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Nuclear medicine uses radioactive compounds, called radiopharmaceuticals, for diagnosis, staging of disease, therapy and monitoring the response of a disease process. An accident involving both fire and radioactive materials has the potential to develop into a critical situation with dual risks: fire damage and the potential release of radioactive materials. The objective of this work is twofold. Firstly, it attempts to model the fire progression in a nuclear medicine facility using the well-established natural temperature–time curves proposed by the Eurocode. The second objective is to investigate how radioactive materials spread in the atmosphere after the fire, with the primary aim of evaluating the possible effects of airborne radionuclides on nearby residents and first responders who come to the scene of the accident. From the analysis conducted, key findings emerge: (I) the risk of fire in a nuclear medicine department can be considered to be low/moderate and a fire accident would likely result in a controllable and manageable scenario. (II) Additional risks that directly affect the radioactive material could arise in addition to the fire event. As a result of the high concentration of radioactive material, the radiopharmacy and the radioactive storage room are the locations that pose the highest risk. (III) According to the results of this research, the highest temperatures that could be reached during a fire, combined with effective and timely fire control, would result in a limited release of radioactive substances into the environment, with a modest impact on workers and nearby residents. [ABSTRACT FROM AUTHOR]

Molecular Radiation Therapy (MRT) is a valid therapeutic option for a wide range of malignancies, such as neuroendocrine tumors and liver cancers. In its practice, it is generally acknowledged that there is a need to evaluate the influence of different factors affecting the accuracy of dose estimates and to define the actions necessary to maintain treatment uncertainties at acceptable levels. The present study addresses the problem of uncertainty propagation in 90Y-PET quantification. We assessed the quantitative accuracy in reference conditions of three PET scanners (namely, Siemens Biograph mCT, Siemens Biograph mCT flow, and GE Discovery DST) available at three different Italian Nuclear Medicine centers. Specific aspects of uncertainty within the quantification chain have been addressed, including the uncertainty in the calibration procedure. A framework based on the Guide to the Expression of Uncertainty in Measurement (GUM) approach is proposed for modeling the uncertainty in the quantification processes, and ultimately, an estimation of the uncertainty achievable in clinical conditions is reported. [ABSTRACT FROM AUTHOR]

An analytical study, corroborated by Monte Carlo simulations, is presented which describes the interaction of a 300 keV–830 mA proton beam with a Cu and Al dumping system. The analytical calculations rely on the theoretical framework of the Particle Induced X-ray Emission, while the Monte Carlo simulations are performed by means of the GEANT4 toolkit. The case study is related to the project SORGENTINA-RF fusion neutron source and in particular to the tests devoted to assess the performance of the ion source of the plant. The results provide a detailed physical insight of the main processes occurring in the beam dump material, and are also important to give some realistic figures of the radiation emission expected during operation. [ABSTRACT FROM AUTHOR]

The SORGENTINA-RF project aims at designing and realizing an accelerator-driven 14 MeV fusion neutron source. The bio-shielding of this plant must guarantee a maximum contact dose rate of 10 μ Sv/h. For radiation protection purposes, baritic concrete is typically used in γ -ray sources. The higher density of the baritic concrete allows to obtain the same attenuation of the ordinary one, but over smaller thicknesses, albeit with higher production costs. In order to verify the effectiveness of the preliminary design of the SORGENTINA-RF neutron source relying on the use of both ordinary and baritic concrete layers, both neutron and γ -ray attenuation measurements were carried out. Neutron measurements were performed at the Frascati Neutron Generator (ENEA Frascati Research Center), while γ -rays measurements were carried out using the 60 Co source of the ENEA Bologna Research Center. The measurements were corroborated by Monte Carlo simulations performed by means of the MCNP6 code. The good agreement between experiments and simulations allowed to establish that the use of a layer of baritic concrete for the SORGENTINA-RF bio-shielding does not appear to be neither advantageous or cost-effective in terms of attenuation of the n/ γ radiation field, then suggesting the use of only ordinary concrete for the whole shielding design. [ABSTRACT FROM AUTHOR]

At a time of increasing evidence for dose-effect relationships in radioembolization (RE) with 90Y-microspheres, the general consensus is that there is an urgent need for accurate treatment planning and dose assessment in patients undergoing RE treatment. This work aimed at assessing the usefulness of 99mTc macroaggregated albumin (MAA) SPECT/CT imaging for personalized provisional RE dosimetry considering a 3D-printed patientlike phantom (AdboMan phantom). A homemade tool was developed in MATLAB for image analysis and absorbed dose calculation. Two dose calculaton methods were implemented and used to calculate dose volume histograms: (I) dose kernel method and (II) local energy deposition method. The accuracy of the two different dosimetric methods was evaluated by means of 3D γ -index (1%–1 mm and 2%–2 mm) implemented in the tool. Differences between the two dose calculation methods using the 3D γ -index are within 1%–1 mm and 2%–2 mm for all AbdoMan inserts, with a passing rate of 99.9% and 100%, respectively, proving a good agreement between the two calculation methods. The present study supports the use of 99mTc-MAA SPECT acquisition for provisional dosimetry along with the local energy deposition method to convert reconstructed SPECT data into absorbed dose maps. As long as 99mTc-MAA SPECT acquisitions are performed on liver lesions larger than 40 mm, the absorbed dose computed by means of the local energy deposition method can lead to results in line with those obtained by Monte Carlo calculations. [ABSTRACT FROM AUTHOR]

Radioembolization (RE) with 90Y-microspheres has gained widespread acceptance as a safe and effective technique for treating liver malignancies. Accurate quantification in RE is a key step in treatment planning optimization and is becoming a pressing issue in light of the Directive 2013/59/EURATOM. The aim of this study was to develop a SPECT/CT imaging protocol for quantitative imaging optimization in RE based on cutting edge imaging technology (Symbia IntevoTM system provided with the innovative xSPECT software) and a novel anthropomorphic 3D-printed phantom. In the present study, 99mTc-labeled macroaggregated albumin was used as a surrogate radiopharmaceutical for treatment planning. Gamma camera calibration factors and recovery coefficients were determined performing preliminary SPECT/CT acquisitions of a point source, a cylindrical homogeneous phantom and the NEMA/IEC phantom. Data reconstruction was performed using the built-in xSPECT package, using both the Ordered Subset Expectation–Maximization (OSEM) and the Ordered Subset Conjugated Gradient (OSCG) algorithm. Specific regions of interest (ROIs) were drawn on the MIM 6.1.7 system according to the physical volume. The quantification procedure was validated using the anthropomorphic phantom provided with a fillable liver section and spheres of different diameters (20 mm, 40 mm and a 40 mm spherical shell). The measured activity concentration in all geometries is consistent within 4%, demonstrating that the xSPECT software permit an absolute quantification in anthropomorphic geometry largely within the 10% recommended from the manufacturer. Caution is advised in the presence of spherical objects with a necrotic core, as underestimations in the order of 20% were obtained. [ABSTRACT FROM AUTHOR]

The SORGENTINA-RF project aims to develop a 14 MeV fusion neutron source to produce medical radioisotopes with special focus on 99 Mo. The facility is based on a positive ion source with an acceleration stage to produce a deuterium (D +) and tritium (T +) ion beam that, impacting on a titanium-coated rotating target, allows fusion reactions to take place. Maximizing the neutron production rate is one of the main issues to be addressed in the project and the optimization of some key parameters of the ion beam is of paramount importance in this regard. In this study, a methodology is discussed to reach a definition of the beam characteristics for an effective and sustainable operation of the plant. The most convenient layout that has been found out is based on a single ion source fed by a deuterium and tritium gas mixture. Eventually, a series of considerations about the operation of the ion source and fuel cycle have been drawn. [ABSTRACT FROM AUTHOR]

The Sorgentina-RF project will use fusion neutrons to produce 99Mo, a precursor of 99mTc, by irradiating natural molybdenum. 99Mo is produced by means of the inelastic reaction 100Mo(n, 2n)99Mo on 100Mo, which is an isotope of natural Mo. From a functional point of view, the project consists of two parts: an irradiation neutron source at 14 MeV and a radiochemistry facility dedicated to the extraction of 99Mo from the solid sample irradiated by the neutron source. Given the degree of complexity of such a facility, the risk management strategy is based on an integrated approach that combines the engineering method of safety with that of radiation protection. Therefore, design issues were studied and systems were planned according to both radiation protection and safety criteria already in the preliminary phase, allowing a general strengthening of the safety of the plant. This work discusses the preventive analysis and the related activities to identify the ways in which potential exposures to radiation may occur. In particular, the preliminary safety analysis is presented for the innovative rotating target, developed for the project, and, accordingly, some specific technical solutions are given to refine the initial design of the facility. [ABSTRACT FROM AUTHOR]

The therapeutic effect from molecular radiation therapy (MRT), on both tumour and normal tissue, is determined by the radiation absorbed dose. Recent research indicates that as a consequence of biological variation across patients the absorbed dose can vary, for the same administered activity, by as much as two orders of magnitude. The international collaborative EURAMET-EMRP project “Metrology for molecular radiotherapy (MetroMRT)” is addressing this problem. The overall aim of the project is to develop methods of calibrating and verifying clinical dosimetry in MRT. In the present paper an overview of the metrological issues in molecular radiotherapy is provided.

The aim of the present study is to model mixing and transport of radioactive effluents in the course of time between two water reservoirs. To test the model, a hypothetical case study is presented of liquid effluents potentially released during normal operation of a fusion neutron source devoted to radioisotopes production. A suitable example is an accelerator-driven intense D-T 14 MeV neutron source relying on T and D ion beams, with the potential to provide a neutron yield in the range 5 - 7 · 10 13 s-1. It is expected that during normal operation a number of radionuclides will be produced and managed. The present report discusses the mechanisms and parameters which affect and control the fate of radionuclides potentially released into two connected water reservoirs during normal operation of the plant. A mathematical mixing model is developed that describes groundwater flow and radioactive transport between the two basins. The aim of this study is to estimate the amount of radioactivity concentration in both water reservoirs at any time, an information that can be used for radiation protection purposes. [ABSTRACT FROM AUTHOR]

The decision to release a patient receiving medical treatments with unsealed radionuclides should take many factors into account, and is the balance among different requirements. The Italian legislative implementation of the new European Commission Basic Safety Standards (BSS) resulted in the recent Legislative Decree 101/2020, which sets specific dose constraints for the public and for carers and comforters. The aim of the present research is to assess acceptable release criteria (in terms of personal dose-equivalent rate at the moment of hospital discharge) to ensure compliance with the current regulatory framework in Italy. The MicroShield® code was used to derive a more realistic model for the emission of radioactivity by patients treated with radiopharmaceuticals. A geometric source-dependent correction factor, G(r), is introduced in order to take into account the volumetric distribution of the radionuclide into the human body and the attenuation of radiation from body tissues. The proposed approach has the potential to be routinely applied by clinic decision-makers to assess release criteria in the nuclear medicine practice. [ABSTRACT FROM AUTHOR]

Abstract Background Cure rate of early Hodgkin Lymphoma are high and avoidance of late toxicities is of paramount importance. This comparative study aims to assess the normal tissue sparing capability of intensity-modulated radiation therapy (IMRT) versus standard three-dimensional conformal radiotherapy (3D-CRT) in terms of dose-volume parameters and normal tissue complication probability (NTCP) for different organs at risk in supradiaphragmatic Hodgkin Lymphoma (HL) patients. Methods Ten HL patients were actually treated with 3D-CRT and all treatments were then re-planned with IMRT. Dose-volume parameters for thyroid, oesophagus, heart, coronary arteries, lung, spinal cord and breast were evaluated. Dose-volume histograms generated by TPS were analyzed to predict the NTCP for the considered organs at risk, according to different endpoints. Results Regarding dose-volume parameters no statistically significant differences were recorded for heart and origin of coronary arteries. We recorded statistically significant lower V30 with IMRT for oesophagus (6.42 vs 0.33, p = 0.02) and lungs (4.7 vs 0.1 p = 0.014 for the left lung and 2.59 vs 0.1 p = 0.017 for the right lung) and lower V20 for spinal cord (17.8 vs 7.2 p = 0.02). Moreover the maximum dose to the spinal cord was lower with IMRT (30.2 vs 19.9, p Conclusions In HL male patients IMRT seems feasible and accurate while for women HL patients IMRT should be used with caution.

Abstract Background To assess the accuracy of fractionated stereotactic radiotherapy (FSRT) using a stereotactic mask fixation system. Patients and Methods Sixteen patients treated with FSRT were involved in the study. A commercial stereotactic mask fixation system (BrainLAB AG) was used for patient immobilization. Serial CT scans obtained before and during FSRT were used to assess the accuracy of patient immobilization by comparing the isocenter position. Daily portal imaging were acquired to establish day to day patient position variation. Displacement errors along the different directions were calculated as combination of systematic and random errors. Results The mean isocenter displacements based on localization and verification CT imaging were 0.1 mm (SD 0.3 mm) in the lateral direction, 0.1 mm (SD 0.4 mm) in the anteroposterior, and 0.3 mm (SD 0.4 mm) in craniocaudal direction. The mean 3D displacement was 0.5 mm (SD 0.4 mm), being maximum 1.4 mm. No significant differences were found during the treatment (P = 0.4). The overall isocenter displacement as calculated by 456 anterior and lateral portal images were 0.3 mm (SD 0.9 mm) in the mediolateral direction, -0.2 mm (SD 1 mm) in the anteroposterior direction, and 0.2 mm (SD 1.1 mm) in the craniocaudal direction. The largest displacement of 2.7 mm was seen in the cranio-caudal direction, with 95% of displacements < 2 mm in any direction. Conclusions The results indicate that the setup error of the presented mask system evaluated by CT verification scans and portal imaging are minimal. Reproducibility of the isocenter position is in the best range of positioning reproducibility reported for other stereotactic systems.