Forward feeding a RapidPlan model through a thresholding selection based on APQM% is proven to produce equal or better results than a model based on a manually and iteratively refined population. A tighter APQM% threshold turns approximately into a higher average quality of plans generated with RapidPlan. A trade-off must be found between the mean quality of the KBP library and its numerosity. The proposed KBP feeding method helps the KBP user, because it makes the model refinement more intuitive and less time consuming.

Our preliminary data showed that RG-PET/CT in lung cancer can affect not only the volume of PTV but also its shape, as demonstrated by the assessment of gated PTVs outside standard PTV. The use of a gating technique is thus crucial for better delineating PTV by tailoring the target volume to the lesion motion in lung cancer patients.

Purpose Technetium‐99m (99mTc) is the radioisotope most widely used in diagnostic nuclear medicine. It is readily available from 99Mo/99mTc generators as the β−decay product of the 99Mo (T½ = 66 h) parent nuclide. This latter is obtained as a fission product in nuclear reactors by neutron‐induced reactions on highly enriched uranium. Alternative production routes, such as direct reactions using proton beams on specific target materials [100Mo(p,2n)99mTc], have the potential to be both reliable and relatively cost‐effective. However, results showed that the 99mTc extracted from proton‐bombarded 100Mo‐enriched targets contains small quantities of several Tc radioisotopes (93mTc, 93Tc, 94Tc, 94mTc, 95Tc, 95mTc, 96Tc, and 97mTc). The aim of this work was to estimate the dose increase (DI) due to the contribution of Tc radioisotopes generated as impurities, after the intravenous injection of four radiopharmaceuticals prepared with cyclotron‐produced 99mTc (CP‐99mTc) using 99.05% 100Mo‐enriched metallic targets. Methods Four 99mTc radiopharmaceuticals (pertechnetate, sestamibi (MIBI), hexamethylpropylene‐amine oxime (HMPAO) and disodium etidronate (HEDP)) were considered in this study. The biokinetic models reported by the International Commission on Radiological Protection (ICRP) for each radiopharmaceutical were used to define the main source organs and to calculate the number of disintegrations per MBq that occurred in each source organ (Nsource) for each Tc radioisotope present in the CP‐99mTc solution. Then, target organ equivalent doses and effective dose were calculated for each Tc radioisotope with the OLINDA/EXM software versions 1.1 and 2.0, using the calculated Nsource values and the adult male phantom as program inputs. Total effective dose produced by all Tc isotopes impurities present in the CP‐99mTc solution was calculated using the fraction of total activity corresponding to each radioisotope and compared with the effective dose delivered by the generator‐produced 99mTc. Results In all cases, the total effective DI of CP‐99mTc radiopharmaceuticals calculated with either versions of the OLINDA software was less than 10% from 6 up to 12 h after EOB. 94mTc and 93mTc are the Tc radioisotopes with the highest concentration in the CP‐99mTc solution at EOB. However, their contribution to DI 6 h after EOB is minimal, due to their short half‐lives. The radioisotopes with the largest contribution to the effective DI are 96Tc, followed by 95Tc and 94Tc. This is due to the types of their emissions and relatively long half‐lives, although their concentration in the CP‐99mTc solution is five times lower than that of 94mTc and 93mTc at the EOB. Conclusions The increase in the radiation dose caused by other Tc radioisotopes contained in CP‐99mTc produced as described here is quite low. Even though the concentrations of the 94Tc and 95Tc radioisotopes in the CP‐99mTc solution exceed the limits established by the European Pharmacopoeia, CP‐99mTc radiopharmaceuticals could be used in routine nuclear medicine diagno...

The exposure of the fingers is one of the major radiation protection concerns in nuclear medicine (NM). The purpose of this paper is to provide an overview of the exposure, dosimetry and protection of the extremities in NM. A wide range of reported finger doses were found in the literature. Historically, the highest finger doses are found at the fingertip in the preparation and dispensing of 18F for diagnostic procedures and 90Y for therapeutic procedures. Doses can be significantly reduced by following recommendations on source shielding, increasing distance and training. Additionally, important trends contributing to a lower dose to the fingers are the use of automated procedures (especially for positron emission tomography (PET)) and the use of prefilled syringes. On the other hand, the workload of PET procedures has substantially increased during the last ten years. In many cases, the accuracy of dose assessment is limited by the location of the dosimeter at the base of the finger and the maximum dose at the fingertip is underestimated (typical dose ratios between 1.4 and 7). It should also be noted that not all dosimeters are sensitive to low-energy beta particles and there is a risk for underestimation of the finger dose when the detector or its filter is too thick. While substantial information has been published on the most common procedures (using 99mTc, 18F and 90Y), less information is available for more recent applications, such as the use of 68Ga for PET imaging. Also, there is a need for continuous awareness with respect to contamination of the fingers, as this factor can contribute substantially to the finger dose.

InTroDucTIon 18 F-FDG PET/CT (18 F-fludeoxyglucose PET/CT) has become a standard procedure in many types of neoplasms in children. 1-11 The combination of anatomical and metabolic imaging modalities provides accurate diagnostic information useful in initial staging, therapy monitoring, and follow-up of different pediatric diseases. Nevertheless, the introduction of integrated PET/MR scanners in clinical practice has raised interest in its use and benefit in pediatric patients. Published studies have confirmed its non-inferiority to PET/CT in many oncological applications. 12-15 The main reasons in support of PET/MR use in children are the potential of MRI to complement PET metabolic information and the significant reduction in radiation exposure.

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