The shielding of positron emission tomography (PET) and PET/CT (computed tomography) facilities presents special challenges. The 0.511 MeV annihilation photons associated with positron decay are much higher energy than other diagnostic radiations. As a result, barrier shielding may be required in floors and ceilings as well as adjacent walls. Since the patient becomes the radioactive source after the radiopharmaceutical has been administered, one has to consider the entire time that the subject remains in the clinic. In this report we present methods for estimating the shielding requirements for PET and PET/CT facilities. Information about the physical properties of the most commonly used clinical PET radionuclides is summarized, although the report primarily refers to fluorine-18. Typical PET imaging protocols are reviewed and exposure rates from patients are estimated including self-attenuation by body tissues and physical decay of the radionuclide. Examples of barrier calculations are presented for controlled and noncontrolled areas. Shielding for adjacent rooms with scintillation cameras is also discussed. Tables and graphs of estimated transmission factors for lead, steel, and concrete at 0.511 MeV are also included. Meeting the regulatory limits for uncontrolled areas can be an expensive proposition. Careful planning with the equipment vendor, facility architect, and a qualified medical physicist is necessary to produce a cost effective design while maintaining radiation safety standards.

Holmium-166 1, 4, 7, 10-tetraazcyclododecane-1, 4, 7, 10-tetramethylenephosphonate ( 166 Ho-DOTMP) is a radiotherapeutic that localizes specifically to the skeleton and can deliver high-dose radiation to the bone and bone marrow. In patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation two phase 1/2 dose-escalation studies of high-dose 166

This investigation was undertaken to assess the risk to the embryo/fetus associated with sentinel lymph node biopsy and lymphoscintigraphy of the breast performed in pregnant patients. Approximately 92.5 MBq (2.5 mCi) of filtered Tc-99m sulfur colloid was injected peritumorally the day before surgery in two nonpregnant women with breast cancer. The whole-body distribution of the radiopharmaceutical was evaluated using a gamma camera 1 hour after injection. We then calculated the absorbed dose to the embryo/fetus for three theoretical extreme scenarios of biodistribution and pharmacokinetics: 1) all of the injected radiopharmaceutical remains in the breast and is eliminated only by physical decay; 2) all of the injected radiopharmaceutical is instantaneously transported to the urinary bladder, where it remains and is eliminated only by physical decay; and 3) the injected radiopharmaceutical behaves as though it were administered intravenously, that is, it has the biodistribution and pharmacokinetics of Tc-99m sulfur colloid injected for a liver/spleen or bone marrow scan. The fetal radiation absorbed dose was then estimated for two Tc-99m dosages: 18.5 MBq (0.5 mCi) and 92.5 MBq (2.5 mCi). The Medical Internal Radiation Dosimetry (MIRD) program was used to estimate the absorbed doses to the embryo/fetus for the first two scenarios. Published data were used to calculate the doses for the third scenario. A single breast is not among the source organs in the MIRD program, so the heart was used as a surrogate in the first scenario. In the two breast cancer patients, whole-body gamma-camera images obtained 1 hour after radiopharmaceutical injection revealed no radioactivity except in the vicinity of the injection site. In the theoretical scenarios, with 92.5 MBq, the highest absorbed doses to the embryo/fetus were as follows: scenario 1, 7.74 x 10(-2) mGy at 9 months of pregnancy; scenario 2, 4.26 mGy during early pregnancy; and scenario 3, 0.342 mGy at 9 months of pregnancy. The maximum absorbed dose to the fetus of 4.3 mGy calculated for the worst-case scenario is well below the 50 mGy that is believed to be the threshold absorbed dose for adverse effects. Thus breast lymphoscintigraphy during pregnancy appears to present a very low risk to the embryo/fetus.

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MRI provides excellent anatomic and functional information that in some patients was not available by echocardiography or catheterization. Combined with echocardiography, MRI provides the high-quality diagnostic information necessary for management planning in most patients with heterotaxy syndrome. Cardiac catheterization is indicated when determination of pulmonary vascular resistance is necessary for decision making or when an interventional procedures is indicated.

A time-varying filter electrocardiographic gating device designed to reduce NMR-induced gradient artifacts during NMR imaging of the acutely ill cardiac patient is described. When used in conjunction with multiple electrocardiographic display monitors, accurate assessment of the electrocardiogram for morphologic changes and arrhythmias during all phases of the NMR examination is possible.

The relationship between magnetic field gradient waveform moments and the motion sensitivity of magnetic resonance imaging was explored analytically and by computer simulation. The analysis and simulations revealed several key points. In general, waveform time moments define sensitivity to the time derivatives of position of moving material only at a single time point: the time about which the moments are computed. A Taylor series description of instantaneous position is expanded about this same time point to compute the phase acquired due to specific derivatives of position. A moment is proportional to phase sensitivity to a particular derivative of position throughout the waveform only when sensitivity to all lower-order derivatives is zero. Under restricted conditions of waveform symmetry and motion characteristics, the phase due to motion may be expressed in terms of the average value of a derivative of position over the duration of the waveform. The choice of the moment center, or point of expansion, adds a degree of freedom that may be used advantageously in the design of motion-compensating and motion phase-encoding gradient waveforms. These results facilitate a more complete understanding of the effects of motion through a magnetic field gradient.

A 90 degrees-tau 1-90 degrees-tau 2-image acquisition pulse sequence allows spatial mapping of resonant frequency. This sort of sequence has previously been used for magnet shimming, and its use in chemical-shift imaging has been proposed. The authors used this sequence in magnetic resonance imaging of a phantom to demonstrate the magnetic field gradients arising from susceptibility differences within the phantom and allow those gradients to be measured. Gradients may arise near interfaces between substances that cannot support the same magnetic flux density. The pulse sequence was found to work well in lower-field-strength instruments.