International Conference on Nuclear Medicine & Radiation Therapy July 14-15, 2016 Cologne, Germany

Daphne James is a nuclear medicine technologist with over 25 years clinical experience. She completed her PhD in 2015. She is Program Director for Medical Radiation Sciences and a lecturer in nuclear medicine at the University of Newcastle, Australia. Her research interests include foetal radiation exposure, occupational radiation exposure and radionuclide breast imaging.

Diagnostic nuclear medicine procedures expose the patient to ionizing radiation. Although the amount of radiation used in these procedures in considered relatively low, in the pregnant patient it has the potential to cause biological effects in the foetus. This is especially important in the early weeks of pregnancy when the foetus is most sensitive to radiation and the woman may be unaware she is pregnant. The use of hybrid imaging techniques, incorporating computed tomography (CT) with nuclear medicine imaging, is increasing and these types of imaging procedures have the potential to dramatically increase the exposure to both the patient and any unknown foetus. \r\nAll female patients of child bearing age should be questioned prior to any diagnostic imaging procedure that utilizes ionizing radiation to determine if they are pregnant. A survey of current practice in Australia in 2011 revealed a lack of a consistent approach to questioning the patient about their pregnancy status. A Delphi study was conducted in 2014 to provide consensus statements regarding the most appropriate method for questioning female patients, and approaches for specific groups of patients deemed challenging, such as teenagers. The study also developed a simple flowchart to assist staff when questioning their patients. These statements and the flowchart should, when implemented into clinical practice, maintain a consistent and thorough approach which will subsequently assist in reducing the possibility of inadvertent foetal irradiation. \r\n

Terezia Kiskova has completed her PhD in 2012 at the University of Pavol Jozef Safarik in Kosice, Slovakia. During her postdoctoral study she studied at Medical University of Vienna. During this period, she has actively created scientific lectures for children and adolescents (Night of Researchers, Day of Science and Research). She has published more than 13 papers in reputed journals. This year, she has won the Competition of Young Oncologists in Slovakia.

The aim of our study was to find out whether thermography (TG) could be used as a predictive method for early diagnosis of breast cancer (BC). BC was induced with 2 doses of N-methyl-N-nitrosourea (50 mg/kg body weight) to 20 female Sprague Dawley rats. Animals were maintained in temperature-controlled room (22°C) for 15 minutes and then imaged using digital infrared camera (FLIR E40, FLIR Systems OÜ, Estonia). Anesthetized rats (isoflurane, 2ml/L of induction chamber volume) were positioned in front of uniform pad and thermographic images were obtained in 0.5 meter from rats. Images were analyzed by software program (FLIR Tools version 2.0, FLIR Systems, Inc., Wilsonville, USA). Symmetrical body areas were monitored to detect temperature patterns of intact breast in compare to potential affected one. Only tumors developing non-parallel were further evaluated. The predictive role of TG has been monitored and evaluated two weeks before tumor appearance. Rats developed 30 evaluable breast tumors – ductal forms (20), papillary forms (9), and hyperplasia (1). Hyperplasia was accompanied by the raising temperature up to 0.2°C two weeks before the palpation. Interestingly, almost all papillary forms of breast tumors (8/9) were characterized by elevated temperature up to 1.1°C. Nonetheless, 11 ductal carcinomas (55%) were characterized by the increased temperature of 0.6±0.3°C. In 7 cases, temperature sank by 0.5±0.3°C. Two tumors showed no differences in body temperature before manifestation. TG could be used as an effective noninvasive predictive tool in BC diagnosis. However, more studies are required to describe the potential of this predictive method

Renal function assessment is fundamental in preventing platinum nephrotoxicity. British Oncology Pharmacy Association advocates glomerular function rate (GFR) measurement using 51-Cr EDTA (1). However, this method is laborious, costly and inconvenient (2). An alternative is GFR estimation (eGFR) using Cockcroft and Gault (C&G) formula. A survey and evaluation of practice revealed lack of standardised care. \r\nObjectives: The primary objective of this clinical audit was for standardised use of EDTA test in assessing renal function. We aimed for 100% of patients who had renal function assessed by EDTA within set criteria, devised by London Cancer Alliance guideline (3). \r\nMethods: Dataset of EDTA measurements done within one year (2014-2015) in oncology department were reviewed. Comparison between eGFR (C&G) and EDTA was done. London Cancer Alliance guideline (3) was used due to lack of national guideline. 51-Cr EDTA was only done if eGFR <60ml/min or >120ml/min, or in patients with extreme BMI (<18.5kg/m2 or >30kg/m2).\r\nResults: EDTA tests carried out in 30% (20/68) of patients were outside set criteria and could be safely avoided. 70% (48/68) patients had renal function assessed by EDTA within set parameters; low eGFR (<60ml/min) in 41 patients and extreme BMI in 7 patients. EDTA measurement, within set limits, has caused practice change with reduction in dose (20%) and change of drug (5%). Correlation exists between estimated GFR using C&G and measured GFR with EDTA. However, the discrepancy of estimated and measured GFR persists, and cannot be reliably explained by extremes of BMI or weight.\r\nConclusion: Presentation of audit highlighted importance of streamlining renal function assessment to optimise cost and service efficiency. Completing audit loop, inclusive of all patients receiving cisplatin chemotherapy, need to be carried out in the future. \r\n

Artificial alpha-emitting radionuclides are significantly utilized in nuclear medicine. So, the skin of practitioners as well as patients in\r\nnuclear medicine and workers in the industry of radiopharmaceuticals may be accidentally contaminated even for a very short time by these\r\nradionuclides. The basic concepts of a Monte Carlo computer code for evaluating the mean absorbed dose in skin due to alpha-particles\r\nemitted by these radioisotopes were described and discussed. Committed equivalent dose to skin from the deposition of different material\r\nsamples were evaluated. The influence of the application time, alpha disintegration ratio, half-life of the radionuclide, and contaminated\r\nskin surface on committed equivalent dose was investigated.\r\n

Radioactive iodine (131I) is successfully used for the treatment of hyperthyroidism and thyroid cancer. Thyroid is the critical organ for\r\niodine. Iodine is taken up by the thyroid follicular cells. 131I simultaneously emits two types of radiation: beta minus particles used for the\r\ntreatment and gamma rays used for diagnosis. Due to the short range of beta minus particles in tissue, damaging effects of beta radiation is\r\nrestricted to thyroid cells. Total activities from the ingestion of 131I were evaluated in different compartments of the human body of patients\r\nby using the ICRP biokinetic model for iodine. A new dosimetric model was developed for evaluating committed equivalent doses due to\r\n131I intakes in the thyroid tissue of different age groups of patients by exploiting data obtained for specific beta-dose deposited by 1Bq of\r\n131I in the thyroid. Data obtained were compared with those obtained by using the ICRP ingestion dose coefficients for iodine.

Optical glasses are presently utilized by a great number of individuals to correct vision weakness. Two\r\ntypes of solid state nuclear track detectors were used for measuring uranium (238U), thorium (232Th), radon\r\n(222Rn) and thoron (220Rn) contents in various optical glasses as well as radon and thoron in air. Radiation\r\ndoses to eyes of individuals due to alpha-particles emitted by the 238U and 232Th series inside the studied\r\noptical glasses and those emitted by the radon and thoron series in air were evaluated. The influence of the\r\nnature of the optical glasses as well as radon concentration in air on radiation doses received by individuals\r\nwearing optical glasses was studied. Radiation doses were found higher for persons wearing mineral\r\noptical glasses than for those wearing organic optical glasses.