Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 3. P. 5-16

l.A. Ilyin¹, J.E. Kenigsberg², I.I. Linge³, I.A. Likhtarev⁴, M.N. Savkin³

Radiation Protection of the Population in Response to the Chernobyl Accident

1. A.I. Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. National Committee on Radiation Protection of Belarus, Minsk, Belarus; 3. Nuclear Safety Institute of the Russian Academy of Sciences, Moscow, Russia; 4. Radiation Protection Institute, Kiev, Ukraine

ABSTRACT

Purpose: The analysis of the radiobiological aspects of emergency response: hygienic criteria for radiation protection of the population in various phases of the accident, radiation zoning, the achievements and shortcomings of the measures taken, comparison of the scientific basis, used for government decision-making, with modern approaches and criteria.

Material and methods: The study was carried out by studying the experience of the implementation of specific actions for localization of the source at the nuclear plant and radiation protection of the population in the first post-accident years, under the condition of really existed decision-making system for emergency situations at the time of the accident.

Results: The basic results and radiological consequences of the emergency work for accident localization at the site and in a 30-km zone are formulated. The degree of safety of emergency radiationhygienic regulations for the liquidators was estimated. Efficiency of the main ways of population protection in the early phase of the accident was investigated: public shelter, population evacuation, iodine prophylaxis. Processes of radiation zoning on the basis of dose approach (L.A. Ilyin, Y.A. Izrael) - the most important remedies implemented in the intermediate and late phases of the accident were analyzed. It was discussed in detail, in practical terms, one of the main short-term and long-term remedies - hygienic regulation of the content of radionuclides in food.

Conclusion: With the exception of iodine prophylaxis, remedies for public radiation protection were timely, helped to avoid deterministic effects of radiological exposure and reduces the longterm consequences. Later, the establishment of the iodine prophylaxis would require a large-scale of health care operations in contaminated areas associated with early diagnosis and treatment of victims. Activities of radiation protection at a late stage of the accident were excessive and ceased to be priority in comparison to other directions of rehabilitation.

Key words: radiation protection, population, radiation dose, standards, permissible levels, food products

REFERENSES

1. USSR State Committee of the Utilization of Atomic Energy. The Accident at the Chernobyl NPP and its Consequences. Summary Report of the Post-Accident Review Meeting of the Chernobyl Accident. Vienna: IAEA. 1986. Safety Series N75-INSAG-1.
2. Mezhdunarodnyi chernobyl'skii proekt. Otsenka radiologicheskikh posledstvii i zashchitnykh mer. Dokl. Mezhdunarodnogo konsul'tativnogo komiteta. Vienna: IAEA. 1992. (In Russ.)
3. Chernobyl'. Pyat' trudnykh let: Sb. materialov. Moscow: IzdAT. 1992. (In Russ.)
4. Mezhdunarodnaya konferentsiya IAEA. 10 let posle Chernobylya. Vienna: IAEA. 1996. (In Russ.)
5. Chernobyl'skaya katastrofa. In V.G. Bar'yakhtara (ed.). Kiev: Naukova dumka. 1995. 559 p. (In Russ.)
6. Il'in L.A. Realii i mify Chernobylya. Publ. 2-e. Moscow: ALARA Limited. 1996. 494 p. (In Russ.)
7. International Conference «Chernobyl: Looking Back to Go Forwards. Vienna. 6-7 September 2005.
8. Aleksakhin P.M., Buldakov L.A., Gubanov V.A. et al. Krupnye radiatsionnye avarii: posledstviya i zashchitnye mery. In L.A. Il'ina i V.A. Gubanova (eds.). Moscow: IzdAT. 2001. (In Russ.)
9. Postanovlenie TsK KPSS i Soveta Ministrov SSSR ot 29 maya 1986. No. 634-188. (In Russ.)
10. Il'in L.A., Kryuchkov V.P., Osanov D.P. et al. Urovni oblucheniya uchastnikov likvidatsii posledstvii chernobyl'skoi avarii v 1986-1987 gg. i verifikatsiya dozimetricheskikh dannykh. Radiats. biologiya. 1995. Vol. 35. Issue 6. P. 803-827. (In Russ.)
11. Sources and Effects of Ionizing Radiation. UNSCEAR 2000 Report to the General Assembly. Annex J. Exposures and the effects of the Chernobyl accident. Vol. II. P. 451–566. United Nations. New York. 2000.
12. Ivanov V.K. Meditsinskie radiologicheskie posledstviya Chernobylya spustya 20 let: dannye natsional'nogo registra. Materialy Rossiiskoi nauchnoi komissii po radiatsionnoi zashchite. 14.03.2006. (In Russ.)
13. Il'in L.A., Konstantinov Yu.O., Likhtarev I.Ya. et al. Vremennye metodicheskie rekomendatsii dlya razrabotki meropriyatii po zashchite naseleniya v sluchae avarii yadernykh reaktorov. Moscow. 1971. (In Russ.)
14. Kriterii dlya prinyatiya resheniya o merakh zashchity naseleniya v sluchae avarii reaktora. Utv. Minzdravom SSSR 04.08.1983. (In Russ.)

For citation: Ilyin LA, Kenigsberg JаE, linge II, likhtarev IA, Savkin MN. Radiation Protection of the Population in Response to the Chernobyl Accident. Medical Radiology and Radiation Safety. 2016;61(3):5-16. Russian.

PDF (RUS) Full-text article (in Russian)

Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 4. P. 68-75

REVIEW

I.A. Znamenskiy^1,2, A.K. Kondakov^1,2, V.V. Mil’kin¹, D.Ju. Mosin¹, A.V. Grechko¹

Positron Emission Tomography with Oxygen-15 in Neurological Practice. Part 2. Clinical Application

1. Hospital for incurable patients -Scientific and Medical Rehabilitation Center, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. N.I. Pirogov Russian National Research Medical University, Moscow, Russia.

ABSTRACT

Purpose: To analyze clinical application of positron-emission tomography with radiopharmaceuticals based on oxygen-15 and to determine the field of its application.

Material and methods: The review of sources, selected from international bibliographic databases.

Results: It is shown that PET with radiopharmaceuticals based on oxygen-15 leads to deep exploration of pathophysiologic basis of a number of brain diseases, among which is ischemic stroke which occupies an important place. Furthermore, the review presents clinical application of PET for chronic cerebrovascular diseases and as a gold standard for validation of other neuroimaging modalities.

Conclusion: PET with radiopharmaceuticals based on oxygen-15 is the only one direct validated method of measurement of a number of quantities characterizing the perfusion and functional capacity of the brain. It may be used in the evaluation of penumbra, quality control of treatment for chronic cerebrovascular diseases and in research. Wide application of this method is prevented by a need of implementation of a large number of costly technical measures.

Key words: positron emission tomography, ¹⁵O, perfusion, brain, review

REFERENCES

1. Znamenskii I.A., Kondakov A.K., Grechko A.V. Pozitronno-emissionnaya tomografiya s kislorodom-15 v nevrologii. Chast' 1. Osnovnye svedeniya i istoricheskii obzor. Medical Radiology and Radiation Safety. 2015. Vol. 60. No. 6. P. 48-54. (In Russ.). (In Russ.).
2. Lassen N.A. The luxury-perfusion syndrome and its possible relation to acute metabolic acidosis localized within the brain. Lancet. 1996. Vol. 2. No. 7473. P. 1113-1115.
3. Baron J.C., Bousser M.G., Rey A. et al. Reversal of focal “misery-perfusion syndrome” by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with ¹⁵O positron emission tomography. Stroke. 1981. Vol. 12. No. 4. P. 454-459.
4. Kety S.S., Schmidt C.F. The Nitrous Oxide Method For The Quantitative Determination Of Cerebral Blood Flow In Man: Theory, Procedure And Normal Values. J. Clin. 1948. Vol. 27. No. 4. P. 476-483.
5. Kudomi N., Hirano Y., Koshino K. et al. Rapid quantitative CBF and CMRO(2) measurements from a single PET scan with sequential administration of dual (15)O-labeled tracers. J. Cereb. Blood Flow Metab. 2013. Vol. 33. No. 3. P. 440-448.
6. Ibaraki M., Shimosegawa E., Miura S. et al. PET measurements of CBF, OEF, and CMRO₂ without arterial sampling in hyperacute ischemic stroke: method and error analysis. Ann. Nucl. Med. 2004. Vol. 18. No. 1. P. 35-44.
7. Powers W.J. Cerebral blood flow and metabolism: regulation and pathophysiology in cerebrovascular disease. In: Stroke: Pathophysiology, Diagnosis, and Management. 6th ed., ed. by Grotta J.C., Albers G.W., Broderick J.P. et al. Elsevier Health Sci. 2015. P. 28-43.
8. Raichle M.E., Grubb R.L.. J., Eichling J.O. et al. Measurement of brain oxygen utilization with radioactive oxygen-15: experimental verification. J. Appl. 1976. Vol. 40. No. 4. P. 638-640.
9. Lebrun-Grandie P., Baron J.-C., Soussaline F. et al. Coupling between regional blood flow and oxygen utilization in the normal human brain. A study with positron tomography and oxygen-15. Arch. Neurol. 1983. Vol. 40. No. 4. P. 230-236.
10. Sette G., Baron J.C., Mazoyer B. et al. Local brain haemodynamics and oxygen metabolism in cerebrovascular disease. Positron emission tomography. Brain. 1989. Vol. 112. Pt. 4. P. 931-951.
11. Leblanc R., Yamamoto Y.L., Tyler J.L. et al. Borderzone ischemia. Ann. Neurol. 1987. Vol. 22. No. 6. P. 707-713.
12. Gibbs J.M., Wise R.J., Leenders K.L. et al. Evaluation of cerebral perfusion reserve in patients with carotidartery occlusion. Lancet. 1984. Vol. 1. No. 8372. P. 310-314.
13. Ackerman R.H., Correia J.A., Alpert N.M. et al. Positron imaging in ischemic stroke disease using compounds labeled with oxygen 15. Initial results of clinicophysiologic correlations. Archives of neurology. 1981. Vol. 38. No. 9. P. 537-543.
14. Wise R.J., Bernardi S., Frackowiak R.S. et al. Serial observations on the pathophysiology of acute stroke. The transition from ischaemia to infarction as reflected in regional oxygen extraction. Brain. 1983. Vol. 106. Pt. 1. P. 197-222.
15. Hakim A.M., Pokrupa R.P., Villanueva J. et al. The effect of spontaneous reperfusion on metabolic function in early human cerebral infarcts. Ann. 1987. Vol. 21. No. 3. P. 279-289.
16. Baron, J.C., Bousser M.G., Comar D. Human hemispheric infarction studied by positron emission tomography and the ¹⁵O continuous inhalation technique. In: Computerized tomography ed. By Caille J.M., Salamon G. New York: Springer Verlag. 1980. P. 231-237.
17. Baron J.C., Jones T. Oxygen metabolism, oxygen extraction and positron emission tomography: Historical perspective and impact on basic and clinical neuroscience. Neuroimage. 2012. Vol. 61. No. 2, 492-504.
18. Powers W.J., Grubb R.L., Darriet D. et al. Cerebral blood flow and cerebral metabolic rate of oxygen requirements for cerebral function and viability in humans. J. Cereb. Blood Flow Metab. 1985. Vol. 5. No. 4. P. 600-608.
19. Touzani O., Young A.R., Derlon J.M. et al. Progressive impairment of brain oxidative metabolism reversed by reperfusion following middle cerebral artery occlusion in anaesthetized baboons. Brain Res. 1997. Vol. 767. No. 1. P. 17-25.
20. Marchal G., Benali K., Iglesias S. et al. Voxel-based mapping of irreversible ischaemic damage with PET in acute stroke. Brain. 1999. Vol. 122. Pt. 1. P. 2387-2400.
21. Frykholm P., Andersson J.L., Valtysson J. et al. A metabolic threshold of irreversible ischemia demonstrated by PET in a middle cerebral artery occlusion-reperfusion primate model. Acta Neurol. 2000. Vol. 102. No. 1. P. 18-26.
22. Marchal G., Rioux P., Serrati C. et al. Value of acutestage positron emission tomography in predicting neurological outcome after ischemic stroke: further assessment. Stroke. 1995. Vol. 26. No. 3. P. 524-525.
23. Marchal G., Furlan M., Beaudouin V. et al. Early spontaneous hyperperfusion after stroke. A marker of favourable tissue outcome?. Brain. 1996. Vol. 119. Pt. 2. P. 409-419.
24. Marchal G., Young A.R., Baron J.C. Early postischemic hyperperfusion: pathophysiologic insights from positron emission tomography. J. Cereb. Blood Flow Metab. 1999. Vol. 19. P. 467-482.
25. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N. Engl. J. Med. 1995. Vol. 333. No. 24. P. 1581-1587.
26. Baron J.C., Bousser M.G., Comar D. et al. “Crossed cerebellar diaschisis” in human supratentorial braininfarction. Trans. Amer. Neurol. Assoc. 1981. Vol. 105. P. 459-461.
27. Yamauchi H., Fukuyama H., Kimura J. Hemodynamic and metabolic changes in crossed cerebellar hypoperfusion. Stroke. 1992. Vol. 23. No. 6. P. 855-860.
28. Baron J.C., Rougemont D., Soussaline F. et al. Local Interrelationships of Cerebral Oxygen Consumption and Glucose Utilization in Normal Subjects and in Ischemic Stroke Patients: A Positron Tomography Study. J. Cereb. Blood Flow Metab. 1984. Vol. 4. No. 2. P. 140-149.
29. Yamauchi H., Fukuyama H., Nagahama Y. et al. Significance of increased oxygen extraction fraction in five-year prognosis of major cerebral arterial occlusive diseases. J. Nucl. Med. 1999. Vol. 40. No. 12. P. 1992-1998.
30. Sobesky J., Thiel A., Ghaemi M. et al. Crossed cerebellar diaschisis in acute human stroke: a PET study of serial changes and response to supratentorial reperfusion. J. Cereb. Blood Flow Metab. 2005. Vol. 25. No. 12. P. 1685-1691.
31. Pantano P., Baron J.C., Samson Y. et al. Crossed cerebellar diaschisis. Further studies. Brain. 1986. Vol. 109. Pt. 4. No. 1. P. 677-694.
32. Serrati C., Marchal G., Rioux P. et al. Contralateral cerebellar hypometabolism: a predictor for stroke outcome?. J. Neurol. Neurosurg. Psychiatry. 1994. Vol. 57. No. 2. P. 174-179.
33. Vinichuk S.M. Diashiz i ego rol' v razvitii reflektorno-dvigatel'nykh rasstroistv pri mozgovom insul'te. Ukrans'kii medichnii chasopis. 2013. No. 2. P. 143-147.
34. Szelies B., Herholz K., Pawlik G. et al. Widespread functional effects of discrete thalamic infarction. Arch. Neurol. 1991. Vol. 48. No. 2. P. 178-182.
35. Baron J.C., D’Antona R., Pantano P. et al. Effects of thalamic stroke on energy metabolism of the cerebral cortex. A positron tomography study in man. Brain. 1986. Vol. 109. Pt. 6. P. 1243-1259.
36. Chabriat H., Pappata S., Levasseur M. et al. Cortical metabolism in posterolateral thalamic stroke: PET study. Acta Neurol. 1992. Vol. 86. No. 3. P. 285-290.
37. Yamauchi H., Fukuyama H., Nagahama Y. et al. Uncoupling of oxygen and glucose metabolism in persistent crossed cerebellar diaschisis. Stroke. 1999. Vol. 30. No. 7. P. 1424-1428
38. Powers W.J., Derdeyn C.P., Fritsch S.M. et al. Benign prognosis of never-symptomatic carotid occlusion. Neurology. 2000. Vol. 54. No. 4. P. 878-882.
39. Hokari M., Kuroda S., Shiga T. et al. Impact of oxygen extraction fraction on long-term prognosis in patients with reduced blood flow and vasoreactivity because of occlusive carotid artery disease. Surg. Neurol. 2009. Vol. 71. No. 5. P. 532-538; discussion 538, 538-539.
40. Yamauchi H., Fukuyama H., Nagahama Y. et al. Evidence of misery perfusion and risk for recurrent stroke in major cerebral arterial occlusive diseases from PET. J. Neurol. Psychiatry. 1996. Vol. 61. No. 1. P. 18-25.
41. Yamauchi H., Higashi T., Kagawa S. et al. Is misery perfusion still a predictor of stroke in symptomatic major cerebral artery disease?. Brain. 2012. Vol. 135. No. 8. P. 2515-2526.
42. Barnett H., Peerless S., Fox A. et al. Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group. N. Engl. J. Med. 1985. Vol. 313. No. 19. P. 1191-1200.
43. Schaller B. Extracranial-intracranial bypass to reduce the risk of ischemic stroke in intracranial aneurysms of the anterior cerebral circulation: a systematic review. J. Stroke Cerebrovasc. Dis. 2008. Vol. 17. No. 5. P. 287-298.
44. Powers W.J., Clarke W.R., Grubb R.L. et al. Extracranial-intracranial bypass surgery for stroke prevention in hemodynamic cerebral ischemia: the Carotid Occlusion Surgery Study randomized trial. JAMA. 2011. Vol. 306. No. 18. P. 1983-1992.
45. Persoon S., van Berckel B.N., Bremmer J.P. et al. Intervention versus standard medical treatment in patients with symptomatic occlusion of the internal carotid artery: a randomised oxygen-15 PET study. EJNMMI Res. 2013. Vol. 3. No. 1. P. 79.
46. Powers W.J., Zazulia A.R. PET in cerebrovascular disease. PET Clin. 2010. Vol. 5. No. 1. P. 83106.
47. Nortje J., Coles J.P., Timofeev I. et al. Effect of hyperoxia on regional oxygenation and metabolism after severe traumatic brain injury: preliminary findings. Crit. Care Med. 2008. Vol. 36. No. 1. P. 273-281.
48. Hutchinson P.J., Gupta A.K., Fryer T.F. et al. Correlation between cerebral blood flow, substrate delivery, and metabolism in head injury: a combined microdialysis and triple oxygen positron emission tomography study. J. Cereb. Blood Flow Metab. 2002. Vol. 22. P. 735-745.
49. Coles J.P., Steiner L.A., Johnston A.J. et al. Does induced hypertension reduce cerebral ischaemia within the traumatized human brain?. Brain. 2004. Vol. 127. No. 11. P. 2479-2490.
50. Takasawa M., Jones P.S., Guadagno J.V. et al. How reliable is perfusion MR in acute stroke? Validation and determination of the penumbra threshold against quantitative PET. Stroke. 2008. Vol. 39. No. 3. P. 870-877.
51. Sobesky J., Weber O.Z., Lehnhardt F.G. et al. Does the mismatch match the penumbra? Magnetic resonance imaging and positron emission tomography in early ischemic stroke. Stroke. 2005. Vol. 36. No. 5. P. 980-985.
52. Yamauchi H., Kudoh T., Kishibe Y. et al. Selective neuronal damage and chronic hemodynamic cerebral ischemia. Ann. Neurol. 2007. Vol. 61. No. 5. P. 454-465.
53. Yamauchi H., Kudoh T., Kishibe Y. et al. Selective neuronal damage and borderzone infarction in carotid artery occlusive disease: a ¹¹C-flumazenil PET study. J. Nucl. Med. 2005. Vol. 46. No. 12. P. 1973-1979.
54. Kuroda S., Shiga T., Houkin K. et al. Cerebral oxygen metabolism and neuronal integrity in patients with impaired vasoreactivity attributable to occlusive carotid artery disease. Stroke. 2006. Vol. 37. No. 2. P. 393-398.
55. Giffard C., Landeau B., Kerrouche N. et al. Decreased chronic-stage cortical ¹¹C-flumazenil binding after focal ischemia-reperfusion in baboons: a marker of selective neuronal loss? Stroke. 2008. Vol. 39. No. 3. P. 991-999.
56. Fox P.T., Burton H., Raichle M.E. Mapping human somatosensory cortex with positron emission tomography. J. Neurosurg. 1987. Vol. 67. No. 1. P. 34-43.
57. Fox P.T., Fox P.T., Miezin F.M. et al. Retinotopic organization of human visual cortex mapped with positron-emission tomography. J. Neurosci. 1987. Vol. 7. No. 3. P. 913-922.
58. Petersen S.E., Fox P.T., Posner M.I. et al. Positron emission tomographic studies of the cortical anatomy of single-word processing. Nature. 1988. Vol. 331. No. 6157. P. 585-589.
59. Posner M.I., Petersen S.E., Fox P.T. et al. Localization of cognitive operations in the human brain. Science. 1988. Vol. 240. No. 4859. P. 1627-1631.
60. Feng C.-M., Narayana S., Lancaster J.L. et al. CBF changes during brain activation: fMRI vs. PET. Neuroimage. 2004. Vol. 22. No. 1. P. 443-446.
61. Cumming P. PET Neuroimaging: The white elephant packs his trunk?. Neuroimage. 2014. Vol. 84. P. 1094-1100.
62. Gunn R.N., Rabiner E.A. PET neuroimaging: The elephant unpacks his trunk. Neuroimage. 2014. Vol. 94. P. 408-410.
63. Horwitz B., Simonyan K. PET neuroimaging: plenty of studies still need to be performed: comment on Cumming: “PET neuroimaging: the white elephant packs his trunk?”. Neuroimage. 2014. Vol. 84. P. 1101-1103.
64. Siebner H.R., Strafella A.P., Rowe J.B. The white elephant revived: a new marriage between PET and MRI: comment to Cumming: “PET neuroimaging: the white elephant packs his trunk?”. Neuroimage. 2014. Vol. 84. P. 1104-1106.
65. Werner P., Zeisig V., Saur D. et al. Simultaneous PET/MRI. A new tool for translational brain imaging early after stroke. J. Nucl. Med. 2014. Vol. 55. Suppl. No. 1. P. 412.

For citation: Znamenskiy IA, Kondakov AK, Milkin VV, Mosin DJu, Grechko AV. Positron Emission Tomography with Oxygen-15 in Neurological Practice. Part 2. Clinical Application. Medical Radiology and Radiation Safety. 2016;61(4):68-75. Russian.

PDF (RUS) Full-text article (in Russian)

Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 4. P. 76-82

MEDICAL PRACTICE ISSUE

A.N. Bashkov¹, Z.V. Sheykh², E.A. Ionova¹, S.A. Mirzoyants¹, N.S. Drebushevskiy¹, O.O. Grigor’eva¹, A.P. Dunaev¹

Unique Case of Giant Exophityc Solitary Liver Metastasis of Neuroendocrine Cancer of Small and Large Intestine

1. A.I. Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. S.P. Botkin City clinical hospital Moscow, Russia.

ABSTRACT

Purpose: To present a rare case of a giant solitary metastasis of the liver with exophytic growth pattern in a patient with neuroendocrine cancer of small intestine and colon, to demonstrate coordinated work of radiology department.

Material and methods: Computer tomography with bolus intravenous administration of 100 ml of contrast agent Ultravist-370 on multislice CT Aquilion 64; whole body scintigraphy on SPECT Philips with intravenous administration of 218.0 MBq ¹¹¹In-octreotide.

Results: Яmputer tomography revealed a mass in the ileocecal region, which had features of carcinoid, and also a large exophytic solid mass in the left lobe of the liver observed since year 2011. The mass in the liver was solitary, with exophytic growth and heterogeneous structure, much more than the mass in the ileocecal region, maximal accumulate of the contrast agent at the venous phase; thus we thougth of the differential diagnosis between primary tumor and liver metastasis. It was recommended to perform ¹¹¹In-octreotide SPECT in connection with suspected neuroendocrine cancer. The study has confirmed neuroendocrine nature of masses in the ileocecal region and liver, as well as the accumulation of a specific agent in the sigmoid colon, where was a colonoscopy found polyps. The histopathological study after surgery confirmed neuroendocrine cancer of the small and large intestine with liver metastasis.

Conclusion: 1. A rare case of a giant solitary metastasis of the liver with exophytic growth pattern in a patient with neuroendocrin cancer of small intestine and colon was presented. 2. Data from computer tomography and single photon emission tomography allow to make correct diagnosis at the stage of preoperative examination, despite the atypical signs of the solid mass in the liver.

Key words: neuroendocrine cancer, carcinoid, multidetector spiral computed tomography, single photon emission computed tomography, a solitary exophytic metastasis

REFERENCES

1. Gorbunova V.A. Neiroendokrinnye opukholi zheludochno-kishechnogo trakta. Printsipy diagnostiki i lecheniya. Moscow. 2009. 196 p. (In Russ.)
2. Hallet J., Law C.H., Cukier M. et al. Exploring the rising incidence of neuroendocrine tumors: a population-based analysis of epidemiology, metastatic presentation, and outcomes. Cancer. Feb 2015. Vol. 27. No. 4. P. 589-597.
3. Taal B.G., Visser O. Epidemiology of neuroendocrine tumours. Neuroendocrinology. 2004. Vol. 80. No. 1. P. 3-7.
4. Arnold R. Endocrine tumours of the gastrointestinal tract. Introduction: definition, historical aspects, classification, staging, prognosis and therapeutic options. Best Pract. Res. Clin.. Gastroenterol. 2005. Vol. 19. No. 4. P. 491-505.
5. Kulke M.H., Benson A.B. 3rd, Bergsland E. et al. Neuroendocrine tumors. J. Natl. Compr. Canc. Netw. 2012. Vol. 10. No. 6. P. 724-64.
6. Modlin I.M., Lye K.D., Kidd M.A. 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003. Vol. 97. No. 4. P. 934-959.
7. Pickhardt P.J., Kim D.H., Menias C.O. et al. Evaluation of submucosal lesions of the large intestine. Part 1. Neoplasms. RadioGraphics. 2007. Vol. 27. P. 1681-1692.
8. Zuetenhorst J.M., Taal B.G. Metastatic carcinoid tumors: a clinical review. Oncologist. 2005. Vol. 10. No. 2. P. 123-131
9. Angela D.L. Gastrointestinal carcinoids: Imaging features with clinicopathologic comparison. RadioGraphcs. 2007. Vol. 27. No. 1. P. 237-257.
10. Karen M.H, Inhab K., Lawrence H. et al. Carcinoid tumors of the Small Bowel: A Multitechnique Imagimg Approach. 2004. Vol. 182. No. 3. P. 559-567.
11. Ganeshan D., Bhosale P., .Yang T. et al. Imaging Features of Carcinoid Tumors of the Gastrointestinal Tract. Amer. J. Roentgenol. 2013. Vol. 201. No. 4. P. 773-786.
12. Elsayes K.M., Menias C.O., Bowerson M. Imaging of carcinoid tumors: spectrum of findings with pathologic and clinical correlation. J. Comput. Tomogr. 2011. Vol. 35. No. 1. P. 72-80.
13. Elias D., Lefevre J.H., Duvillard P. et al. Hepatic metastases from neuroendocrine tumors with a “thin slice” pathological examination: they are many more than you think. Ann Surg. 2010. Vol. 251. P. 307-310.
14. De Herder W.W., Kwekkeboom D.J., Valkema R. et al. Neuroendocrine tumors and somatostatin: imaging techniques. J. Endocrinol. 2005. Vol. 28. P. 132-136.
15. Fuccio C., Spinapolice E. G., Chondrogiannis S. et al. Evolving role of SPECT/CT in neuroendocrine tumors management: staging, treatment response, and followup. Clin. Nucl. Med. 2013. Vol. 38. No. 10. P. 384-389.
16. Modlin I.M., Cornelius E., Lawton G.P. Use of an isotropic somatostatin receptor probe to image gut endocrine tumors.. Arch Surg. 1995. Vol. 130. P. 367-373.

For citation: Bashkov AN, Sheykh ZV, Ionova EA, Mirzoyants SA, Drebushevskiy NS, Grigor'eva OO, Dunaev AP. Unique Case of Giant Exophityc Solitary Liver Metastasis of Neuroendocrine Cancer of Small and Large Intestine. 2014;61(4):76-82. Russian.

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Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 61. P. 64-67

NUCLEAR MEDICINE

Yu.V. Lysak¹, B.Ya. Narkevich^2,3, S.V. Shiryaev², V.V. Krylov⁴

Mathematical Modeling of Liquid Radioactive Waste in Radionuclide Therapy

1. Moscow Engineering Physics Institute, Moscow, Russia; 2. N.N. Blokhin Russian Oncological Research Center, Moscow, Russia; 3. Institute of Medical Physics and Engineering, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 4. A.F. Tsyb Medical Radiological Research Center, Obninsk

ABSTRACT

Purpose: To determine the estimated capacity of the station cleaning in special units radionuclide therapy based on mathematical modeling of processes of accumulation and exposure to the collapse of liquid radioactive waste.

Material and methods: The simulation is based on solving a system of linear first order differential equations with constant coefficients under certain simplifying assumptions about these processes of accumulation and exposure. For specific numerical simulation results technical and clinical settings for typical units of radionuclide therapy were used.

Results: It is shown that only the presence of a vacuum in the unit special sewage radionuclide therapy ensures that the requirements of regulations on permissible discharge disintegrated liquid radioactive waste into the domestic sewage. Water consumption was hospitalized in “active” patient rooms should not exceed 50 liters / day for 1 person.

Conclusion: Mathematical modeling allows to objectify the processes of dealing with liquid radioactive waste in radionuclide therapy units of radiological clinics in Russia.

Key words: radionuclide therapy, liquid radioactive waste, cleaning station power, mathematical modeling

REFERENCES

1. Normy radiatsionnoi bezopasnosti NRB-99/2009. SanPiN 2.6.1.2523-09. (In Russ.). (In Russ.).
2. Osnovnye sanitarnye pravila obespecheniya radiatsionnoi bezopasnosti OSPORB-99/2010. SP 2.6.1.2612-10. (v red. izmenenii No. 1, utv. postanovleniem Glavnogo gosudarstvennogo sanitarnogo vracha RF ot 16.09.2013 No. 43). (In Russ.). (In Russ.).
3. Sanitarnye pravila obrashcheniya s radioaktivnymi otkhodami SPORO-2002. Izmeneniya i dopolneniya no. 1 k SP 2.6.6.1168-02. SanPiN 2.6.6.2796-10. (In Russ.). (In Russ.).
4. Gigienicheskie trebovaniya po obespecheniyu radiatsionnoi bezopasnosti pri provedenii luchevoi terapii s pomoshch'yu otkrytykh radionuklidnykh istochnikov. SanPiN 2.6.1.2368-08. (In Russ.). (In Russ.).
5. Osnovnye sanitarnye pravila obespecheniya radiatsionnoi bezopasnosti OSPORB-99/2010. SP 2.6.1.2612-10. (In Russ.). (In Russ.).
6. Sanitarnye pravila obrashcheniya s radioaktivnymi otkhodami (SPORO-2002). SP 2.6.6.1168-02. (In Russ.). (In Russ.).
7. Narkevich B.Ya., Shiryaev S.V., Krylov V.V. Povyshaet li novaya versiya OSPORB-99/2010 uroven' radiatsionnoi bezopasnosti v yadernoi meditsine? // Medical Radiology and Radiation Safety. 2015. Vol. 60. No. 6. P. 5-9. (In Russ.). (In Russ.).
8. Manual on Therapeutic Uses of Iodine-131. IAEA. Vienna. 1996. 65 p.
9. Radiological Protection after Nuclear Medicine Procedures. ICRP Publication 94. 2006. 27 p.

For citation: Lysak YuV, Narkevich BYa, Shiryaev SV, Krylov VV. TMathematical Modeling of Liquid Radioactive Waste in Radionuclide Therapy. Medical Radiology and Radiation Safety. 2016;61(6):64-7. Russian.

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