Article Figures & Data
Figures
- FIGURE 1.
Number of nuclear medicine procedures in United States from 1984 to 2006. In this time span, number of nuclear medicine procedures increased by almost factor of 3, from 6.3 to 18.1 million (4).
- FIGURE 2.
Estimated annual per capita adult effective dose in United States. Chart on left illustrates distribution of effective dose in 1980–1982. Chart on right shows distribution in 2006 (6).
- FIGURE 3.
Dose response for incidence of solid cancer as function of weighted colon dose as derived from Life Span Study. Weighted colon dose was used as surrogate for whole-body dose within Life Span Study. Solid line demonstrates linear fit through data. (Reprinted with permission of (36).)
- FIGURE 4.
Excess relative risk per dose (ERR/Gy) of thyroid cancer from 6 epidemiologic studies including Life Span Study. Excess relative risk is traditional relative risk minus 1 (e.g., if relative risk is 2.5, then excess relative risk is 1.5) and represents fractional increase in natural disease rate as result of exposure in question. □ = value adjusted for nonzero intercept because lower bound was less than zero. Most subjects in these studies were children. Results show consistency. (Reprinted with permission of (40).)
- FIGURE 5.
Extrapolation models for estimating radiation risk at low dose. Image shows 4 models: linear, no threshold (solid black line); linear, with threshold (dashed black line); super linear (blue line); and hormetic (red line) (42).
- FIGURE 6.
Lifetime attributable risk of cancer death as function of age at time of exposure and sex resulting from 10-mSv exposure. Dashed lines indicate attributable risk levels of 1 in 700, 1 in 1,000, and 1 in 2,000 corresponding to sex-averaged risk for 1-, 10-, and 40-y-old, respectively (3).
- FIGURE 7.
Demonstration of 1 in 2,500 risk in comparison to 550 in 2,500. For example of 10-y-old receiving 99mTc-MDP bone scan, excess attributable risk for cancer death is 1 in 2,500. In this figure, there are 2,500 small circles. Lone red star at lower right represents 1 case in 2,500 in which bone scan patient may contract fatal cancer. In addition, there are 550 dark blue circles that represent number of the original 2,500 that will naturally die of cancer (22%).
Tables
- TABLE 1
Estimates of Critical Organ and Effective Dose for Common Pediatric Nuclear Medicine Procedures
Max admin act (MBq) 1-y-old 5-y-old 10-y-old 15-y-old Adult Mass (kg) 9.7 19.8 33.2 56.8 70 99mTc-MDP* 740 Bone surface (mGy) 54.5 46.0 45.6 49.2 46.6 Effective dose (mSv) 2.8 2.9 3.9 4.2 4.2 99mTc-ECD† 740 Bladder wall (mGy) 13.4 23.0 30.5 37.2 37.0 Effective dose (mSv) 4.1 4.6 5.3 5.9 5.7 99mTc-sestamibi* 740 Gallbladder (mGy) 32.9 20.9 20.4 27.0 28.9 Effective dose (mSv) 5.4 5.9 6.3 7.2 6.7 99mTc-MAG3* 370 Bladder wall (mGy) 17.2 19.8 31.3 44.1 42.7 Effective dose (mSv) 1.2 1.3 2.2 2.8 2.7 123I-MIBG* 370 Liver (mGy) 16.6 18.5 22.4 25.6 24.8 Effective dose (mSv) 3.4 3.8 4.5 5.0 4.8 18F-FDG† 370 Bladder wall (mGy) 25.6 35.9 44.4 48.8 50.5 Effective dose (mSv) 5.2 5.9 6.6 7.3 7.4 Procedure Average effective dose (mSv) Posterior/anterior and lateral chest radiography 0.1 99mTc-radionuclide cystography 0.1 Mammography 0.4 Lumbar spine radiography 1.5 Head CT 2.0 99mTc-MAG3 renal scanning 2.7 Intravenous urography 3.0 99mTc-MDP bone scanning 4.2 123I-metaiodobenzylguanidine scanning 4.8 99mTc-ethylcysteinate dimer brain scanning 5.7 Pelvic CT 6.0 99mTc-sestamibi for stress/rest cardiac scanning 6.7 Chest CT 7.0 Coronary angiography 7.0 18F-FDG PET scanning 7.4 Abdominal CT 8.0 Coronary angioplasty with stent placement 15.0 Radiopharmaceutical doses are from Table 1 except 99mTc-radionuclide cystogram dose (24–27). Radiographic doses are from Mettler et al. (23).
- TABLE 3
Estimate of Radiation Dose to Anthropomorphic Phantom from CT Component of Hybrid Imaging as Function of Patient Size and Tube Current
Patient size 40 mA 80 mA 160 mA Newborn 5.05 10.1 20.20 1-y-old 4.45 8.89 17.78 5-y-old 4.08 8.16 16.31 10-y-old 3.67 7.35 14.69 Medium adult 2.55 5.10 10.19 All data were acquired with tube voltage of 120 kVp, rotation speed of 0.8 s, and pitch of 1.5:1. All data were acquired with 160 mA and linearly scaled for the various tube currents shown here (30).
- TABLE 4
Lifetime Excess Attributable Risk of Mortality per 100,000 Individuals for 10-mSv Whole-Body Exposure (3)
Tumor type Sex Newborn 10-y-old 40-y-old Breast F 27.4 16.7 3.5 Lung F 64.3 44.2 21.2 M 31.8 21.9 10.7 Colon F 10.2 7.3 3.7 M 16.3 11.7 6.0 All solid F 172 105 45.5 M 103 64.1 31.0 Leukemia F 5.3 5.3 5.2 M 7.1 7.1 6.7 - TABLE 5
Administered Activity and Estimates of Radiation Dose and Additional Relative Risk for 99mTc-MAG3
Age (y) Weight (kg) Administered activity (MBq) Effective dose (mSv) Risk (%) 1 9.7 53.8 1.2 0.04 5 19.8 109.9 1.3 0.03 10 33.2 184.3 2.2 0.05 15 56.8 315.2 2.8 0.05 20 70.0 388.5 2.7 0.04 40 70.0 388.5 2.7 0.02 Activity Lifetime risk Assault 214 Accident while riding in car 304 Accident as pedestrian 652 Choking 894 Accidental poisoning 1,030 Drowning 1,127 Exposure to fire or smoke 1,181 Cancer from 18F-FDG PET scan (10-y-old) 1,515 Falling down stairs 2,024 Cancer from 99mTc-MDP bone scan (10-y-old) 2,560 Cancer from 18F-FDG PET scan (40-y-old) 2,700 All forces of nature 3,190 Accident while riding bike 4,734 Cancer from 99mTc-MDP bone scan (40-y-old) 4,760 Accidental firearms discharge 6,333 Accident while riding in plane 7,058 Falling off ladder or scaffolding 10,606 Hit by lightning 84,388 Lifetime risk of 304 for accident while riding in car indicates that 1 of every 304 Americans will die as result of accident while riding in car during his or her lifetime.
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