考虑生物廓清作用时细胞剂量转换因子模型的改进

放射免疫治疗(radioimmunotherapy, RIT)是以单克隆抗体为载体,以放射性核素为弹头,通过抗体特异性结合表达肿瘤细胞相关抗原,将产生高能射线的放射性核素靶向到肿瘤细胞,实现对肿瘤的近距离内照射治疗^[1]。α射线射程短、传能线密度高的特性,使得α核素的旁效应(bystander effect)很小,非常适合于非实体瘤的放射免疫治疗。Hamacher等^[2]和Cruz等^[3-4]从理论上计算了不同核素、不同靶源组合和不同靶源大小时细胞亚细胞水平(即微剂量领域,micordosimetry)的S因子,并以此作为估算辐射吸收剂量、评估治疗风险以及预测治疗效果的基本参数。然而,RIT临床和理论研究中涉及的许多重要的放射性核素(如²¹¹At、²¹³Bi、²²⁵Ac、²²³Ra等)衰变后会生成一系列放射性子核。这些放射性子核对靶区同样有剂量贡献。特别是当反应链中含有很多α核素时,其对靶区的剂量贡献甚至大于母核。此时仅用母核的细胞S因子来表示一次辐射在特定靶区内的剂量沉积就不再合适。基于以上考虑,Hamacher等^[2]提出用随截止时间τ₀变化的细胞剂量转换因子(cellular dose conversion factor,DCF)来修正医用内照射剂量委员会(Medical Internal Radiation Dosimetry Committee)提出的MIRD剂量估算模型中的细胞S因子。     

山羊牙釉质电子自旋共振的剂量学特性

目的 探讨山羊牙釉质电子自旋共振(ESR)的剂量学的特性.方法 采用机械和化学处理相结合的方法,制备5组不同年龄的山羊牙釉质样品.用137 Cs γ射线照射山羊牙釉质样品,使用ESR波谱仪测量辐射前和不同辐射剂量后不同牙釉质样品的ESR信号.结果 137Cs γ射线照射前,山羊牙釉质所固有的ESR本底信号平均值为21.5,明显低于人的平均本底强度水平39.5;与人牙釉质相同,山羊牙釉质照射后产生的剂量学信号的强度与照射剂量线性相关,5组100 mg山羊牙釉质样品,其剂量学峰的辐射灵敏度的平均值为(34.3±1.9)/Gy,与人牙釉质样品的辐射响应平均值36.3/Gy非常接近.结论 人类牙釉质样品缺乏时,可以用相同辐射环境中的山羊牙釉质作为替代品进行剂量重建,为正确地评价辐射事故剂量提供科学依据.

Abstract：

Objectlve To study the properties of goat tooth enamel electron spin resonance (ESR)dosimetry.Methods Tootll enamel samples of goats were achieved by combined mechanical and chemical treatment at the ages of l,2,3,5,and 6 years.respectively and 9 enamel samples of adult molar were obtained.These enamel samples were exposed to 137Cs γ-rays at the cumulative doses of 0,0.5,1.0,2.0,and 5.0 Gy,respectively.ESR spectra Was measured before and after exposure.Results The background signal of goat tooth samples W88 21.5,significantly lower than that of the adult molar samples(39.5).The dusimetric signal intensity of the goat enamel increased with the radiation dose in a linear manner just as that of the human molars.The average radiation sensitivity of the goat tooth samples was(34.3±1.9)/Gy,close to that of the human tooth samples.Conclusions Goat teeth can be used for retrospective radiation dose reconstruction when human teeth are unavailable,in order to previde scientific data for dose reconstruction accurately.     

山羊牙釉质电子自旋共振的剂量学特性

Objectlve To study the properties of goat tooth enamel electron spin resonance (ESR)dosimetry.Methods Tootll enamel samples of goats were achieved by combined mechanical and chemical treatment at the ages of l,2,3,5,and 6 years.respectively and 9 enamel samples of adult molar were obtained.These enamel samples were exposed to 137Cs γ-rays at the cumulative doses of 0,0.5,1.0,2.0,and 5.0 Gy,respectively.ESR spectra Was measured before and after exposure.Results The background signal of goat tooth samples W88 21.5,significantly lower than that of the adult molar samples(39.5).The dusimetric signal intensity of the goat enamel increased with the radiation dose in a linear manner just as that of the human molars.The average radiation sensitivity of the goat tooth samples was(34.3±1.9)/Gy,close to that of the human tooth samples.Conclusions Goat teeth can be used for retrospective radiation dose reconstruction when human teeth are unavailable,in order to previde scientific data for dose reconstruction accurately.     

心血管介入手术中操作者职业照射的临床调查

目的 调查心血管介入手术中操作者的有效剂量。方法 利用热释光方法对某省属三级甲等医院进行的24例冠状动脉血管造影术(CA)或者继续行经皮穿刺腔内冠状动脉成形术(PTCA)或者继续行冠状动脉支架植入术(PICAS)和4例起搏器植入术(PT)的操作者进行了体表剂量测定和有效剂量估算。结果 在CA、PTCA、PICAS中平均手术时间为(19.2±6.3)min,操作者平均每次手术的有效剂量为(4.1±0.9)μSv,在没有铅衣防护的条件下,为(52.2±15.5)μSv;而PT平均手术时间为(14.1±4.6)min,操作者平均每次手术的有效剂量为(5.5±1.4)μSv,在没有铅衣防护的条件下,为(220±42)μSv。结论 应努力提高操作者的技术水平,缩短荧光照射时间,保证医护人员防护设施的配置,以降低操作者的受照剂量。     

心血管病介入操作时患者受照剂量研究

目的 对心血管介入手术中患者所受辐射剂量及与辐射剂量相关的指标进行采集和分析,为改善患者的辐射防护提供依据.方法 对在省属三级甲等医院进行的26例完整的心血管介入手术的患者进行临床数据采集,按手术类别分成冠状动脉血管造影术(CA)及行冠状动脉血管造影术(CA)后继续行经皮穿刺腔内冠状动脉成形术(PTCA)两组,采用TLD个人剂量计照射野矩阵测量法,检测患者荧光照射时间、入射皮肤剂量(ESD)、最高皮肤剂量(PSD)、剂量-面积乘积(DAP)等指标,用TLD测量在模拟心血管手术条件下体模器官剂量.结果 荧光透视时间为(17.7±15.6)min,范围为0.80～42.4 min;ESD范围为(159±138)mGy,4.40～459 mGy;PSD范围为(769±705)mGy,22.6～2.43×103mGy.CA+PTCA组的荧光照射时间、ESD、PSD均大于CA组,差异有统计学意义.最大皮肤受照剂量与透视时间有较好的相关性(r=0.84,P＜0.01).结论 心血管病放射性介入操作时,可通过透视时间来估算最大皮肤受照剂量.

Abstract：

Objective To collect and analyze the radiation dose to patients in cardiovascular interventional procedures and the radiation dose-related indicators,in order to provide a basis for improving radiation protection of patients.MethodsThe clinical data of 26 cases of complete cardiovascular interventional procedures was collected in the municipal Grade A Class Three hospitals,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA),and the patient-received radiation doses and other related factors was studied.TLD personal dosimeter radiation field matrix method was used to measure fluorescence time,the entrance skin dose (ESD),the peak skin dose (PSD),dosearea product (DAP) and other indicators.TLD was used to measure the organ dose of the phantom under the cardiovascular interventional procedure condition.ResultsThe fluoroscopy time was (17.7 ±15.6) min during the range of 0.80-42.4 min.The average entrance skin dose (ESD) was (159 ± 138)mGy during the range of 4.40-459 mGy.The peak skin dose (PSD) was (769 ± 705) mGy during the range of 22.6 - 2.43 × 103mGy.The fluorescence time,entrance skin dose (ESD) ,peak skin dose (PSD) of the group CA + PTCA are greater than the group CA and the difference has statistical significan.The peak skin dose and the fluoroscopy time have good linear correlation (r = 0.84,P ＜ 0.01 ).Conclusion The peak skin dose the patient received in cardiovascular interventional radiological operation can be estimated through the fluoroscopy time.