DTC清甲治疗后诊断性131I SPECT/CT全身显像中的辐射剂量分析

Analysis of radiation dose of diagnostic 131I SPECT/CT whole-body imaging in patients with differentiated thyroid cancer after iodine remnant ablation

    摘要
  • 摘要:
    目的 探讨分化型甲状腺癌（DTC）清甲治疗后诊断性131I SPECT/CT全身显像中，患者服131I后对周围的辐射剂量及其变化规律，为辐射安全评价和职业防护研究提供依据。
    方法 采用方便抽样方法，回顾性分析2021年6至12月在联勤保障部队第九八〇医院行诊断性131I SPECT/CT全身显像的20例患者男性5例、女性15例，年龄（45.7±11.7）岁，范围24.0~65.0岁。采用X、γ剂量率仪分别测量患者服131I后胸前体表不同时间（2、24、48、72、96 h）、距离胸前体表不同距离（1.0、2.0、3.0 m）的辐射剂量率，采用热释光探测器分别测量患者服131I后第1~4天的辐射当量剂量。
    结果 患者服131I后2 h，胸前体表的辐射剂量率最高186.12（135.52~201.01） μSv/h，且随着服131I后时间的延长和距胸前体表距离的增加，辐射剂量率均明显下降；服131I后96 h以上胸前体表的辐射剂量率，以及任何时间距离胸前体表3.0 m处的辐射剂量率均可达到本底辐射水平。患者服131I后，第1天对周围的辐射当量剂量为（1.19±0.28） mSv（范围为0.90~1.66 mSv），从第2天开始及之后均较前1天不再明显增加。
    结论 清甲治疗后行诊断性131I SPECT/CT全身显像的DTC患者对周围的辐射剂量较低，且衰减较快，无需进行隔离；但是在服131I的早期，患者体表辐射剂量较高，应避免长时间近距离接触他人，并做好内照射的防护。

     

    Abstract:
    Objective To explore the radiation dose and its variation patterns of diagnostic 131I SPECT/CT whole-body imaging in patients with differentiated thyroid cancer after iodine remnant ablation to provide a basis for radiation safety evaluation and occupational protection research.
    Methods Using convenience sampling, retrospective analysis was conducted on 20 patients (including 5 males and 15 females, aged (45.7±11.7) years, ranging from 24.0 to 65.0 years old) who underwent diagnostic 131I SPECT/CT whole-body imaging at the 980th Hospital of the Joint Logistics Support Force of PLA from June to December 2021. An X-γ dose rate meter was used to measure the radiation dose rate on the chest surface of patients at different time periods (2, 24, 48, 72, and 96 h) and at different distances (1.0, 2.0, and 3.0 m) after taking 131I. The effective dose equivalent of patients was measured on the first to fourth day by using a thermoluminescent dosimeter after taking 131I.
    Results After 2 h of taking 131I, the highest radiation dose rate was observed on the chest surface of patients (186.12 (135.52–201.01) μSv/h), and the radiation dose rate significantly decreases with the prolongation of time after taking 131I and with the increase of distance from the chest surface. The radiation dose rate on the chest surface above 96 h after taking 131I, as well as the radiation dose rate at any time 3.0 m away from the body surface, can reach the background radiation level. After taking 131I, the radiation equivalent dose on the chest surface of patients was (1.19±0.28) mSv (ranging from 0.90 to 1.66 mSv) on the first day, and no significant increase was found from the second day onwards compared with the previous day.
    Conclusions The radiation dose rate of patients with differentiated thyroid cancer who underwent diagnostic 131I SPECT/CT whole-body imaging after iodine remnant ablation was low, and it decreased rapidly. Therefore, quarantine is not required for patients, but the radiation dose on the body surface is relatively high in the early stages of taking 131I, so abstaining the patients from contacting others is necessary.

     

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