1989;ill:223—226. i983,222:l129—1132. 7. Rosebrougji SF, McAfee JO, Grossman ZD, et al. Thrombosis imagins@a 2. Rosebrough SF, Grossman ZD, McAfee JG, et al. Aged venous thrombi; comparison of radiolabeled GC4 and T2G1S fibiin-specific monoclonal radioimmunoimagingwith fibnn-specific monoclonal antibody. Radiology antibodies. JNuclMed 1990;31:1048-l054. l987;l62:575—577. 8. Rubin RH, FischmanAS,NeedlemanM, et al. Radiolabeled,nonspecific, 3. Knight LC, Maurer AH, Ammar IA, et al. Evaluation of indium-ill polyclonai human immunogiobulin in the detection offocal inflammation labeledanti-fibrinantibodyfor imagingvascularthrombi.J NuclMed by scintigraphy with gallium-87 citrate and technetium-99m-iabeled albu i98829:494-502. mm. JNuclMed 1989;30:385—389. 4. Rosebrough SF, Grossman ZD, McAfeeJG, et al. Thrombus ima@ngwith 9. KairemoK.JA,WiklundTA, LiewendahiK, MiettinenM, HeikkonenJJ, indium-ill and iodine-13i-iabeledfibrin-specificmonoclonal antibody Ct al. Imaging ofsoft-tissue sarcoma with indium-ill-labeled monocional anditsF(ab'handF(ab)fragments.JNuclMed 198829:l2l2—l222. antimyosin Fab fragments. INuc/Med i990,3i:23-3l. 5. Jung M, IGetterK, DudczakR, et al. Deep veinthmmbosis scintigraphic 10. FlschmanAJ. When magic ballets ricochet[Editorial].I NucI Med diagnosiswith In-ill-labeled monoclonal anti-fibrin antibodies. Radiology l990;3l:32—33. (continued from page 1174) SELF.STUDY TEST Radiobiology and Radiation Protection Questionsaretakenfromthe NuclearMedicineSelf-StudyProgramI, published by The SoCietyof Nuclear Medicine Yournuclear medicine clinic operates from 8AMto 5PMMon 34. The amountof O9mTcspilledis sufficientlygreatthatthe day through Friday and is closed on Saturdays and Sundays. person whocleans up the debris and decontaminatesthe On Friday afternoon at 1PMa technologist who was prepar areashouldwearleadgloves,a leadapron,andspecial ing 9@mTcmacroaggregated albumin dropped the (99mTc] disposable clothing. pertechnetate stock vial. The vial, which contained 20 GBq 35. Theexposurerate(mR/hour)inthedosecalibrator/dose (about 500 mCi) of (99mTcJpertechnetate, broke and its con preparationareawill be sufficientlygreatto requirethat workinthisareabediscontinuedfortheremainderofthe tents splashed on the floor,the wall, and the adjacent cabinets. day. The contaminated area was infrontofthe radioactive material 36. Thecontaminatedareashouldbecompletelydecontami storage and waste disposal area, which is about 4 m from the natedtobackgroundlevelsbeforeleavingfortheweekend dose preparation area and the dose calibrator. Which of the sothathousekeepingpersonnelwill not be exposedto following statements concerning this accident are true? excessive radiation levels. 33. The amountof99―Tcspilledistoolargetobe ignoredand to be allowed to decay to background levels. SELF-STUDY Skeletal NuclearTESTMedicineAN$WIR$ ITIN$ 1—5iRdlatlon-lnducd ThyroIdCancer ITIMI S—lOiCalculatIngProbabllftyof Causation ANSWERS:1, F; 2, T;a F; 4, F; 5, T ANSWERS:6,@7,1@8,F;9,1@10,F Thyrcidcancer,in @spapillaryform,isthepredominantradia@on-inducedTheradioepidemiologictablesthat provideprobat@lftyofcausation(PC) entity, with a lesser increase in follicular cancer. The incidences of values were designed to estimate the likelihood that a person who has medullaryand anaplasticcancersare notincreasedby radiationex orhashada “radiation-related―cancerandwhoreceiveda specific posurs The etiologyofindividualcases ofthyroidcancer cannot be at doseof radiationpriortoitsonsetdevelopedthediseaseasa resultof tnbutedtoradiationbyanypathologicalcriteriacurrentlyknown.Expo theirradialon.Proba@yofcausalontablaspertalntoaparticularcancer sureto1311hasnotbeenshowntocauseanincreasedincidenceofthyroid in a particular individual. cancerinmedicallytreatedhumansubjects,whereasx-raytherapyhas Therelativeriskperunitofradiationdosecanbeusedtodetermine been shownto be a potent cause, especiallyinthe youngest exposed the PC that a given cancer is the result of a previous exposure; this is individuals,femalesbeingmoresensitivethanmales.Adolescentsare calculated by use of the following relationship: less sensitivethan youngerchildren.The relativeriskfollowingexternal irradiationisatleastthreetimesgreaterthanthatfollowingirradiation PC—R/(1+ A), by internal emitters. whereAistherelati@riskduetoradiationexposureandthespontaneous 1. Schneider AB, Recant w, Pinsky SM, Ryo UY, Bekerman c, Shore-Freedman riskis1. E. Radia@on-induced thyrcid carcinoma. clinical course and results oftherapy Patientsexposedto diagnosticandtherapeutic radiationare different in 296 patienta Ann Intern Med 1986;105:405-412. fromthe general populationto some degree.
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