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Resources Nuclear Medicine Manual IAEA
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NUCLEAR MEDICINE, RESOURCES MANUAL, The following States are Members of the International Atomic Energy Agency. AFGHANISTAN GREECE PANAMA, ALBANIA GUATEMALA PARAGUAY. ALGERIA HAITI PERU, ANGOLA HOLY SEE PHILIPPINES, ARGENTINA HONDURAS POLAND. ARMENIA HUNGARY PORTUGAL, AUSTRALIA ICELAND QATAR, AUSTRIA INDIA REPUBLIC OF MOLDOVA. AZERBAIJAN INDONESIA ROMANIA, BANGLADESH IRAN ISLAMIC REPUBLIC OF.
RUSSIAN FEDERATION, BELARUS IRAQ, SAUDI ARABIA, BELGIUM IRELAND. BENIN ISRAEL, SERBIA AND MONTENEGRO, BOLIVIA ITALY. SEYCHELLES, BOSNIA AND HERZEGOVINA JAMAICA, SIERRA LEONE. BOTSWANA JAPAN, BRAZIL JORDAN SINGAPORE, BULGARIA KAZAKHSTAN SLOVAKIA. BURKINA FASO KENYA SLOVENIA, CAMEROON KOREA REPUBLIC OF SOUTH AFRICA.
CANADA KUWAIT SPAIN, CENTRAL AFRICAN KYRGYZSTAN SRI LANKA. REPUBLIC LATVIA SUDAN, CHAD LEBANON SWEDEN, CHILE LIBERIA SWITZERLAND. CHINA LIBYAN ARAB JAMAHIRIYA SYRIAN ARAB REPUBLIC, COLOMBIA LIECHTENSTEIN TAJIKISTAN. COSTA RICA LITHUANIA THAILAND, C TE D IVOIRE LUXEMBOURG THE FORMER YUGOSLAV. CROATIA MADAGASCAR REPUBLIC OF MACEDONIA, CUBA MALAYSIA TUNISIA.
CYPRUS MALI TURKEY, CZECH REPUBLIC MALTA UGANDA, DEMOCRATIC REPUBLIC MARSHALL ISLANDS. OF THE CONGO MAURITANIA, UNITED ARAB EMIRATES, DENMARK MAURITIUS. UNITED KINGDOM OF, DOMINICAN REPUBLIC MEXICO, GREAT BRITAIN AND. ECUADOR MONACO, NORTHERN IRELAND, EGYPT MONGOLIA, UNITED REPUBLIC. EL SALVADOR MOROCCO, ERITREA MYANMAR OF TANZANIA, ESTONIA NAMIBIA UNITED STATES OF AMERICA.
ETHIOPIA NETHERLANDS URUGUAY, FINLAND NEW ZEALAND UZBEKISTAN. FRANCE NICARAGUA VENEZUELA, GABON NIGER VIETNAM, GEORGIA NIGERIA YEMEN. GERMANY NORWAY ZAMBIA, GHANA PAKISTAN ZIMBABWE, The Agency s Statute was approved on 23 October 1956 by the Conference on the Statute of. the IAEA held at United Nations Headquarters New York it entered into force on 29 July 1957. The Headquarters of the Agency are situated in Vienna Its principal objective is to accelerate and. enlarge the contribution of atomic energy to peace health and prosperity throughout the world. NUCLEAR MEDICINE, RESOURCES MANUAL, INTERNATIONAL ATOMIC ENERGY AGENCY. VIENNA 2006, COPYRIGHT NOTICE, All IAEA scientific and technical publications are protected by the terms.
of the Universal Copyright Convention as adopted in 1952 Berne and as. revised in 1972 Paris The copyright has since been extended by the World. Intellectual Property Organization Geneva to include electronic and virtual. intellectual property Permission to use whole or parts of texts contained in. IAEA publications in printed or electronic form must be obtained and is. usually subject to royalty agreements Proposals for non commercial. reproductions and translations are welcomed and will be considered on a. case by case basis Enquiries should be addressed by email to the Publishing. Section IAEA at sales publications iaea org or by post to. Sales and Promotion Unit Publishing Section, International Atomic Energy Agency. Wagramer Strasse 5, P O Box 100, A 1400 Vienna, fax 43 1 2600 29302. tel 43 1 2600 22417, http www iaea org books, Printed by the IAEA in Austria. February 2006, STI PUB 1198, IAEA Library Cataloguing in Publication Data. Nuclear medicine resources manual Vienna International Atomic. Energy Agency 2006, STI PUB 1198, ISBN 92 0 107504 9.
Includes bibliographical references, 1 Nuclear medicine physicians Handbooks manuals etc. 2 Nuclear medicine Equipment and supplies Handbooks. manuals etc 3 Nuclear medicine Instruments Handbooks. manuals etc 4 Nuclear medicine Safety measures Handbooks. manuals etc 5 Radiotherapy Handbooks manuals etc, I International Atomic Energy Agency. IAEAL 05 00421, Over the past decade many IAEA programmes have significantly. enhanced the capabilities of numerous Member States in the field of nuclear. medicine Functional imaging using nuclear medicine procedures has become. an indispensable tool for the diagnosis treatment planning and management of. patients However due to the heterogeneous growth and development of. nuclear medicine in the IAEA s Member States the operating standards of. practice vary considerably from country to country and region to region This. publication is the result of the work of over 30 international professionals who. have assisted the IAEA in the process of standardization and harmonization. This manual sets out the prerequisites for the establishment of a nuclear. medicine service including basic infrastructure suitable premises reliable. supply of electricity maintenance of a steady temperature dust exclusion for. gamma cameras and radiopharmacy dispensaries It offers clear guidance on. human resources and training needs for medical doctors technologists. radiopharmaceutical scientists physicists and specialist nurses in the practice of. nuclear medicine The manual describes the requirements for safe preparation. and quality control of radiopharmaceuticals In addition it contains essential. requirements for maintenance of facilities and instruments for radiation. hygiene and for optimization of nuclear medicine operational performance. with the use of working clinical protocols The result is a comprehensive guide. at an international level that contains practical suggestions based on the. experience of professionals around the globe, This publication will be of interest to nuclear medicine physicians. radiologists medical educationalists diagnostic centre managers medical. physicists medical technologists radiopharmacists specialist nurses clinical. scientists and those engaged in quality assurance and control systems in public. health in both developed and developing countries, The IAEA is grateful to all those who have contributed to and reviewed.
this manual, The IAEA officers responsible for this publication were A K Padhy and. K K Solanki of the Division of Human Health, EDITORIAL NOTE. Although great care has been taken to maintain the accuracy of information. contained in this publication neither the IAEA nor its Member States assume any. responsibility for consequences which may arise from its use. The use of particular designations of countries or territories does not imply any. judgement by the publisher the IAEA as to the legal status of such countries or territories. of their authorities and institutions or of the delimitation of their boundaries. The mention of names of specific companies or products whether or not indicated. as registered does not imply any intention to infringe proprietary rights nor should it be. construed as an endorsement or recommendation on the part of the IAEA. CHAPTER 1 GENERAL INTRODUCTION 1, CHAPTER 2 HUMAN RESOURCE DEVELOPMENT 5. 2 1 Training of medical doctors 10, 2 2 Training of nuclear medicine technologists 37. 2 3 Training in radiopharmacy 41, 2 4 Training in medical physics 44.
2 5 Training in nuclear instrumentation 49, 2 6 Training in radiation safety and radiation protection 50. Bibliography to Section 2 6 53, 2 7 Training in molecular biology using radionuclide methods 53. 2 8 Training in radioimmunoassay 57, 2 9 Training of nurses 66. CHAPTER 3 ESTABLISHING NUCLEAR MEDICINE, SERVICES 67. 3 1 Introduction and categorization 67, 3 2 In vivo diagnostic procedures 68.
3 3 In vitro and radioimmunoassay laboratories 76, 3 4 Radiopharmacies 85. 3 5 Medical physics 90, 3 6 Positron emission tomography 91. 3 7 Cyclotrons 94, 3 8 Establishment of a molecular biology laboratory 97. 3 9 Radiation safety 103, Bibliography to Chapter 3 106. CHAPTER 4 INSTRUMENTATION 107, 4 1 Introduction 107.
4 2 Purchase of imaging equipment 108, 4 3 Single photon imaging 113. 4 4 Dual photon imaging 131, 4 5 Other instrumentation 138. 4 6 Computers and networking 151, 4 7 Glossary of technical terms 157. Bibliography to Chapter 4 164, CHAPTER 5 GUIDELINES FOR GENERAL IMAGING 167. 5 1 Introduction 167, 5 2 Nuclear cardiology 171, 5 3 Central nervous system 201.
5 4 Nephrology and urology 228, 5 5 Respiratory system 260. Bibliography to Section 5 5 267, 5 6 Liver and gastrointestinal system 267. 5 7 Nuclear medicine imaging studies in endocrinology 299. 5 8 Musculoskeletal system 318, Bibliography to Section 5 8 335. 5 9 Special procedures in oncology 336, 5 10 Haematology 359. Bibliography to Section 5 10 376, 5 11 Inflammation and infection 377.
Bibliography to Section 5 11 393, 5 12 Radioimmunoassay protocols 393. 5 13 Molecular methods Use of radionuclides in, molecular biology 410. Bibliography to Section 5 13 430, CHAPTER 6 RADIONUCLIDE THERAPY 433. 6 1 Setting up a unit 433, 6 2 Radionuclide therapy Safety principles 435. Bibliography to Section 6 2 448, 6 3 Dosimetry and mathematical models in.
radiopharmaceutical therapy 449, 6 4 Radioiodine therapy for thyrotoxicosis 451. 6 5 Iodine 131 therapy in thyroid cancer 455, 6 6 Palliative treatment of metastatic bone pain 461. 6 7 Iodine 131 meta iodobenzylguanidine therapy 464. Bibliography to Section 6 7 468, 6 8 Phosphorus 32 therapy in polycythemia rubra vera 469. 6 9 Radiosynovectomy 471, Bibliography to Section 6 9 476. 6 10 Iodine 131 Lipiodol 477, Bibliography to Section 6 10 487.
6 11 Intracoronary radionuclide therapy using the, Re 188 DTPA balloon system 487. 6 12 Radiopeptide therapy for cancer 491, Bibliography to Section 6 12 494. 6 13 Radioimmunotherapy 494, CHAPTER 7 QUALITY ASSURANCE AND QUALITY CONTROL. PROTOCOLS FOR RADIOPHARMACEUTICALS 499, 7 1 Introduction 499. 7 2 Requirements for documentation 499, 7 3 Control of starting materials 500.
7 4 Radionuclidic activity 501, 7 5 Radionuclidic purity 501. 7 6 Radiochemical purity 502, 7 7 Chemical purity 503. 7 8 Determination of particle size 504, 7 9 Particulate contamination 504. 7 10 Control of pH 505, 7 11 Sterility and apyrogenicity 505. 7 12 Ongoing evaluation of product performance 506. 7 13 Conclusions 507, Bibliography to Chapter 7 508.
CHAPTER 8 RADIATION SAFETY PRACTICE IN NUCLEAR, MEDICINE 509. 8 1 Introduction 509, 8 2 Local rules 509, 8 3 Radiation safety aspects of radiopharmaceutical. preparation 511, 8 4 Safety precautions Ward and other non nuclear. medical staff 511, 8 5 Disposal of radioactive waste 514. 8 6 Administration of radionuclides to women of, child bearing age or pregnant patients 515.
8 7 Breast feeding patients 515, 8 8 Typical radiation doses from diagnostic studies 517. 8 9 Monitoring 518, 8 10 Radiation safety infrastructure 520. CHAPTER 9 NUCLEAR MEDICINE FUTURE TRENDS 523, 9 1 Electronic data transfer 523. 9 2 Radioimmunoassay and molecular biology 524, 9 3 Imaging and therapy 526. 9 4 Competence and education 528, CONTRIBUTORS TO DRAFT AND REVIEW 531.
GENERAL INTRODUCTION, The key to the successful development of nuclear medicine is that it must. be appropriate to the culture of the country The present Nuclear Medicine. Resources Manual offers guidance on human resources and training needs in. the practice of nuclear medicine for medical doctors physicists technologists. technicians and nurses Nuclear medicine physicians must be able to interpret. the wishes of their clinical colleagues and demonstrate how clinical practice can. be improved by the use of nuclear medicine techniques It is of course. imperative to achieve a certain standard of clinical practice before it can. benefit from nuclear medicine The introduction of complex nuclear medicine. techniques for imaging or treating cancer with radiolabelled antibodies and. peptides is only useful where there is an existing cancer service with qualified. nuclear medicine staff at all levels The International Atomic Energy Agency. IAEA has a longstanding tradition of conducting regional training courses. and arranging further training abroad for individuals to ensure the safe practice. of nuclear medicine in its client countries, The present manual sets out the prerequisites for the establishment of a. nuclear medicine service Basic infrastructure should include suitable premises. a reliable supply of electricity air conditioning temperature control and dust. exclusion for gamma cameras and other equipment Local government and. customs officials must be familiar with the properties of radiopharmaceuticals. and be prepared to expedite customs clearance procedures since radiopharma. ceuticals decay if they are delayed in customs The manual also contains details. of the required instrumentation as well as instructions on maintenance and. optimization of performance, There is also a section on practical clinical protocols and unlike. traditional textbooks where the emphasis is on outlining why protocols should. be followed this manual describes how they should be followed It also stresses. the importance of an accurate interpretation of results and describes pitfalls. likely to be encountered There are five parts in a nuclear medicine report. 1 The patient and demographic data, 2 The details of the test undertaken and the patient s response. 3 A description of the findings, 4 A conclusion based on these findings.
5 The clinical data and request and clinical advice as a result of the study. CHAPTER 1 GENERAL INTRODUCTION, In all cases practicality is emphasized rather than perfection. Both in vivo and in vitro methods are described highlighting the growth. nuclear medicine in the IAEA s Member States the operating standards of practice vary considerably from country to country and region to region This publication is the result of the work of over 30 international professionals who have assisted the IAEA in the process of standardization and harmonization This manual sets out the prerequisites for the establishment of a nuclear medicine

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