Effect of urinary excretion on radiation dose in patients having PET/CT scans

Effect of urinary excretion on radiation dose in patients having PET/CT scans

Objectives: 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/ computed tomography(PET/CT) is commonly used for diagnosis, staging and re-staging of cancers and for determining theeffectiveness of treatment. Because of renal, ureteral and urinary involvement of 18F-FDG radiopharmaceuticalafter its injection, patients subject to radioactivity during its effective half-life. The aim of the present studywas to determine the degree of association between effective dose levels of patients and bladder emptying ofpatients having PET/CT scans.Methods: The present retrospective study included 108 patients (43 females and 65 males, average age: 60.9± 12.7 years). Effective dose level as mSv/h was determined from a distance of 1 m in all patients before andafter bladder emptying at the first hour following 18F-FDG injection. Radioactivity excretion amounts werecompared based on gender, age, body mass index, fasting blood sugar level and clinical diagnosis.Results: Amount of radioactivity decreased by 22.75% ± 14.77% after bladder emptying. No association wasfound between urinary excretion level and age, gender, fasting blood sugar and body mass index (p > 0.05).Conclusions: Active emptying of bladder in patients having PET/CT scans where 18F-FDG radiopharmaceuticalis involved is an effective method for the radiation safety of both health workers and patients.

___

  • [1] Siegel JA, Stabin MG. Medical imaging: the challenges of radiation risk assessment. J Nucl Med 2014;55:16-7.
  • [2] Grigsby PW. The prognostic value of PET and PET/CT in cervical cancer. Cancer Imaging 2008;8:146-55.
  • [3] Anderson C, Koshy M, Staley C, Esiashvili N, Ghavidel S, Fowler Z, et al. PET-CT fusion in radiation management of patients with anorectal tumors. Int J Radiat Oncol Biol Phys 2007;69:155-62.
  • [4] Jha AK, Zade A, Rangarajan V. Estimation of radiation dose received by the radiation worker during F-18 FDG injection process. Indian J Nucl Med 2011;26:11-3.
  • [5] Hasbek Z, Doğan ÖT, Sarı İ, Yücel B, Şeker MM, Turgut B, et al. The diagnostic value of the correlation between serum antip53 antibody and positron emission tomography parameters in lung cancer. Mol Imaging Radionucl Ther 2016;25:107-13.
  • [6] Delgado Bolton RC, MucientesRasilla J, Perez Castejon MJ, Carreras Delgado JL. [Positron emission tomography (PET) and PET-CT in renal, bladder and prostate cancer: update]. Actas Urol Esp 2009;33:11-23. [Article in Spanish]
  • [7] Hoilund-Carlsen PF, Poulsen MH, Petersen H, Hess S, Lund L. FDG in urologic malignancies. PET Clin 2014;9:457-68.
  • [8] Khiewvan B, Torigian DA, Emamzadehfard S, Paydary K, Salavati A, Houshmand S, et al. Update of the role of PET/CT and PET/MRI in the management of patients with cervical cancer. Hell J Nucl Med 2016;19:254-68.
  • [9] Do KH. General principles of radiation protection in fields of diagnostic medical exposure. J Korean Med Sci. 2016;31:6-9.
  • [10] Börksüz MF, Erselcan T, Hasbek Z, Yücel B, Turgut B. Morphologic and metabolic comparison of treatment responsiveness with 18fludeoxyglucose-positron emission tomography/ computed tomography according to lung cancer type. Mol Imaging Radionucl Ther 2016;25:63-9.
  • [11] Shyn PB. Interventional positron emission tomography/computed tomography: state-of-the-art. Tech Vasc Interv Radiol 2013;6:182-90.
  • [12] Hasbek Z, Yucel B, Salk I, Turgut B, Erselcan T, Babacan NA, et al. Potential impact of atelectasis and primary tumor glycolysis on F-18 FDG PET/CT on survival in lung cancer patients. Asian Pac J Cancer Prev 2014;15:4085-9.
  • [13] Anjos DA, Etchebehere EC, Ramos CD, Santos AO, Albertotti C, Camargo EE. 18F-FDG PET/CT delayed images after diuretic for restaging invasive bladder cancer. J Nucl Med 2007;48:764-70.
  • [14] Gorospe L, Jover-Diaz R, Vicente-Bartulos A. Spectrum of PET-CT pelvic pitfalls in patients with gynecologic malignancies. Abdom Imaging 2012;37:1041-65.
  • [15] Yildirim-Poyraz N, Ozdemir E, Uzun B, Turkolmez S. Dual phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography with forced diuresis in diagnostic imaging evaluation of bladder cancer. Rev Esp Med Nucl Imagen Mol 2013;32:214-21.
  • [16] Noh S, Jeong S, An M, Jang HK, Kwon TE, Lee JI, et al. Internal dosimetry for intake of 18FDG using spot urine sample. Radiat Prot Dosimetry 2016;168:343-9.
  • [17] Bach-Gansmo T, Dybvik J, Adamsen T, Naum A. Variation in urinary excretion of FDG, yet another uncertainty in quantitative PET. Acta Radiol Short Rep 2012;1(8). pii: arsr.2012.120038.
  • [18] Stangenberg L, Shuja F, van der Bom IMJ, van Alfen MHG, Hamdan AD, Wyers MC, et al. Modern fixed imaging systems reduce radiation exposure to patients and providers. Vasc Endovascular Surg 2018;52:52-8.
  • [19] Chen MK, Menard DH, Cheng DW. Determining the minimal required radioactivity of 18F-FDG for reliable semiquantification in PET/CT imaging: a phantom study. J Nucl Med Technol 2016;44:26-30.
  • [20] ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Approved by the Commission in October 2007. Ann ICRP 2008;38:1-197.
  • [21] Kode V, Karsch H, Osman MM, Muzaffar R. Impact of renal failure on F18-FDG PET/CT scans. Front Oncol 2017;7:155.
  • [22] Aydoğan F, Uygun K. Kanser hastalarında palyatif tedaviler. Klinik Gelişim 2011;24:4-9.
  • [23] Elçigil A. [Palliative care nursing]. Gülhane Tıp Derg 2012;54:329-34. [Article in Turkish]