— record keeping and report writing;
— Quality control of radiopharmaceuticals and radionuclide generators;
— acceptance and commissioning;
— Quality control of equipment and software;
— Waste management procedures;
— Training and continuing education of staff;
— clinical audit;
— General outcome of the nuclear medicine service.
further details on the general components of a Qa programme and the associated quality control tests are given in ref. [3.3]. The Who has also published guidelines on Qa in nuclear medicine [3.12], covering the organization of services, the training of personnel, the selection of procedures, quality control requirements for instrumentation and radiopharmaceuticals, as well as the interpretation and evaluation of results. The iaea has several other relevant publications on Qa for various aspects of nuclear medicine (see the bibliography for details).
REFEREnCEs
[3.1] iNTerNaTioNal coMMissioN oN radioloGical ProTecTioN, recommendations of the icrP, Publication 103, elsevier (2008).
[3.2] euroPeaN coMMissioN, food aNd aGriculTure orGaNiZaTioN of The uNiTed NaTioNs, iNTerNaTioNal aToMic eNerGy aGeNcy, iNTerNaTioNal labour orGaNiZaTioN, oecd Nuclear eNerGy aGeNcy, PaN aMericaN healTh orGaNiZaTioN, uNiTed NaTioNs eNViroNMeNT ProGraMMe, World healTh orGaNiZaTioN, radiation Protection and safety of radiation sources: international basic safety standards, iaea safety standards series No. Gsr Part 3, iaea, Vienna (2014).
[3.3] iNTerNaTioNal aToMic eNerGy aGeNcy, applying radiation safety standards in Nuclear Medicine, safety reports series No. 40, iaea, Vienna (2005).
[3.4] iNTerNaTioNal aToMic eNerGy aGeNcy, Nuclear Medicine resources Manual, iaea, Vienna (2006).
[3.5] iNTerNaTioNal aToMic eNerGy aGeNcy, occupational radiation Protection, iaea safety standards series No. rs-G-1.1, iaea, Vienna (1999).
[3.6] iNTerNaTioNal aToMic eNerGy aGeNcy, assessment of occupational exposure due to intakes of radionuclides, iaea safety standards series No. rs-G-1.2, iaea, Vienna (1999).
[3.7] iNTerNaTioNal aToMic eNerGy aGeNcy, assessment of occupational exposure due to external sources of radiation, iaea safety standards series No. rs-G-1.3, iaea, Vienna (1999).
[3.8] iNTerNaTioNal aToMic eNerGy aGeNcy, Management of Waste from the use of radioactive Material in Medicine, industry, agriculture, research and education, iaea safety standards series No. Ws-G-2.7, iaea, Vienna (2005).
[3.9] iNTerNaTioNal aToMic eNerGy aGeNcy, regulations for the safe Transport of radioactive Material, 2012 edition, iaea safety standards series No. ssr-6, iaea, Vienna (2012).
[3.10] World Medical associaTioN, 18th World Medical assembly, helsinki, 1974, as amended by the 59th World Medical assembly, seoul (2008).
[3.11] couNcil for iNTerNaTioNal orGaNiZaTioNs of Medical scieNces, World healTh orGaNiZaTioN, international ethical Guidelines for biomedical research involving human subjects, cioMs, Geneva (2002).
[3.12] World healTh orGaNiZaTioN, Quality assurance in Nuclear Medicine, Who, Geneva (1982).
BIBLIOGRAPHY
euroPeaN coMMissioN, european Guidelines on Quality criteria for computed Tomography, rep. eur 16262 eN, office for official Publications of the european communities, brussels (1999).
iNTerNaTioNal aToMic eNerGy aGeNcy (iaea, Vienna)
Quality control of Nuclear Medicine instruments 1991, iaea-Tecdoc-602 (1991).
radiological Protection for Medical exposure to ionizing radiation, iaea safety standards series No. rs-G-1.5 (2002).
iaea Quality control atlas for scintillation camera systems (2003).
Quality assurance for radioactivity Measurement in Nuclear Medicine, Technical reports series No. 454 (2006).
radiation Protection in Newer Medical imaging Techniques: PeT/cT, safety reports series No. 58 (2008).
Quality assurance for PeT and PeT/cT systems, iaea human health series No. 1 (2009).
Quality assurance for sPecT systems, iaea human health series No. 6 (2009).
Quality Management audits in Nuclear Medicine Practices (2009).
radiation Protection of Patients (rPoP), https://rpop.iaea/rPoP/rPoP/content/index.htm
iNTerNaTioNal coMMissioN oN radioloGical ProTecTioN
radiological Protection of the Worker in Medicine and dentistry, Publication 57, Pergamon Press, oxford and New york (1989).
radiological Protection in biomedical research, Publication 62, Pergamon Press, oxford and New york (1991).
radiological Protection in Medicine, Publication 105, elsevier (2008).
Pregnancy and Medical radiation, Publication 84, Pergamon Press, oxford and New york (2000).
iNTerNaTioNal coMMissioN oN radiaTioN uNiTs aNd MeasureMeNTs, Quantities and units in radiation Protection dosimetry, icru rep. 51, bethesda Md (1993).
MadseN, M.T., et al., aaPM Task Group 108: PeT and PeT/cT shielding requirements, Med. Phys. 33 (2006) 1.
sMiTh, a.h., harT, G.c. (eds), iNsTiTuTe of Physical scieNces iN MediciNe, Quality standards in Nuclear Medicine, iPsM rep. No. 65, york (1992).
h.o. luNdQVisT
department of radiology, oncology and radiation science, uppsala university,
uppsala, sweden
4.1. The oriGiNs of differeNT Nuclei
all matter in the universe has its origin in an event called the ‘big bang’, a cosmic explosion releasing an enormous amount of energy about 14 billion years ago. scientists believe that particles such as protons and neutrons, which form the building blocks of nuclei, were condensed as free particles during the first seconds. With the decreasing temperature of the expanding universe, the formation of particle combinations such as deuterium (heavy hydrogen) and helium occurred. for several hundred million years, the universe was plasma composed of hydrogen, deuterium, helium ions and free electrons. as the temperature continued to decrease, the electrons were able to attach to ions, forming neutral atoms and converting the plasma into a large cloud of hydrogen and helium gas. locally, this neutral gas slowly condensed under the force of gravity to form the first stars. as the temperature and the density in the stars increased, the probability of nuclear fusion resulting in the production of heavier elements increased, culminating in all of the elements in the periodic table that we know today. as the stars aged, consuming their hydrogen fuel, they eventually exploded, spreading their contents of heavy materials around the universe.
owing to gravity, other stars formed with planets around them, composed of these heavy elements. four and a half billion years have passed since the planet earth was formed. in that time, most of the atomic nuclei consisting of unstable proton–neutron combinations have undergone transformation (radioactive decay) to more stable (non-radioactive) combinations. however, some with very long half-lives remain: 40k, 204Pb, 232Th and the naturally occurring isotopes of uranium.
The discovery of these radioactive atoms was first made by henri becquerel in 1896. The chemical purification and elucidation of some of the properties of radioactive substances was further investigated by Marie Skłodowska-Curie and her husband Pierre curie. since some of these long lived radionuclides generated more short lived radionuclides, a new scientific tool had been
discovered that was later found to have profound implications in what today is known as nuclear medicine. George de hevesy was a pioneer in demonstrating the practical uses of the new radioactive elements. he and his colleagues used a radioactive isotope of lead, 210Pb, as a tracer (or indicator) when they studied the solubility of sparingly soluble lead salts. de hevesy was also the first to apply the radioactive tracer technique in biology when he investigated lead uptake in plants (1923) using 212Pb. only one year later, blumengarten and Weiss carried out the first clinical study, when they injected 212bi into one arm of a patient and measured the arrival time in the other arm. from this study, they concluded that the arrival time was prolonged in patients with heart disease.