lnternol Rodiotion

Dosimetry

tr

Absorption of energy from ionizing radiation
can cause damage to living tissues. This is
used to advantage in
but it is a limitation
tions because it is a p
patient. In either case, it is necessary to
aîalyze the energy distribution in body
tissues quantitatively to ensure an accurate
therapeutic prescription or to assess poten_
tial risks. The study of radiation effects on
living organisms is the subject of rod,iation
biology (or radiobiology) and is discussed in
several excellent texts, some of which are
Iisted at the end of this chapter.
One of the most important factors to be
evaluated in the assessment of radiation
effects on an organ is the amount of radia-
I radiation dose is the gray, abbreviated Gy,*
-energy deposited in that organ,
culation of radiation energ)¡ deposìted
internal radionuclides is thó subject of
rnal radiation d,osimetry. There are two
eral methods by which these calculations
'be performed: the classic method, and,
external radiation sources as well as health
physics aspects of radiation dosimetry are
discussed in Chapter 22. Some radiation dose
estimates for nuclear medicine procedures
are summarized in Appendix E.
Rodiotion Dose ond
Equivolenl Dose:
Quqnlities ond Units
Radiation dose D refers to the quantity of
radiation energy deposited in an absorber
per gram of absorber material. This quantity
applies to any kind of absorber material,
including body tissues. The basic unit of
1 Gy: 1 joule energy deposited
per kg absorber
(2L-r)
The traditional unit for absorbed dose is the
rad,, an acronym for radiation øbsorbed dose,

1 rad: 100 ergs energy deposited

(2t-2)
per g absorber
n as the MIRD method, after
-generally
Ùledical lnternal ,Radiation Dose
tittee of the Society of Nuclear
gives more
has gained
method for
calculations.
in using the
summarized
culations for
406 co ¡ PHYSICS lN NUCLEAR MEDICINE Chopter 2l: lnfernolRadiofion Dosimetry o ¡ o 4O7
T A B L E 2I - I
commonplace
Fqclors for Differenl lypes of
chapter, radi ,'Èöotdtlon ln the Colculolion of
grays, with v '.'1.,t,
. Dosg
selected examPles.
EquiuøIent dose, symbolically indicated Type of Rcdiotion Weighting Foctor,
e
by H, is a quantity that takes into account x rays 1
túe relative biologic damage caused by Y rays I
radiation interacting with tissue' Tissue Electrons, positrons 1
Neutrons
damage per gïay of absorbed dose depends <1-0 keV 5 Figure 2l-1. Absorbed dose delivered to a
on thãtype ofradiation and the enerry ofthe 10-100 keV 10 target organ from one or more source organs
radiatiorl, and how exactly the radiation >100 keV to 2 MeV 20 containing radioactivity is calculated by the
>2-20 MeV 10 absorbed fraction dosimetry method.
>20 MeV 5
Protons >2 MeV 5
a Particles 20

tors, Q, for different types and energies of delivered to atarget orgøn from radioactivity
radiation. The SI unit of equivalent dose is contained in one or more source orgøns in the
the sieuert,* abbreviated Sv. It is related to body (Fig. 2l-L). The source and target may
the absorbed dose D bY be the same organ, and, in fact, frequently
H:D the most important contributor to radiation Each of these steps involves certain In spite of the refined mathematical
x Q QI-B)
dose is radioactivity contained within the difficulties. Step 2 involves physical charac- models used in the absorbed fraction model,
The traditional unit for equivalent dose is target organ itself. Generally, organs other teristics of the radionuclide, which generally the results obtained are only estimates of
the rem, an acronym for roentgen-equivalent than the target organ are considered to bg are known accurately. Step 3 involves auerage values and should be used for
man. The conversion factor between tradi- source organs ifthey contain concentrationñ patient anatomy, which can be quite differ- guideline purposes only in evaluating the
tional and SI units is of radioactivitY that exceed the ent from one patient to the next. Step 1 is potential radiation effects on a patient.
concentration in the bodY' haps the most troublesome. Such data on
rem : 10-2 Sv : l cSv : 10 mSv (2t-4) The general Procedure for cal armaceutical distribution as are
1
the radiation dose to a target organ vailable usually are obtained from studies
2. Cumuloted Activity, ã
radioactivity in a source organ is a th a relatively small number of
For radiations of interest in nuclear medi- human The radiation dose delivered to a target
process, as follows: or animals. There are variations in organ depends on the amount of activity
1. The amount of activity and time spent bolism and distribution of radionuclides present in the source organ and on the
the radioactivity in the source organ g human subjects, especially in differ- length of time for which the activity is
disease states. Also, the distribution of present. The product of these two factors is
determined.
Gy (or rads). activity and vity within an organ may be inho- the cumulated actiuity A in the source organ.
rgeneous, leading to further uncertainties
pr"."rrt, th" I
the dose specification for that organ.
The SI unit for cumulated activity is the
delivered bY it. bequerel.sec (Bq.sec). The corresponding
Colculotion of Rodiqlion Dose -2. The total amount of radiation e Because of these complications ánd vari- traditio x
(MIRD Method) ¡y the radioactivitv i tne; radiation dose calculations are made 104 Bq; hr
"*itt"J
organ is calculated' This deP-enc Ða..
ù,, ^ :
-1.332 x
I. Bosic Procedure ond Some mãrily on the enerry of the radion is
or
Procticol Problems e*issions and their frequencY essentially a measure of the total number of
radioactive disintegrations occurring during
The absorbed fraction dosimetry method , !ïälïi;'"*#"#'Jilä
îri: '
l. An exception is made when one is
tically interested in a surføce d,ose to an
the time that radioactivity is present in the
allows one to calculate the radiation dose source organ that is absorþ€o,' de t from activity contained within that
source organ. The radiation dose delivered
;;;;;""s;" is determined' This by activity in a source organ is proportional
t, for example, the dose to
the bladder to its cumulated activity.
due to bladder contents. This is
con- Each radiotracer has its own unique
ed to have a value one half the average spatial and temporal distribution in the body,
;*ifrHiiffi¡"g¿¡j'ål# to.the organ
or, in this case, the bladdãr as determined by radiotracer delivery, up-
shaPe, and distan take, metabolism, clearance and/or excretion
chambers.
408 ¡ ¡ o PHYSICS lN NUCLEAR MEDICINE Chopler 2l: lnlernolRodiation Dosimetry o o ¡ 409

As

0.840
è
'E
Hypothetical time-activity o.ano
Figure 2 I -2. o FigUle 2J-3. Illustration of relationship
curve for radioactivity in a source organ' 4 between A and average lifetime Í.44 T:)
Cumulated activity A in Bq'sec is the 0.440 of a radionuclide for simple exponentiãl
area under the curve (equivalent to the decay.
integral in Equation 21-5). 1.44T1p
o.2Ao

0
234
Time (number of rhalf-lives)
Time (sec)

and the physical decay of the radionuclide' there is no biologic excretion. The time- Answer then is given by
The amount of activity contained in a source activity curve then is described by ordinary T
organ therefore generally changes with time. radioactive decay (Equations 4-7 and 4-10): Ã: I.44 x 100MBq x 0.G0 x 6.0hr 7 - Ao fr"-o'unt','o,dt
If the time-activity curve is known, the :518.4MBq.hr J
cumulated activity for a source organ is A(t) : As¿-o6szt¡r' (21-6)
: L.g7 x 106MBq.sec
0
æ
obtained by measuring the area under this ¡ 4 II
curve (Fig. 2L-2). Mathematically, if the
f2e-o'6erttraz *... (21-8)
0
time-activity curve is described by a function :
A(ú), then present in the organ. Thus, Situøtion 2: Uptah,e is instantaneouE, l.44TatftAo i I.4LTtzfzAo i .. .

ønd clearance is by biologic excretion only

æ
æ f (no plrysical decay, or physical hatf-life uery
I
¿.= IlA(t)dt (2t-5) Ã - Ao I| dt Iong in comparison to biologic excretion). In
"-o'6e3t/rv
0 this situation, biologic excretion must be Exomple 2l-2
0
carefully analyzed. Frequently, it can be
where it is assumed that activity is adminrs-
:T,-!g-
- 0.693
eL- described by a set of exponential excretion
Suppose that 100 MBq of ee-Tc-labeled
microspheres are injected into a
tered to the patient at time t : 0 and is : L.44TpAo
components, with a fraction fi of the initial
activity As bei
patient, with essentially instantaneous
measured to complete disappearance from uptake of activity by the lungs. What is
The quantity l.44To is the avetage half-life Tat, à the cumulated activity in the lungs if
the organ (ú : oo).
time of the radionuclide (Chapter 4, and so on (Fig. 607o of the activity is excreted from the
To estimate the radiation dose received
from a particular radiotracer, time-activity
8.3). Thus, the cumulated activitY
source organ, when eliminated by ph
curves for all the major organs are required.
decay only, is the same as if activity
Ao
These can be obtained from animal present at a constant level As for a tAo Ñ- _-
studies (which are then extrapolated with
ãqual to the average lifetime of the :

some uncertainty to the human), imaging t\

nuclide (Fig. 21-3).
studies in normal human subjects, prior fzAo
rl\
knowledge of the tracer kinetics, or some
combination of these approaches. Time-
activity curves can be quite complex, and
Exomple 21-l
0.1A0 f.\ n-Tolal Figure 2l-4. Iltustration of a multicom-
ponent exponential excretion curve.
thus Equation 21-5 may be diffrcult to faAo Fraction fi is excreted with biologic half-
in I life ?61, fz witln halfJife ?62, /3 with half-
analyze. Frequently, however, certain What is the cumulated activitY c life ?63, etc.
assumptions can be made to simplify this liver for an injection of 100 MBq
ee-Tc-labeled sulfur colloid, as:ul -I¡r -Tdp t
In"
calculation.
Situation 7: Uptah,e by the organ is that 607o of the injected couorq I
"instantaneous" (i.e., uery røpid with respect ä;p"J bv the livËr and retatt I

to the hølf-life of the radionuc.lide), and there indefrnitelY? Time

410 o o o PHYSICS lN NUCLEAR MEDICINE
lungs with a biologic half-life of 15
minutes and 407o with a biologic half-
Iife of 30 minutes?
Answer
Because eem1" physical decay is much
slower than the biologic excretion
process, we may assume that no physi-
cal decay occurs during the time that
activity is present in the lungs. Thus
(Equation 2l-8),
Ã: çt.++ x L/4inr x 0.60 x 100 MBq)
+ (1.44 x 1.l2hr x 0.40 x 100 MBq)
: (2t.6 + 28.8)MBq.hr
: 50.4MBq.hr
: x 105MBq.sec
1.81
Situation 3: Uptahe is instantaneous but
clearance by both physical decay and biologic
excretion øre significant. In this case, if
biologic excretion is described by a single-
component exponential curve with biologic
half-life ?5, and the physical half-life is ?o,
then the total clearance is described by a
single-component exponential curve with an
effectiue half-life ?" given by*
111
_-__J-_
T.- Tr' T,o
T":
Cumulated activity is given by
Ãx t.44T"Ao
If there is more than one component to the
biologic excretion curve, then each compo-
nent has an effective half-life given by
Equation 21-9 for that component, and the
cumulated activity is computed with effec-
tive half-lives replacing biologic half-lives in
Equation 21-8.
*Equation 2L-9 can be derived from Equations 4-2
and 4-9 by treating biologic excretion as the equivalent
ofa second pathway in a "branching" radioactive decay
scheme.
.¿.
Chopter 2l: lnfernol Rodiotion Dosimetry ¡¡r 4l I
Exomple 2l-3
uptake half-time frequency of that emission (number emitted
per disintegration) by the radionuclide. In
Suppose in Example 2l-2 that because ry T'TP
'u"-7rJfo (2L-14) traditional units, the equilibrium absorbed
of a metabolic defect 60Vo of ttre activitv
dose constant is
is excreted from the lungs with a half_
life of 2 hours and 407o with a half-life L¡ : 2.I3N¡E¡rad. g/pCi.hr (21- 16)
of 3 hours. What is the cumulated
activity in the lungs for a 100 MBo Exomple 2l-4
injection for this patient? A radioactive gas having a half-life of Exomple 2l-5
20 seconds is injected in an intravenous A certain radionuclide decays by emit-
Answer solution. It appears in the lungs with
ting B particles in I00Vo of its disin-
The effective half-lives for the two an uptake half-time of'80 seconds and
tegrations with EB : 0.3 MeV. This is
components of biologic excretion are is excreted (by exhalation) with a followed in 80Vo of its disintegrations
(Equation 21-10) biologic half-life of 10 seconds. What by emission of a 0.2-MeV y ray and
is the cumulated activity in the rfungs
for a 250-MBq injection?
in 20Vo by emission of a 0.1g5-MeV
Tet:6x21(6 *2):1.5hr conversion electron and a 0.005-MeV
Tez:6xBl(6*3):2¡" characteristic x ray. What are the
Answer equilibrium absorbed dose constants
Thus applying Equation 21-8, with ?"
The effective uptake half-time is for the emissions of this radionuclide?
(Equation 2I-L4)
replacing 76,
Trc:20 x 30/(20 + B0) : Answer
12 sec
l: 1t.++ x 1.5hr x 0.60 x 100MBq)
+ (1.44 x 2hr x 0.40 x 100MBq) and the effective excretion half-life is Ap : x 10-13) x 1.0 x 0.80
(1.6
: (t29.6 * 115.2)MBq.hr T" : 20 x t0/(20 + 10) : 6.2 sec ,.,
:4.90 x lo-laGy.kglBq. sec
A, : (1.6 x 10-13) x 0.g0 x 0.20
: 244.8MBq.hr Thus, from Equation 2l-lï,
: 8.81 x 105MBq. sec :2.56 x lo-1aGy.kglBq. sec
Ã, : L.44 x 250MBq x 6.T sec : (1.6 x 10-13) x 0.20 x 0.195
x (12 sec/80 sec) ^e
:6.24 x 10-15Gy.kglBq. sec
Situation 4: Uptahe is not instantuneous. : 964.8MBq. sec
(2t-e) The equations developed thus far will over' a* : (1.6 x 10-13) x 0.2 x 0.005
estimate radiation doses when uptake by the : 1.60 x 10-16Gy.kg/Bq. sec
source organ is not rapid in comparison to
physical decay, that is, if a signifrcant 3. Equilibrium Absorbed Dose
amount of physical decay occurs during The product of cumulated activity ã and
(21- 10)
uptake process, before the activity
Constont, À
equilibrium absorbed dose constant A¿ is the
the source organ of interest' This si radiation eners/ emitted by the lth emission,
arises with radionuclides that have a sl in Gy. kg, during the time that radioactivity
pattern of uptake in comparison to th is present in a source organ.
(21- 11) physical half-life. Frequently, uptake can
described by an exponential equation oI
1
form constant A. The factor A must be Example 2l-ó
calculated
for each type of emission for the radio-
(2L- nuclide. It is given by*
Assume that the radionuclide in
A(t):Ao(l - Example 21-5 is used for the problem
"-o'6s3ttr"¡ described in Example 21-4. What is the
where ?, is the biologic uptake half-time'
a¡ : 1.6 x 1o-13N,¡E¿ Gy.kg/Bq. sec
ny total amount of energy emitted from
this case, cumulated activity is given (2r_L5) radioactivity contained in the lungs in
Example 2I-4?
II.".",P' is the average energy (in MeV) of
à x l.44AoT"(Tu"lTò QL- v¡tts l'^'
emission and N; is the relative
Answer
h ---_
where T" is the effective excretion *"Jf, îïi',i:'ü,åi." jïäryîir,,i,.#:ilcTicleardisin- The total energy emitted per Bq. sec is
(Equation zl-LU and ?'" is the er the sum of the equilibrium absorbed
412 o o o PHYSICS lN NUCLEAR MEDICINE Chopter 21: hfernolRodiofion Dosimetry ¡ o¡ 413

dose constants for the p, y, conversion ANTERIOR VIEW OF THE PRINCIPAL ORGANS lN THE
electron and x-ray emissions: HEAD AND TRUNK OF THE PHANTOM

a: ap*ay*au*À* 0 5 10 ORGANS NOT

SHOWN
: 8.0 x 10-1aGy.kg/Bq.sec centimeters
Adrenals
: 8.0 x t0-8 Gy. kglMBq.sec Stomach
Marrow
Pancreas
The cumulated activity is 9.65 x 102 Skin
MBq. sec. Using these values and source organ, Spleen
Figure 2l-5. Representation of an "average
Equation 2l-1, the total enerry Ovaries
man" used for MIRD dose calculations and tables.
Testes (From Snyder WS, Fisher HL Jr, Ford MR,
emitted is A Thymus
D7r¡. *- ,Ð : ) I0,(", <-- r¡)L¡ (21_18)
Warner GG: Estimates of absorbed fractions for
ã x ¡: 9.65 x 102MBq.sec x 8.0 mtT Thyroid
Uterus
monoenergetic photon sources uniformly distrib-
uted in va¡ious organs of a heterogenous phan-
Leg bones tom. J Nucl Med Suppl 3:9, 1969.)
x 10-8 Gy.kglMBq.sec
The total dose to the target organ then is
: 7 .72 x 10-5 Gy. kg
obtained by summing the doses from all of
Kidneys

: 7.72 x 10-5 joules the source organs in the body. Small intestine
Values of $ have been calculated for Lower large
mathematical humanoid models incorporat- intestine
Values of  are presented in Appendix C ing organs and anatomic structures of Pelvis
for some of the radionuclides of interest in "average" size and shape (Fig. 21-5). The
nuclear medicine and a full listing can be model used for many years was that
found in reference 1. committee of the
icine.2 Cristy and
4. Absorbed Froction, $ developed a series it is useful to sum the equilibrium absorþed
of models representing newborn, l-year-old, dose constants for the nonpenetrating Exomple 2l-7
The frnal step is to determine the fraction of 5-year-old, 1O-year-old, 15-year-old, and radiations and treat them as a single Compute the absorbed dose delivered
the enerry emitted by the source organ that adult individuals. Stabin and associates parameter, A.o, because the absorbed frac- to the lung by nonpenetrating radia-
is absorbed by the target organ. This is given extended the model to pregnant women.4 tions for all of these emissions are equal tions in the problem described by
by the absorbed fraction $. The absorbed Organ masses for the adult male phantom (unity when the source and target are the Examples 2l-4 and2l-5.
fraction depends on the amount of radiation developed by Cristy and Eckerman are same organ, zero otherwise).
enerry reaching the target organ (tissue given in Table 2l-2. Most of the values for'
and distance attenuation between source their adult male model are similar to thej
and target organs) and on the volume and model originally developed by the MIRDI
composition (e.g., lung, bone) of the target committee; however, there are some signifi' ili.i;;,9l gt Mosses ror lhe cristv ond Eckermon Adult Mole
organ. Thus it depends on the type and cant differences as well, such as in the
ß
Orgon Moss (g) Orgon Moss (g)
energy of the emission and on the anatomic and values of 0 for bone m
relationship of the source-target pair. In a Consequently, the Cristy and Adrenals 16.3 Ovaries 8.71
Brain r42o Pancreas 94.3
dosimetry calculation, a value of $ must be models now have replaced the older Breasts (excludingskin) 951 Skeleton
determined for each type of emission from model. Gallbladder contents 55.7 Activemarrow ll20
the radionuclide and for each source-target Calculations of þ are comPlex, and Gallbladder wall 10.5 Corticalbone 4000
pair in the calculation, The notation Gastrointestinal tract Trabeculat bone
tables are quite lengthy for "penetratrn Lower large intestine contents I43 Skin
1000
3010
þ¿(r¡, <- r¡) is used to indicate absorbed radiations (photons with enerry ¿-10-k: Lower large intestine wall 167 Spleen 183
Small intestine contents and wall Testes
fraction for enerry delivered from a source because ofthe enerry dependence ofphoù 1100 39.1
organ (or region), r¡,to atarget organ, r¡r,fot
Stomach contents 260 Thymus 20.9
attenuation and absorption; however' Stomach wall 158 Thyroid 20.7
the ith emission of the radionuclide. situation is simpler fo Urinary bladder contents 2ll
The total enerry absorbed by a specific radiations (photons with Urinary bladder wall 47.6
target organ thus is given by and electrons), for which
Uterus 79.0

that all of the emitted o¡

Remaining tissue 51,800

Total enerry absorbed (Gv.ke) absorbed," that is, within the source
itself. For these emissions, S = 1 when
: L¡ (21-17)
ÃDþ¡1u.¡ <- r¡) target and the source are the same o^-F"gT Cristy M, Eckerman K: Specific Absorbed Fractions of Energy at Various Ages From Internal Photon Sources (ORNL
O ] O otherwise. In dosimetry
calcu -¡eport
ORNL/TM-83S1 V1-V7). Oak Ridge, TN, Oak Ridge National iäboratory, tSSã.
a¿'
414 o o o PHYSICS lN NUCLEAR MEDICINE Chopter 21: lnternol Radiafion Dosimefry o o ¡ 415

Answer Given the values of S and cumulated activity, Dlt I <_ RM) : (3.11 x 105 MBq.sec)
Ã,, th" average
dose to an organ is given by x (g.98 x lO-8mGy/MBq. sec)
The nonpenetrating radiations are the
B particles (AÊ : 4.80 x 10-14 Gy.kg/ :2'78x 10-2mGy
Bq.sec), conversion electrons (4. : D(r¿ - r):Ãx S(r¿ <- r¿) (21-27)
6.24 x 10-15 Gy. kg/Bq. sec), and 5 keV The average total dose to the liver is
characteristic x rays (A*: 1.60 x 10-16 therefore
Gy'_kg/Bq'sec). Thus, Â,p : 5.44 x 0 (r¿ - ,ù :#,x þ(r¡ <- r¡) (21-23) Exam?le 2l-B D:6.04 +6.72 x 10-2 +2.78 x 1"0-2mGy
10-14-Gy. kg/Bq. sec. Cumulated activ- Calculate the radiation dose to the liver :6.14mGy(
ity is A : 9.65 x 108 Bq. sec. Lung mass (LI) for an injection of 100 MBq of - 0.6rads)
is 1 kg (see Table 2l-2). Thus, the ee-Tc sulfur colloid. Assume that 607o
ó. Meon Dose per Cumuloted
average radiation dose delivered by of the activity is trappèd by the liver,
Activiiy, S Example 21-8 demonstrates that most of
these emissions to the lungs is 307oby the spleen (SP), and l0%obyred
the dose delivered to an organ that con-
Radiation dose calculations bone marrow (RM), with instantaneous
penetrating centrates the radionuclide arises from the
D : (9.65 x 108 Bq. sec) -for
radiations can be quite tedious, especial! uptake and no biologic excretion. !,
radioactivity in the target organ itself
x (5.44 x 10-laGy.kglBq. sec) when there are multiple emissions to con_ [D(Lr <- Lr)].
sider. The problem has been simplified by Answer
x (0: l)/lkg the introduction of S, the mean dose per unit The cumulated activities for the three
: 5.25 x 10-5Gy cumulated activity: source organs are (Equation 2l-7) Exomple 2l-9
'l A patient is to be treated with 131I for
S(r¿ <- ro) : *I þ¡þp <- r¡) L¡ á¡: L.44 x 6.0hr x 0.60 x 100MBq hyperthyroidism. It is determined by
mnT
:518.4MBq.hr prior studies with a tracer dose of 131I
5. Specific Absorbed Froction, o, :Io,e¡<_r¡)L¡ : x 106MBq. that the patient's thyroidal iodine
1.87 sec
ond the Dose Reciprocity uptake is 607o and the biologic half-
Theorem (2t_24) ãr" : L44 x6.0hr x 0.30 x 100MBq life of iodine in the thyroid gland is 2
: 259.2 MBq.hr
days. Assuming instantaneous uptake
Tlae specific a.bsorbed fraction is given by The quantity S has units of Gy/Bq. sec. It ("" << ?o : 8 daYs), what is the dose to
has been calculated for different source- :9.33 x 1-05MBq.sec the thyroid (THY) from radioactivity
o: Ö (21-19) target organ pairs for a number of radio-
nuclides of interest in nuclear medicine.6 ãor: I.44 x 6.0hr x 0.10 x 100MBq contained in the thyroid for this
ITL¡
patient, per MBq 131I?
Tables 2t-3 to 21-5 present values of S for :86.4MBq.hr
It is the fraction of radiation emitted by the n'^T", 131I, and 18F, respectively. Because
source organ that is absorbed per grøm of :3.11 x 105MBq. sec Answer
most of the publications relating to tabula-
target organ mass. The absorbed dose equa-
tions of S values date to the 1970s or 1980s¡ The effective half-life of 131I in the
tion can be written using specific absorbed The values of S for ee-Tc are (see Table thyroid for this patient is (Equation
they often are presented in traditional units
fractions as 21-10)
of rad/¡.tCi. hr. The conversion factor 27_3)
Dçr¿ <- rÐ:ÃDr,eu <- r¡) L¡ (21-20) between SI and traditional units is I : 3,23 x 10-6 mGy/MBq. sec
S(LI <- LI) T" : 8 x 2l@ + 2) : 16/10days

lrad/pCi.hr :7.5 x 10-11Gy/Bq'sec S(LI +- SP) : .20 x 10-8 mGy/MBq. sec

7
: 1.38 x 105 sec
The dose reciprocity theorem says that
for a given organ pair the specific absorbed
: 7.5 x 10-2 mGY/MBo' sec '¡ S(LI <- RM) : 8.93 x 10-8 mGy/MBq. sec Therefore, the cumulated activity per
QL-26\ MBq administered is (Equation 2l-LL)
fraction is the same, regardless of which Therefore, the absorbed doses are
organ is the source and which is the target:
j
Ã: t.++ x (1.88 x 105 sec)
lmGy/MBq' sec: l3.32tad,/PCi'hr D(LI <- LI) x0.60xlMBq
Þ¡(r¡, <- rn) : Q¡(r¡ <- r¡r) (21-2I) QL-26) : x 106 MBq. sec)
(1.87 : 1.19 x 105 MBq.sec/MBq
This simply says that the energy absorbed per x 10-6 mGy/MBq.
x (3.23 sec) administered
gram is the same for radiation traveling from :6.04mGy
The dose per MBq. sec is (see Table
r¡to r¡ as it is for radiation traveling from r¿ 2t_4):
to r¡, a fact that seems intuitively obvious.* Dg,I.- sp): (9.8g x 105 MBq. sec)
The dose reciprocity theorem is useful x (7.20 x 10-8mGy/MBq. sec) S(TIIY <- TrrY)
when tables for þ are not available for all :1.57 x 10 3 mGy/MBq.
source-target organ pairs. If þ(rp<-rr¡) is :6.72x 10-2mGy sec
416 c o o PHYSICS lN NUCLEAR MEDICINE
Thus, the average absorbed dose for
the thyroid is
D(THY <- THY)
: (1.19 x 105 MBq. sec/MBq
administered)
x (1.57 x 10-3 mGy/MBq. sec)
: 187 mGy/MBq administered
In traditional units (Equation 2I-26),
the average dose to the thyroid is
D(THY <- THY)
: (187 mGy/MBq administered
x 37MBq/mCi x 0.1rads/mGy
: 692rads/mCi administered.
One could include the radiation dose to
the thyroid from activity in other organs in
the calculation performed in Example 2l-9;
however, inspection of Table 21-4 reveals
that in comparison to the thyroid as the
source organ, other organs have much
smaller values of S (by about a factor of
500). This, plus the fact that other organs
concentrate much less of the activity than
the thyroid, eliminates the need to consider
them as source organs in this calculation.
Examples 21-8 and 21-9 represent sim-
plified situations in which only a few organs
are involved and where the cumulated
activities of the organs are relatively easy
to estimate. In many cases, the calculations
are more involved, with complex time-
activity curves and more widespread distri-
bution of the radiopharmaceutical among
different organs. To facilitate dosimetry
calculations, a software program6 has been
developed to calculate all the S value tables
for commonly employed radionuclides using
the MIRD,2 Cristy and Eckermans and
Stabina phantom models of human anatomy.
This greatly simplifies dose calculations,
although it still is necessary to provide the
cumulated activity data for each organ for
the radiopharmaceutical of interest.
Estimated radiation doses for a large
number of commonly used radiopharmaceu-
ticals are available from the Radiation
Internal Dose Information Center' (RIDIC)
7. Whole-Body Dose, Effective
Dose, ond Effective Dose
Equivolent
The complete output of a dose calculation is
an estimate of the radiation dose for all the
major organs in the body. This provides a
large amount of information that is difficult
to assimilate into a perception of the risk of a
specific radiopharmaceutical study, or for
comparison of the dose from a nuclear medi_
cine procedure with that from other medical
procedures that use radiation sources. For
these reasons, it would be convenient to
condense radiation dose estimates such as
those in Table 21-6 into a single riumber.
There are three different approaches to doing
this: whole-body (or total-bod,y) dose, effectiue
dose equiuølent, and effectiue d.ose.
The whole-body or total-body dose is the
total energy deposited in the body divided by
the total mass of the body, or in terms of the
S factor for the total body (TB):
Dlre <- TB) : ã x S(TB <- TB) (2L-28)
This parameter was used for many years as
the standard for evaluating the risks of
different nuclear medicine procedures.
However, the whole-body dose does not
take into account the nonuniformity of
distribution among the organs in the bod
and its validity for comparing the risks
different nuclear medicine procedures
been strongly criticized.s
The efiective dose equivalent, HB,
the effective dose, E, were introduced by
International Commission on Hadrorogrue
P;;;;il i1çPþ¡s'to also as attemPtsdosg to
chatactetize a nonuniform internal
by a single number. These quantities
intended primarily for estimating .
tion risks and doses received by rad
to cun¡'
support
dentical
concept. Both represent the whole-body
dose that would result in the same overall
risk as a nonunifgrm dose distribution
achnlly delivered. This is achieved by
assigning different weighting factors to
the doses delivered to individual organs.
The parameters differ in the values of the
weighting factors 'assigned to different
organs. Thé two sets of weighting factors,
W(Hn) and W(E), are shown in Table 21-7.
The effective dose equivalent and effective
dose, both ofwhich have units of sieverts, are
calculated from
HE:IDxQxW(Hs) (2t-29)
i regarded to be better indicators of overall
u:ÐUxQxw(E) (21-30)
As noted in Section A, A : 1 for all
in diagnostic nuclear
radiations used
cine procedures.
Exomple 2l-10
Calculate the effective dose equivalent,
HB, following the injection of 250 MBq
of 18F-FDG.
Answer
Using the dose values in Table 2l-6
the weighting factors in Table 21-7:
:0.25 x (1.7 x 10-2 mGy/MBq)
Hn
x 250 MBq(gonads)
+ 0.t2 x (1.3 x 10-2 mGy/MBq)
x 250 MBq(redmarrow)
+ 0.I2 x (1.7 x 10-2mGy/MBq)
x 250 MBq(lungs)
+ 0.15 x (9.2 x 10-3 mGy/MBq)
x 250 MBq (breasts)
+ 0.03 x (1.0 x 10-2 mGy/MBq)
x 250 MBq (thyroid)
+ 0.03 x (I.2 x 10-2 mGy/MBq)
x 250 MBq (bone surfaces)
+ 0.06 x (1.9 x 10-l mGy/MBq)
x 250 MBq (urinarybladderwall)
+ 0.06 x (6.0 x 10-2 mGy/MBq)
x 250 MBq (heart wall)
Chopter 2l: lnfernolRodiofion Dosimefry coo 417
+ 0.06 x (3.7 x 10-2 mGy/MBq)
x 250 MBq (spleen)
+ 0.06 x (2.6 x 10-2 mGy/MBq)
x 250 MBq (pancreas)
+ 0.06 x (2.3 x 10-2 mGy/MBq)
x 250 MBq (uterus)
: 7 .51 mSv (or 0.751rem)
In practice, HB and E provide similar
results across a very wide range of radio-
pharmaceuticals.s Although they are
radiation risk than whole-body dose for
radiation protection purposes, there still is
much debate about their relevance, and care
should be taken in their use and interpreta-
medi-
tion. In particular, they are not recom-
mended for use in radionuclide therapy
applications, nor should they be used to
evaluate the risk from a radionuclide study
to a specifrc individual. This is because
calculations ofHB are based on an "average"
human, whereas the actual dose can vary
considerably with body shape and size, as
well as the specific distribution of the radio-
nuclide in the individual. This, along with
and,
some other general limitations of internal
radiation dose estimates, is discussed in the
next section.
8. Limitotions of lhe MIRD Method
There are a number of important limitations
in the MIRD approach for calculating radia-
tion dose. Although Equation 2I-L8 is
fundamentally correct, the values of þ are
based on standard models of human anat-
omy that assume specific relationships in the
shape, size, and location of various organs.
The MIRD formulation also implicitly
assumes that activity is distributed uni-
formly within each organ and, furthermore,
that enerry is uniformly deposited through-
out the organ. The assumption can cause
a significant error in the calculated dose
from nonpenetrating radiation (e.g., Auger
electrons) when the activity is taken up in
specific regions or cell types within an organ.
Local radionuclide concentrations and,
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S-Volues (mGy/MBq.sec) for Ïc-99m in The Reference Adull* m
Source Orgons
Ð

Torget Orgons Adrenols Broin Breosls Goll- LLI Smoll Slomoch ULI Heort Heort Kidneys Liver Lungs m
o
blodder ConlenTs lntestine Conlents Contents Woll
0
Adrenals 1.90E-04 4.17E-10 5.04E-08 3.t28-07 2.24E'-08 7.44E.08 2.72F-07 9.55E-08 2.528-07 2.84E-07 7.228-07 4.34F-07 2.338-07 zm
Brain 4.17E-10 4.338-06 3.17E-09 1.48E-10 1.56E-11 3.90E-11 4.268-10 4.67E-rt 3.138-09 2.538-09 1.58E-10 8.148-10 7-618-09
Breasts 5.04E-08 3.17E-09 1.18E-05 3.32E-08 2.278-09 7.338-09 5.728-08 7.988-09 2.40F,-07 2.60F-07 1.99E-08 6.80E-08 2.338-07
Gallbladder wall 3.56E-07 1.538-10 3.408-08 3.518-05 6.48E-08 4.37E-07 3.048-07 7.5tE-07 1.03E-07 t.22E.07 4-08E-07
8.678-07 7.448-08
LLI wall 1.97E-08 1.32E-11 2.4tE-09 5.918-08 1.28E-05 5.89E-07 9.07E-08 2.148-07 4.05E-09 4.89E-09 5.48E-08 1.448-08 3.29E-09
Small intestine 7.448-08 3.90E-11 7.33E-09 4.568-07 7.138-07 4.418-06 2.07F-07 1.25E-06 1.56E-08 2.06E-08 2.128-07 1.16E-07 1.34E-08
Stomach 2.848-07 2.51E-10 5.92E-08 2.928-07 r.23F-07 2.12E'-07 8.83E-06 2.858-07 1-65E-07 2.64E-07 2.528-07 1.48E-07 1.19E-07
ULI wall 9.39E-08 4.758-rr 7.498-09 7.758-07 3.09E-07 1.35E-06 2.658-07 8.71E-06 2.118-08 2.64E-08 2.128-07 1.888-07 1.808-08
Heart wall 2.848-07 2.53E-09 2.60F,-07 1.04E-07 5-41E-09 2.06E-08 2.32F'07 2.96E-08 5.65E-06 t.248-05 8.20E-08 2.32F-07 4.38E-07
Kidneys 7.22E.07 1-58E-10 1.998-08 3.88E-07 7.08E-08 2.t28-07 2.728-07 2.t2F-07 6.44E-08 8.20E-08 1.37E-05 2.93E.07 6.648-08
Liver 4.348-07 8.14E-10 6.80E-08 8.17E-07 1.79E-08 1.168-07 r.46E-07 1.868-07 2.t28-07 2.32D-07 2.938-07 3.23E-06 1.96E-07
Lungs 2.33F,-07 7.61E-09 2.33E'-07 7.08E-08 4.498-09 1.34E-08 1.10E-07 1.768-08 4.58E-07 4.38E-07 6.64E-08 2-08E-07 3.73E-06
Muscle 1.118-07 2.208-08 4.23E-08 1.14E-07 t.238-07 1.11E-07 9.93E-08 1.06E-07 8.80E-08 9.17E-08 9.76E-08 7.49E-08 9.30E-08
Ovaries 3.13E-08 1.51E-11 2.61E-09 1.11E-07 1.26E-06 9.20E.07 5.84E-08 7.68F-07 4.53E-09 6.14E-09 7.00E-08 3.80E-08 5.38E-09
Pa¡creas 1.09E-06 4-14E-10 6.20E-08 6.73E-07 5.20E-08 L.428-07 1.23E-06 t.62E-07 2.648-07 3.56E-07 4.968-07 3.85E-07 r.74Ð-07
Red marrow 2.53E-07 1.00E-07 5.508-08 1.02F-07 2.018-07 r.788-07 7.488-08 r.43F-07 1.10E-07 1.10E-07 I.708-07 8.298-08 1.11E-07
Bone surfaces 2.67E,-07 2.98E-07 7.73E-08 1.13E-07 1.81E-07 1.48E-07 1.03E-07 7.2t8-07 1.59E-07 1.59E-07 1.61E-07 7.238-07 1.658-07
Skin 3.40E-08 3.96E-08 7.58E-08 3.08E-08 3.61E-08 3.00E-08 3.41E-08 3.08E-08 3.40E-08 3.69E-08 3-78E-08 3.618-08 4.01E-08
SpIeen 4.568-07 5.188-10 4.368-08 1.33E-07 6.51E-08 1.01E-07 7.81E-07 1.048-07 r.248-07 r.67E-07 7.208-08
6.6LF,-07 t.638-07
Testes 1.53E-09 t.458-t2 0.00E+00 6-90E-09 1.40E-07 2.60E-08 2.89E-09 1.91E-08 5.148-10 6.15E-10 3.09E-09 7.578-09 3.66E-10
Thymus 5.64E-08 6.86E-09 2.28E-07 1.42E-08 2.04E-09 4.65E-09 3.64E-08 5.42E-09 8.848-07 7.33E.07 1.73E-08 5.928-08 2.848-07
Thlroid 8-09E-09 1.35E-07 3.00E-08 2.45E-09 2.488-t0 4.85E-10 2.678-09 7.678-10 5.168-08 4.328-08 2.958-09 8.62F-09 8.80E-08
Urinary bladder wall 7.53E-09 6.01E-12 1.338-09 4.21E-08 4.97E'-07 2.t2F.07 1.73E-08 7.608-07 2.218-09 2.16E-09 7.878-08 1.168-08 7.338-09
Uterus 1.89E'-08 1.3lE-11 2.61E-09 1.16E-07 5.16E-07 8.348-07 5.04E-08 3.96E-07 4.85E'-09 5.46E-09 6.40E'-08 3.288-0E 4.09F'-09
Total bocly 1.74E-07 1.278-07 1-04E-07 1.36E-07 1.50E-07 1.61E-07 L.L7E-07 L.42E-07 L.778-07 7.67E-07 7.608-07 7.678-07 1.46E'-07

Source Orgons
Torgef Orgons Muscle Ovories Poncreos Red Corticol Trobeculor Spleen Tesles Thymus Thyroid Urinory Uterus Totol
Monow Bone Bone Blodder Body

Adrenals 1-11E-07 3.138-08 1.09E-06 2.418-07 1.06E-07 1.06E-07 4.568-07 1.53E-095.64E-08 8.09E-09 8.398-09 1.89E-08 1.69E-07
Brain 2.2O8-OB 1.518-11 4.14E-10 8.05E-08 1.17E-07 1.17E-07 5.18E-10 r.458-126.868-09 1.35E-07 5.93E-12 1.?1E-11 r.238-07
Breasts 4.23E-08 2.61E-09 6.208-08 5.11E-08 3.098-08 3.098-08 4-36E-08 0.00E+00 2.288-07
3.00E-08 1.308-09 2.61E-09 t.028-07
Gallbladder wall 1.19E-07 9.888-08 8.11E-07 1.14E-07 4.40E-08 4.408-08 1.358-07 6.70E-09 2.648-08
2.648-09 3.448-08 1.14E-07 1.78E-07
LLI wall 1-33E-07 1.128-06 4.16E-08 1.98E-07 7.238-08 7.23E-08 1.95E-07 1.61E-09 2.06E-10 5.778-07
4.64E-08 4.96Ð-07 r.748-07
Small intestine 1.11E-07 9.208-07 t.428-07 1.85E-07 5.73E-08 5.73E-08 2.60E-08 4.65E-09 4.85E-10 2.248-07
1.01E-07 8.34E-07 1.78E-07
Stomach 1.08E-07 5.848-08 1.26E-06 8.21E-08 3.888-08 3.88E-08 4.428-09 3.60E-08 3.70E-09 2.098-08
7.738-07 5.52E-08 1.60E-07
ULI wall 1.09E-07 8.25E-07 1.698-07 1.55E-07 5.0lE-08 5.01E-08 1.78E-08 5.30E-09 7.67E,-10 1.60E-07
1.06E-07 4.t6Ð-07 r.73E,-07
Heart wall 9.17E-08 6.14E-09 3.56E-07 1.09E-07 5.73E-08 5.73E-08 1.67E-07
6.15E-10 7.33E-07 4.32E-08 2.228-09 5.46E-09 r.628-07
Kidneys 9.76E-08 7.00E-08 4.96F,-07 1.698-07 6.218-08 6.21E-08 6.618-07 3.09E-09 1.73E-08 2.958-09 2.00E-08 6-40E-08 1.568-07
Liver 7.49E-08 3-80E-08 3.85E-07 8.93E-08 4.81E-08 4.81E-08 7.20E-08 1.57E-09 5.92E-08 8.62E-.09 1.17E-08 3.28E-08 1.57E-07
Lungs 9.32E-08 5.38E-09 t.75F.07 1.09E-07 6.65E-08 6.65E-08 1.64E-07 3.66E-10 2.96E-07 8.80E-08 1.03E-09 4.098-09 1.43E-07
Muscle 1.988-07 1.438-07 r.238-07 9.04E-08 7.43E-08 7.43E-08 1.03E-07 9.858-08 1-05E-07 1.16E-07 1.30E-07 r.438-07 1.338-07
Ovaries 1.43E-07 3.428-04 3.64E-08 2.t28-07 6.52E-08 6.528-08 3.84E-08 0.00E+00 1.93E-09 2.298-t0 5.40E-07 1.57E-06 1.82E-07
Pancreas I.238-07 3.64E-08 3.918-05 r.478-07 6.52E-08 6.528-08 1.28E-06 2.58E-09 6.128-08 7.26F-09 1.38E-08 3.728-08 1.80E-07
Red marrow 9.04E-08 2.128-07 1.40E-07 t.74F-06 2.00E-07 6.698-07 8.41E-08 2.68E-08 8.22E;08 7.928-08 8.00E-08 1.39E-07 L.438-07
Bone surfaces 1.84E-07 1.65E-07 1.66E-07 1.07E-06 3.25E-06 3.78E-06 r.268-07 1.018-07 t.22F,-07 1.978-07 1.058-07 o
Skin 5.69E-08 3.088-08 3.00E-08 4.19E-08 4.678-08 4.67E-08 3-49E-08 r.028-07 4.38E-08 4-37E-08 3.898-08 3.00E-08 9.348-08 J
Spleen 1.03E-07 3.84E-08 1.28E-06 9.17E-08 4.93E-08 4.938-08 2.33E-05 2.t78-09 3.88E-08 7.81E-09 8.38E-09 2.56E-08 1.56E-07 co+
Testes 9.85E-08 0.00E+00 2.58E-09 3.08E-08 4.08E-08 4.08E-08 2.178-09 9.06E-05 1-90E-10 2.3lE-11 3.72F'07 0-00E+00 1.308-07 o
Th¡'rnus 1.058-07 1.93E-09 6.12E-08 8.42E-08 4.8lE-08 4.81E-08 3-88E-08 1.908-10 1.59E-04 r.62E.07 8.048-10 1-80E-09 r.45E.07
Thyroid 1.16E-07 2.298-t0 7.26E.09 7.528-08 7.65E-08 7.658-08 7.81E-09 2.31E-11 t.62F.07 1.57E-04 9.54E-11 2.L4 -t0 r.478-07 ì
Urinary bladder wa-ll 1.40E-07 5.48E-07 1.38E-08 9.16E-08 4.00E-08 4.008-08 8.02E-09 3.84E-07 8.128-10 9.62E-11 1.14E-05 1.28E-06 1.69E-07
Uterus 1.43E-07 1.57E-06 3.72E-08 1.54E-07 4.88E-08 4.88E-08 2.56E-08 0-00E+00 1.80E-09 2.L4F-t0 1-23E-06 4.90E-05 1.84E-07 o
Total body 1.35E-07 1.88E-07 1.86E-07 1.548-07 r.428-07 r.428-07 1.61E-07 1.348-07 1.50E-07 1.518-07 1.20E-07 1.89E-07 1.408-07 l
a.
LLI, lower large intestine; ULI, upper læge intestine.
*Data calculated using softwæe described in reference 6 \J
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S-Volues (mGy/MBq'sec) for l-l3l in the Reference Adult* m
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Source Orgons

Torgef Adrenols Broin Breosts Golì- LLI Smoll Stomqch ULI Heort Heort Kidneys Liver Lungs m
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Orgons blodder Contents lnlestine Contents ContenTs Woll
0
Adrenals 1.96E-03 3.398-09 r.648-07 8.35E-07 7.908-08 2.538-07 6.90E-07 7.85E-07 2.03E-06 1.20E-06 6-66E-07 z
Brain 3.39E-09 2.878-05 t.428-08 1.878-09 2.61E-10 5.188-10 3.48E-09 6.158-10 1.67E-08 1.55E-08 t.478-09 5.50E-09 3.33E-08
Breasts 1.64E-07 1.42E-08 1.00E-04 1-08E-07 1.40E-08 3.31E-08 1.82E-07 3.83E-08 7.27F-07 7.918-07 7.498-08 2.L78-07 6.688-07
Gallbladder wall 8.97E-07 1.50E-09 t.r4E-07 3.078-04 1.78E-07 1.178-06 8.11E-07 1.98E-06 2.778-07 3.478-07 1.08E-06 2.33E-06 2.148-07
2.208-10 1-418-08 1.55E-07 1.17E-04 1.61E-06 2.508-07 6.44F-07 1.90E-08 2.38E-08 1.66E-07 5.18E-08 1.648-08
LLI wall 7.63E-08
Small intestine 2.18E-07 5.18E-10 3.31E-08 1.20E-06 1.92E-06 3.95E-05 5.378-07 3.42E-06 5.68E-08 7.40E-08 5.89E-07 3.268-07 5.02E-08
2.678-09 1.91E-07 7.74E,-07 3.63E-07 5.91E-07 6.948-05 7.91E-07 4.588-07 6.94E-07 6.93E-07 4.218-07 3.24î,-07
Stomach 7.t7E-07
ULI wall 2.578-07 6-20E-10 3.29E-08 2.05E-06 8.53E-07 3.77E-06 6.95E-07 7.46E-05 7.63E-08 9.08E-08 5.78E-07 5.13E-07 6.36E-08
7.918-07 2.868-07 2.58E-08 7.408-08 6.66E-07 9.38E-08 4.148-05 1.08E-04 2.278-07 6.32E-07 1.18E-06
Heart wall 7.858-07 1.55E-08
t.478-09 7.49E-08 1.03E-06 2.218-07 5.89E-07 7.778-07 5.81E-07 1.99E-07 2.27F,-07 1.17E-04 8.13E-07 1.958-07
Kidneys 2.03E-06
Liver 1.20E-06 5.50E-09 2.178-07 2.18E-06 6.37E-08 3.26F-07 4.08E-07 5.25Ð-07 5.778-07 6.32î'07 8.13E-07 2.t2F.05 5.44E,-07
6.69E-07 1.938-07 2.18E-08 5.02E-08 3.05E-07 6.12E-08 1.248-06 1.18E-06 1.95E-07 5.45E-07 3.35E-05
Lungs 6.66E-07 3.33E-08
MuscIe 3.29E-07 7.05E-08 1.35E-07 3.25E.07 3.45E-07 3.15E-07 2.82E-07 3.00E-07 2.488-07 2.628-07 2.86F,-07 2.t98-07 2.658-07
Ovaries r.t2E-07 2.648-t0 1.44E-08 2.978-07 3.498-06 2.45F--06 1.80E-07 2.06E-06 2.58E-08 3.15E-08 2.16E.07 1.198-07 2.65E-08
Pa¡rcreas 4.16E-09
2.858-06 1.96E-07 1.81E-06 1.40E-07 3.958-07 3.29E-06 4.42Ð-07 6.89E-07 9.35E-07 1.40E-06 1.028-06 4.728-07
Red ma¡row 7.278-07 2.75E-07 1.818-07 3.05E-07 6-068-07 5.10E-07 2.378-07 4.24Ð-07 3.34E-07 3.348-07 5.148-07 2.62F-07 3.348-07
Bone surfaces 4.748-07 5.28E-07 1.49E-07 1.88E-07 3.06E-07 2.44Ð-07 t.768-07 2.128-07 2.688-07 2.68F'07 2.878-07 2.15î,-07 2.938-07
Skin 1.14E-07 1.39E-07 2.478-07 1.018-07 1.13E-07 9.88E-08 L.t4E-07 1.01E-07 r.r4Ð-07 1.19E-07 1.338-07 t.778-07 7.29Ð-07
1.50E-07 3.36E-07 r.76F-07 2.91E-07 2.07F-06 2.76Ð-07 3.248-07 4.368-07 1.858-06 2.t48-07 4.518-07
SpIeen 1.248-06 5.718-09
Testes 1.01E-08 4.79E-11 0.008+00 3.3lE-08 4.408-07 9.048-08 1.85E-08 7.438-08 4.288-09 4.93E-09 1.90E-08 1.02E-08 3.158-09
Thymus 1.858-07 3.50E-08 7.978-07 5.618-08 1.20E-08 2.19E-08 1.338-07 2.71E-08 2.398-06 1.96E-06 6.79E-08 7.76F,-07 7.898-07
Th1'roid 3.14E-08 4.18E-07 1-03E-07 1.49E-08 2.378-09 3.03E-09 1.56E-08 5.948-09 7.42E'-07 7.358-07 7.928-08 3.498-08 2.528-07
Urinary bìadder wail 3.5lE-08 1.33E-10 9.07E-09 1.59E-07 1.298-06 5.728-07 7.198-08 4.528-07 1.30E-08 9.258-09 7.438-08 5.008-08 8.758-09
7.968-08 2.40E-10 1.69E-08 3.29E-0? 1.38E-06 2.L68-06 1.50E-07 1.02E-06 2.528-08 2.948-08 7.988-07 7.038-07 2.02I'-08
Uterus
Total botly 7.918-07 6.628-0? 6.24E.07 3.99E-07 5.95E-07 6.90E-07 4.228-07 5.4r8-O7 4.288-07 7.778-07 7.62F-07 7.628-07 7.738-07

Source Orgons
ïorget Orgons Muscle Ovories Poncreos Red Corticol Trobeculor Spleen Testes Thymus Thyroid Urinory Uterus To'tol
Monow Bone Bone Blqdder Body
Ad¡ena-ls 3.298-07 r.r2Ð-07 2.85E-06 7.27E.07 3.29E-07 3.298-07 t.248-06 1.01E-08 1.85E-07 3.14E-08 4.14E-08 7.96E-08 7.90E-07
Brain 7-05E-08 2.64E-t0 4.16E-09 2.588-07 3.71E-07 3.7L8-07 5.71E-09 4.798-Lt 3.50E-08 4.18E-07 1.33E-10 2.408-10 6.62E-07
Breasts 1-35E-07 1.448-08 1.96E-07 r.77E.07 1.08E-07 1.08E-07 1.50E-07 0.00E+00 7.978-07 1.03E-07
Gallbladder wall 3.378-07 2.958-07 2.05E-06 3.34E-07 1.33E-07 1.33E-07 3.448-07 3-218-08 9.1lE-08 1.52E-08 1.198-07 3.298-07 8-18E-07
LLI wall 3.76E-07 3.17E-06 r.298-07 5.758-07 2.2tE-07 2.2LF-07 1.34E-07 5.65E-07 9.778-09 1.99E-09 1.53E-06 1.28E-06 8.06E-07
Sma-lì intestine 3-15E-07 2.458-06 3.95E-07 5.178-07 1.668-07 1.66E-07 2.9t8-07 9.04E-08 2.19E-08 3.03E-09 5.738-07 2.16E-06 8.18E-07
Stomach 3.11E-07 1.85E-07 3.428-06 2.448-07 t.2tE-O1 L.2LE-O7 2.02E-06 2.268-08 t.28F.-07 2.16E-08 7.29E-08 t.728-07 7.77F.-07
ULI wa-ll 3.09E-07 2.218-06 4.348-07 4.398-07 1.48E-07 1.48E-07 2.828-07 6.80E-08 2.978-08 5.94E-09 4.33F-07 1.08E-06 8.06E-07
Heart wa-ll 2.62F,-07 3.15E-08 9.35E-07 3.2tE,-07 r.738-07 1.73E-07 4.368-07 4.93E-09 1.96E-06 1.35E-07 1.03E-08 2.948-08 7.748-07
Kidneys 2.86Ð-07 2.t68-07 1.40E-06 5.128-07 1.91E-07 1.91E-07 1.85E-06 1-908-08 6.798-08 1.92E-08 8.00E-08 1.98E-07 7.61E-07
Liver 2.198-07 1.19E-07 1.028-06 2.66Ð-07 r.498-07 1.49E-07 2.t48-07 1.02E-08 t.768-07 3.49E-08 4-79E-08 1-03E-07 7.61E-07
Lungs 2.65E-07 2.65E-08 4.728-07 3.328-07 2.058-07 2.058-07 4.5t8-07 3.158-09 7.90E-07 2.528-07 6.16E-09 2.028-08 7.13E-07
Muscle 1.40E-06 4.04Ð-07 3.50E-0? 2.738-07 2.288-07 2.288-07 2.98E-07 3.00E-07 3.09E-07 3.35E-07 3-67E-07 4-00E-07 7.028-07
Ova¡ies 4.04x-07 3.62E-03 t.2rE-07 5.94E-07 1.90E-07 1.90E-07 t.t2E-07 0.00E+00 1.208-08 2.35E-09 1.38E-06 3.95E-06 8.268-07
Pa¡creas 3.50E-07 t.2tE-07 3.56E-04 4.418-07 r.978-07 1.97E-07 3-58E-06 1-51E-08 t.748-07 3.208-08 5.428-08 t.23E-07 8.218-07
Red ma¡row 2.73E-07 5.948-07 4.338-07 1.49E-05 6.06E-07 7.53E-06 2.698-07 9.56E-08 2.53E-01 2.36î,-07 2.388-07 4.04F.-07 7.39E-07
Bone surfaces 3.25E-07 2.76F-07 2.88E-07 8.35E-06 1.028-05 1.83E-05 2.168-07 1.85E-07 2.178-07 3.39E-07 1.768-07 2.t28-07 8.128-07 o
Skin 1.88E-07 1.01E-07 9.878-08 t.458-07 1.70E-07 1.70E-07 t.2LE-07 3.26E-07 1.51E-07 r.448-07 t.26E-07 9.87E-08 5.99E-07 J
Spleen 2.98E-07 r.r2E-07 3.588-06 2.74F,-07 1.498-07 t.49F-07 1.93E-04 1.30E-08 1.04E-07 3.10E-08 4.28E-08 9.278-08 7.61E-07 o
Ð
+
Testes 3.00E-07 0.008+00 1.518-08 1.00E-07 1.31E-07 1.318-07 1.30E-08 8.478-04 2.01E-09 4.13E-10 1.02E-06 0.00E+00 7.028-07 o
Thymus 3.09E-07 1.20E-08 r.748-07 1.49E-07 1.04E-07 2.018-09 1.56E-03 4.398-07 6.04E-09 1.138-08 7.31E-07 Ì\)
Thy'roid 3.35E-07 2.35E-09 3.20E-08
Urinary bladder wall 3.94E-07 1.44E-06 5.768-08
2.31F,-07 2.358-07 2.35F.07
2.54F,-07 L.2tE-07 t.2tE-07
3.10E-08
4.028-08
4.39E-07 1.578-03 1.18E-09 2.218-09
4.13E-10
6.03E-09 1.19E-09 8.72E-05 3.428-06
1.02E-06
7.31E-07
7.978-07
-
f
Uterus 4.00E-07 3.95E-06 t.238-07 4.23Ð-07 r.478-07 t.478-07 9.278-08 0.00E+00 1.13E-08 2.21F.-09 3.26E-06 4.318-04 8.33E-07
o
Total body 7.02E-07 8.278-07 8.218-07 7.38E-07 7.05E-07 7.05E-07 7.62D-07 7.02E-07 7.328-07 7.318-07 3.92E-07 8.33E-07 7.078-07
=
r-)
LLI, lower lrge intestine; ULI, upper læge intestine.
xData calculated using software described in reference 6. a\
ar
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S-volues (mGy/MBq'sec) fot F-18 in lhe Reference Adult* m

Source Orgons

'.Torgel Orgons Adrenqls Broin Breosls Goll- LLI Smoll Stomoch ULI Heort Heort Kidneys Liver Lungs m
U
blodder Contents lntestine Contents Conlents Woll
0
Adrenals 2.7tE-03 1.16E-08 4.74E-07 2.L2E'06 2.t38-07 5.888-07 2.12E-06 6.688-07 1.79E-06 2.11E-06 5.38E-06 3.10E-06 1.798-06 zm
Brain 1.168-08 4.77E-05 4.12E-08 6.90E-09 9.28E-10 1.838-09 1.09E-08 2.178-09 5.10E-08 4.928-08 4.99E-09 1.81E-08 1.00E-07
Breasts 4.748-07 4.128-08 1.5lE-04 3.10E-07 4.448-08 9.84E-08 5.07E-07 1.16E-07 1.95E-06 2.12E-06 2.L38-07 6.03E-07 1.798-06
Gallbladder wall 2.28E.06 5.158-09 3.26E-07 4.52F,-04 4.73E.07 3.09E-06 2.12E-06 5.04E-06 7.19E-07 9.60E-07 2.92E-06 6.038-06 5.70E-07
LLI wall 2.t28-07 7.778-10 4.43E-08 4.098-07 1.69E-04 4.248-06 6.84E-07 1.79E-06 5.74E-08 7.21E-08 4.4L8-07 r.448-07 5.08E-08
Small intestine 5.88E-07 1.83E-09 9.84E-08 3.09E-06 4.89E-06 5.67E-05 1.39E-06 8.958-06 1.64E-07 2.128-07 1.55E-06 8.64E-07 t.44E-07
Stomach 1.80E-06 9.45E-09 5.39E-07 1.95E-06 9.62E.07 1.56E-06 1.06E-04 2.12F,-06 1.19E-06 1.80E-06 1-80E-06 1.14E-06 8.48E-07
ULI wall 7.028-07 2.18E-09 9.83E-08 5.37E-06 2.28E'06 9.93E-06 1.80E-06 1.11E-04 2.t2E-07 2.458-07 1.51E-06 1.35E-06 1.80E-07
Hea¡t wall 2.1lE-06 4.928-08 2.t2F,-06 7.518-07 7.87E-08 2.128-07 1.79E-06 2.468-07 6.52E-05 1-598-04 6.048-07 1.63E-06 3.09E-06
Kidneys 5.38E-06 4.99E-09 2.13E-07 2.768-06 6.02E.07 1.55E-06 1.808-06 1.52E-06 5.55E-07 6.048-07 t.75F,-04 2.t28-06 5.238-07
Liver 3.10E-06 1.818-08 6.03E-07 5.70E-06 1.80E-07 8.648-07 1.08E-06 1.40E-06 1.50E-06 1.63E-06 2.t2E.06 3.518-05 t.428-06
Lungs 1.79E-06 1.00E-07 1.79E-06 5.06E-07 6.55E-08 r.448-07 8.16E-07 1.808-07 3.26E-06 3.09E-06 5.238-07 t.428-06 4.85E-05
Muscle 8.80E-07 1.96E-07 3.75F-07 8.64E-07 9.13E-07 8.328-07 7.50E-07 7.99F.-07 6.52E-07 7.01E-07 7.668-07 5.87E-07 7.01E-07
Ovaries 2.778-07 9.44F,-10 4.6lE-08 7.998-07 9.298-06 6.35E-06 5.05E-07 5.38E-06 8.04E-08 9.49E-08 5.87E-07 3.278-07 7.85E-08
Pancreas 7.33E-06 r.448-08 5.39E-07 4.87E-06 3.768-07 1.06E-06 8.478-06 1.16E-06 1.79E-06 2.44F.-06 3.758-06 2.60E-06 1-278-06
Red ma¡row 1.95E-06 7.L7F,-O7 5.06E-07 8.15E-07 1.63E-06 1.35E-06 6.518-07 1.16E-06 9.t2E-07 9.12F-07 1.38E-06 7.178-07 9.L28-07
Bone surfaces 1-098-06 t.248-06 3.59E-07 4.078-07 6.85E-07 5.38E-07 3.91E-07 4.728-07 6.028-07 6.02E.07 6.35E-07 4.898-07 6-84E-07
Skin 3.26E-07 3.928-07 6.85E-07 2.78E,-07 3.108-07 2.788-07 3.26E-07 2.78F-07 3.26E-07 3.27F-07 3.768-07 3.278-07 3.59E-07
SpIeen 3.26E-06 1.978-08 4.24E'-07 8.50E-07 4.73F-07 7.828-07 5.378-06 7.17E,-07 8.32E-07 1.14E-06 4.89E-06 5.7tF-07 1.17E-06
Testes 3.298-08 1.71E-10 0.00E+00 9.99E-08 t.22E.06 2.62E.07 5.91E-08 2.738-07 7.448-08 1.63E-08 6.06E-08 3.298-08 1.068-08
Thymus 5.05E-07 1.078-07 2.28F,-06 1.64E-07 3.788-08 6.39E-08 3.76E-07 8.18E-08 6.20E-06 5.068-06 1.96E-07 4.748-07 2.728-06
Thyroid 9.19E-08 1.14E-06 2.94F--07 4.768-08 8.108-09 9.75E-09 4.93E-08 1.98E-08 3.758-07 3.758-07 6.05E-08 9.978-08 6.858-07
Urinary bladder wall 1.06E-07 4.77E-10 2.968-08 4.568-07 3.26E-06 1.488-06 2.t38-07 1.208-06 4.ttB-08 2.79F-08 2.738-07 7.478-07 2.808-08
Uterus 2.28E-07 8.618-10 5.418-08 8-798-07 3.58E-06 5.54E-06 4.09E-07 2.618-06 7.778-08 9.00E-08 5.398-07 2.788-07 6.068-08
Total bocly 1.548-06 1.21E-06 1.13E-06 9.968-07 1.258-06 1.38E-06 9.47E-07 L.77E.06 9.398-07 1.508-06 r.478-06 7.478-06 1.348-06

Source Orgons
ïorget Orgons Muscle Ovories Poncreos Red Corticol Trobeculor Spleen Testes Thymus Thyroid Urinory Uterus ToÌol
Morrow Bone Bone Blodder Body
Adrenals 8.808-07 2.778-07 7.33E-06 1.958-06 8.968-07 8.96E-07 3.26E-06 3.298-08
Brain 1.96E-07 9.448-10 5.058-07 9-19E-08 r.22F,-07 2.288-07 1-548-06
7.44E,-08 7.178-07 1.03E-06 1.03E-06 1.97E-08
Breasts 3.758-07 1.7lE-10 1.07E-07 1.14E-06
4.778-10 8.61E-10 1.21E-06
4.61E-08 5.39E-07 5.06E-07 3.108-07 3.10E-07
Gallbladder wall 4.248-07 0.00E+00 2.288-06 2.948-07 2.308-08
8.978-07 7.82E.07 5.37E-06 8.958-07 3.58E-07 5.41E-08 1.13E-06
LLI wall 3.58E-07 8.98E-07 9.66E-08 2.458-07 4.768-08 3.268-07
9.948-07 8.468-06 3.428-07 1.53E-06 6.028-07 8.668-07 r.628-06
Small intestine 6.028-07 3-598-07 1.50E-06 3.12E-08 6.79E-09
8.328-07 6.35E-06 1.06E-06 1.35E-06 4.40F-07 3.91E-06 3.268-06 1.598-06
Stomach 4.408-07 7.82E-07 2.628-07 6.39E-08 9.75E-09
8.318-07 5.238-07 8.96E-06 6.52F-07 3.268-07 1.48E-06 5.54E-06 1.62E-06
ULI wall 3.268-07 5.218-06 6.71E-08 3.768-07 6.56E-08 1.96E-07
8.158-07 5.70E-06 1.12E-06 1.14E-06 3.91E-07 4.748-07 1.52E-06
Heart wall 3.91E-07 7.188-07 1.96E-07 9.33E-08 1.98E-08
7.01E-07 9.49E-08 2.44E,-06 8.64E-07 4.728-07 1.13E-06 2.778-06 1.59E-06
Kldneys 4.72E,-07 1.14E-06 1.638-08 5.06E-06 3.75E-07 3.12E-08
7.668-07 5.878-07 3.758-06 1.39E-06 5-228-07 9.00E-08 1.50E-06
Liver 5.228-07 4.89E-06 6.06E-08 1.968-07 6.05E-08 2.288-07
5.878-07 3.27E.07 2.608-06 7.178-07 4.078-07 5.39E-07 I.478-06
Lungs 4.07E-07 5.7L8-07 3.29E-08 4.748-07 9.97E-08 1.39E-07
7.018-07 7.85E-08 t.27E.06 9.12E-07 5.70E-07 2.788-07 1.47E-06
Muscle 5.70E-07 1.17E-06 1.06E-08 2.128-06 6.85E-07 1.98E-08
2.288-06 1.08E-06 9.29E-07 7.348-07 6.198-07 6-06E-08 1.34E-06
Ovaries 6.19E-07 7.998-07 8.15E-07 8.31E-07 8.96E-07 9.78E-07
1.08E-06 4.978-03 3.268-07 1.58E-06 5.05E-07 1.068-06 1.33E-06
Pa¡creas 5.058-07 2.778-07 0.00E+00 3.78E-0A 8.1lE-09 3.58E-06
9.298-07 3.26E-07 5.17E-04 1.19E-06 5.37E,-07 1.03E-05 1.63E-06
Red ma¡row 5.37E-07 9.44E-06 4.76F.08 4.568-07 9.17E-08 L.548-07
7.348-07 1.58E-06 1.19E-06 2.09E-05 1.63E-06 3.268-07 r.628-06
Bone surfaces 1.10E-05 .7.508-07 2.778-07 6.85E-07 6.35E-07 6.35E-07
7.50E-07 6.03E-07 6.518-07 1.18E-05 9.20E-06 1.09E-06 1.42E-06
Skin 2.00E-05 4.89E-07 4.248-07 4.89E-07 7.828-07 3.75E-07
5.228-07 4.568-07
SpÌeen 7.99F-07
2.788-07
2.778-07
2.78E.07 4.08E,-07 4.89E-07 4.89E.07 3.43E-07 8.978-07 4.248-07 3.928-07 3.438-07 2.788-07
1.49E-06
1.06E-06
o
f
9.448-06 7.508-07 4.08E-07 4.08E-07 2.92F,-04
Testes 8.15E-07 0.00E+00 4.76E-08
4.11E-08 2.798-07 8.99E-08 1.31E-07 2.628-07 1.47E-06 o
2.778-07 3.59E-07 3.59E-07 4.11E-08 I.228-03
Th¡znus 8.31E-07 3.78E-08 4.568-07
6.96E-09 1.49E-09 2.61F-06 0.008+00 1.33E-06 +
Thyroid
6.85E-07 4.088-07 4.08F.07 2.798-07 6-96E-09 2.218-03 1.14E-06 1.98E-08 3.618-08 o
8-96E-07 8.11E-09 9.178-08 6.35E-07 6.528-07 1.39E-06
Urinary bladder wall 6.528-07 8.99E-08 1.49E-09 1.14E-06 2.2LF,-03 4.16E-09 N)
1.04E-06 3.748-06 1.63E-07 6.678-07 3.268-07 7.628-09 1.398-06 rl
Uterus 3.26E-07 r.238-07 2.61E-06 1.98E-08 4-16E-09
1.068-06 1.038-05 3.268-07 1.09E-06 1-36E-04 8.95E-06 1.57E-06
Total body 3.9lE-07 3.91E-07 2.62E,-07 0.00E+00 3.61E-08 7.628-09
1.33E-06 1.63E-06 1.62E-06 1-41E-06 8.46E-06 6.328-04 1.658-06 +
1.33E-06 1.33E-06 t.478-06 1.33E-06 1.398-06 o
1.39E-06 9.33E-07 1.65E-06 1.33E-06
lower large intestine; IJI,I, upper large intestine. 5
-LLI,
*Data \J
ca-lculated using software describedìn refe¡ence 6.
Ð
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+

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424 c o o PHYSICS lN NUCLEAR MEDICINE Chopter 21: lnternol Radiofion Dosimefry a ça 425
A B t E 2I -6
T uptake in radiosensitive organs. As well,
Rodlotion Dose Eslimoles for t8F-Fluorodeoxyglucose in on Adult Sublecl* ndiation dose estimates for therapeutic
applications should incorporate data
Orgon Dose (mGy/MBq Administered) Orgon Dose (mGy/MBq Administercar acquired on the specific patient, as described
Adrenals 1.3x102 Muscle 1.1 x 10-2 ijExample 2I-9.
Brain 1.9 x 10-2 Ovaries 1.7 x 10-2
Breasts 9.2 x 10-3 Pancreas 2.6x102
Gallbladder wall 1.4 x I0-2 Red marrow 1.3 x 10-2
Lower large intestine wall 1.7 x l0-2 Bone surfaces 1.2 x 10-2 References
Small intestine 1.4 x 10-2 Skin 8.4 x 10-B
Stomach 1.3x102 Spleen 3.7 x 10-2 SocíetYof ublica-
Upper large intestine wall 1.3 x 10-2 Testes 1.3 x 10-2 tion's, 10.
ide the
Heart walì 6.0 x 10-2 Thymus 1.2 x 10-2 basíc
Kidneys 2.0xI02 Thyroid 1.0 x 10-2
Liver 1.6 x 10-2 Urinary bladder wall 1.9 x 10-1
Lungs I.7 x l0-2 Uterus 2.3 x 10-2
*Data from reference 7.
A general guid,e for performing internal dositnetrv caL_
culations with the MIRD approach is the
fotLíwing:
Loevinger R, Budinger T, Watson E: MIRD primer f'or
hence,the absorbed dose can be much pathophysiolog¡' on uptake, clearance, and Absorbed Dose Calculations. New york, Society of
higher than organ average calculations excretion of the radiopharmaceutical. Nuclear Medicine, 1991.
might suggest. Despite these limitations, the MIRD
The following booh is usefut for MIRD calculations at the
Calculation of cumulated activity, A, also method is a useful tool for comparing the cellular leuel:
is problematic. Initially, with a new radio- average dose to various organs in patients
Goddu.-SM, Howell RW, Bouchet LG, et al: MIRD
pharmaceutical, this must be determined for a wide variety of nuclear medicine Llellular S Values. New york, Society of Nuclear
from animal studies. There can be signifi- procedures. It also is an essential tool in Medicine, 1997.
cant differences bet\¡¡een the kinetics of a the approval process for new radiopharma-
tracer in an animal model and in the human. ceuticals. In circumstances where the Recomtnend,ed, textboohs on basic rad,iation bíology are
the following:
Once a radiopharmaceutical is approved for assumptions on which the MIRD approach
human use, it is po_ssible to obtain human is based are unacceptable, more complex Alpen EL: Radiation Biophysics, 2nd ed. San Diego, CA,
Academic Press, 1998.
data to estimate A. However, values for and involved methods can be used. For Hall_EJ: R-adiobiologSr for the Radiologist, 5th ed. New
healthy subjects may differ widely from example, microdosimetric (cellular level) York, Lippincott, Williams & Wikìns, ZOOO.
those for patients and from one patient calculations should be done for radiophar-
to the next because of the effects of maceuticals that have very nonuniform