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There is a widespread variation in the practices with regard to the release of patients from hospital after unsealed radionuclide therapies. This publication harmonizes the different approaches, drawing on advice issued by the International Commission on Radiological Protection and on a number of regional and national approaches.
Radioimmunotherapy, also known as systemic targeted radiation therapy, uses antibodies, antibody fragments, or compounds as carriers to guide radiation to the targets. It is a topic rapidly increasing in importance and success in treatment of cancer patients. This book represents a comprehensive amalgamation of the radiation physics, chemistry, radiobiology, tumor models, and clinical data for targeted radionuclide therapy. It outlines the current challenges and provides a glimpse at future directions. With significant advances in cell biology and molecular engineering, many targeting constructs are now available that will safely deliver these highly cytotoxic radionuclides in a targeted fashion. A companion website includes the full text and an image bank.
Does radiation medicine need more regulation or simply better-coordinated regulation? This book addresses this and other questions of critical importance to public health and safety. The issues involved are high on the nation's agenda: the impact of radiation on public safety, the balance between federal and state authority, and the cost-benefit ratio of regulation. Although incidents of misadministration are rare, a case in Pennsylvania resulting in the death of a patient and the inadvertent exposure of others to a high dose of radiation drew attention to issues concerning the regulation of ionizing radiation in medicine and the need to examine current regulatory practices. Written at the request from the Nuclear Regulatory Commission (NRC), Radiation in Medicine reviews the regulation of ionizing radiation in medicine, focusing on the NRC's Medical Use Program, which governs the use of reactor-generated byproduct materials. The committee recommends immediate action on enforcement and provides longer term proposals for reform of the regulatory system. The volume covers: Sources of radiation and their use in medicine. Levels of risk to patients, workers, and the public. Current roles of the Nuclear Regulatory Commission, other federal agencies, and states. Criticisms from the regulated community. The committee explores alternative regulatory structures for radiation medicine and explains the rationale for the option it recommends in this volume. Based on extensive research, input from the regulated community, and the collaborative efforts of experts from a range of disciplines, Radiation in Medicine will be an important resource for federal and state policymakers and regulators, health professionals involved in radiation treatment, developers and producers of radiation equipment, insurance providers, and concerned laypersons.
This book explains clearly and in detail all aspects of radiation protection in nuclear medicine, including measurement quantities and units, detectors and dosimeters, and radiation biology. Discussion of radiation doses to patients and to embryos, fetuses, and children forms a central part of the book. Phantom models, biokinetic models, calculations, and software solutions are all considered, and a further chapter is devoted to quality assurance and reference levels. Occupational exposure also receives detailed attention. Exposure resulting from the production, labeling, and injection of radiopharmaceuticals and from contact with patients is discussed and shielding calculations are explained. The book closes by considering exposure of the public and summarizing the "rules of thumb" for radiation protection in nuclear medicine. This is an ideal textbook for students and a ready source of useful information for nuclear medicine specialists and medical physics experts.
Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.
Nearly 20 million nuclear medicine procedures are carried out each year in the United States alone to diagnose and treat cancers, cardiovascular disease, and certain neurological disorders. Many of the advancements in nuclear medicine have been the result of research investments made during the past 50 years where these procedures are now a routine part of clinical care. Although nuclear medicine plays an important role in biomedical research and disease management, its promise is only beginning to be realized. Advancing Nuclear Medicine Through Innovation highlights the exciting emerging opportunities in nuclear medicine, which include assessing the efficacy of new drugs in development, individualizing treatment to the patient, and understanding the biology of human diseases. Health care and pharmaceutical professionals will be most interested in this book's examination of the challenges the field faces and its recommendations for ways to reduce these impediments.
The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. This up-to-date, comprehensive book, written by world-renowned experts, discusses the basic principles of radionuclide therapy, explores in detail the available treatments, explains the regulatory requirements, and examines likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the role of the therapeutic nuclear physician in coordinating a diverse multidisciplinary team, which is central to the safe provision of treatment.
This book reevaluates the health risks of ionizing radiation in light of data that have become available since the 1980 report on this subject was published. The data include new, much more reliable dose estimates for the A-bomb survivors, the results of an additional 14 years of follow-up of the survivors for cancer mortality, recent results of follow-up studies of persons irradiated for medical purposes, and results of relevant experiments with laboratory animals and cultured cells. It analyzes the data in terms of risk estimates for specific organs in relation to dose and time after exposure, and compares radiation effects between Japanese and Western populations.
"A key requirement for the effective implementation of the therapeutic approach, based on the intravenous administration of radiolabelled compounds (radionuclide therapy), is the sufficient availability of radionuclides with appropriate physical characteristics. Based on their nuclear properties, 188Re and 90Y are considered among the most interesting radionuclides for therapy. Furthermore, they are produced through portable generators, which provide a crucial advantage toward ensuring a worldwide distribution of these radionuclides. This publication illustrates recent studies aimed at investigating efficient quality control methods to ensure both the radionuclidic purity of generator eluates, and the proper preparation of new target specific 188Re and 90Y radiopharmaceuticals for various clinical applications."--Publisher's description.
This book explains clearly and in detail all aspects of radiation protection in nuclear medicine, including measurement quantities and units, detectors and dosimeters, and radiation biology. Discussion of radiation doses to patients and to embryos, fetuses, and children forms a central part of the book. Phantom models, biokinetic models, calculations, and software solutions are all considered, and a further chapter is devoted to quality assurance and reference levels. Occupational exposure also receives detailed attention. Exposure resulting from the production, labeling, and injection of radiopharmaceuticals and from contact with patients is discussed and shielding calculations are explained. The book closes by considering exposure of the public and summarizing the "rules of thumb" for radiation protection in nuclear medicine. This is an ideal textbook for students and a ready source of useful information for nuclear medicine specialists and medical physics experts.