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72
Dosimetry of Internally Administered Radionuclides
and MIRD formulae shows that the formalisms adopted by MIRD and ICRP for dose
estimation use similar concepts and share the same dosimetric quantities, anatomic models
and radionuclide data. Source regions in both the systems are neither restricted to be organs
or tissues (e.g., activity within the contents of GI tract); nor to volume distributed activity
(e.g., activity may be distributed on surfaces of airways or bone mineral). Important
differences are as under:
Feature MIRD ICRP
Type of radionuclides short lived wide range of half-life
Intake of radionuclide acute continuous & acute
Period of integration over infinite time over a commitment period,
(for adult 50 y and for
children 75 y)
Biological component cumulative activity, Ã integrated activity
of dose equation (number of nuclear
transformations in source
region during the period of
commitment following
the intake)
cumulative activity per unit integrated activity coefficient
intake or residence time
Physical component Equivalent dose rate in
target region per unit activity
present in source region of
the Reference Person
S-value ( only WR weighted) SEE (specific effective
energy, only WR weighted)
Symbols used
Parameters ICRP MIRD
Target region T r
Source region S r
Absorbed fraction for radiation, i AF(TS)
Equilibrium Absorbed Dose constant for radiation, i YiE
Activity integral or Cumulative activity q
i
S
Specific Effective Energy or Dose equivalent in SEE(TS;t) S(r
i(rkrh
Ã
krh
k
h
i
h
T per nuclear transformation or mean dose per
unit cumulative activity
)
)
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Dosimetry of Internally Administered Radionuclides
73
Influence of pathological state of the organ of interest on kinetics of the
radiopharmaceuticals
However, appreciable alterations in the data are produced in case of pathology intrinsic to
the organ of interest. For example, with
131
I-Rose Bengal, estimated T
in normal and
eff
hepatitis cases are respectively 0.062 d and 2.2 d; the consequent absorbed doses (rad/mCi)
are 12 and 440 respectively. In case of intrahepatic disease, percent administered activity in
urine was 30% as against 25% in normals. Hence the consequent absorbed doses are
respectively 4.67 and <0.78 rad per mCi. Such appreciable alterations in metabolism are
also observed in patients undergoing radiotherapy and chemotherapy.
At this stage it might be concluded that there exists a sound physical base for accurate
internal average dose estimates to model organs under the MIRD schema.
Software packages for dosimetry of internal emitters
Number of software packages were developed for S-value based dose assessment of internal
emitters. The most widely-used of these, MIRDOSE3, incorporates S factors for 223
radionuclides and 10 different anthropomorphic models, including standard male, female,
and pediatric models (4). This software was replaced by Organ Level Internal Dose
Assessment (OLINDA; Vanderbilt University). OLINDA is U.S. Food and Drug
Administration (FDA) approved as a device and includes S values specific to 10 phantoms
and 5 organ models for more than 800 radionuclides, including alpha-particle emitters,
which were not previously included in S value tabulations. The program also includes a
pharmacokinetic module that may be used to determine organ-cumulated activities.
MABDOSE (University of Colorado), another package that also implements fixed geometry,
allows the user to place spherically shaped tumors within the simplified anatomic model
originally described by the MIRD Committee (23-24). To do this, an on the fly Monte Carlo
simulation was incorporated into the code. This method could accommodate tumor dosimetry
within the idealized geometry defined by the MIRD Committee.
A software package, Multiple Image Analysis Utility (MIAU), was developed for
estimating patient specific 3-dimensional voxel by voxel cumulated activities in source
regions based on time dependent spatial distribution of radioactivity in patient from SPECT
and PET images and patient anatomic information based images from CT and MRI (25).
These cumulated activities were used as input to a 3-dimensional internal dosimetry (3DID) software package that uses Monte Carlo and point kernel based S-values for obtaining
patient specific tumor / normal tissue minimum, maximum and mean absorbed doses, dosevolume histograms (26). A DOSIMG software was developed with mathematical anthropometric phantoms to study the impact of SPECT images on dose distribution (27-28).
GSPant\Newbook\Final-2007\5-chp\73
74
Examples of generic dose assessment
Dosimetry of Internally Administered Radionuclides
(i) Dose due to
99m
Tc–labeled sulfur colloid
Consider two simple calculations of internal dose performed with the MIRD method
(29). First, consider the dose due to an irreversibly bound liver agent. Assume that f =
85% of the 1 mCi (37.0 MBq) activity of an injected
99m
Tc-–labeled sulfur colloid is
instantaneously bound to the liver with no biologic washout. What is the cumulated activity
in the liver? What are the doses to liver and uterus from the activity in the liver?
The effective half-time T
in this case is equal to physical half-time, Tp that is equal to
eff
6 hours since there is no biological wash out of the colloid from the liver. The cumulated
activity is à = 1.44 × 0.85 × 1000 µCi × 6 h = 7344 µCi · h (9.8 × 105 MBq · sec).
From MIRD Pamphlet no. 11, S (liver liver) = 4.6 × 10-5 rad/µCi . h (3.5 × 10
Gy/MBq . sec), so that the dose D = Ã × S = 7344 µCi . h × 4.6 × 10-5 rad/µCi . h = 0.34 rad
(3.4 mGy). The dose to the uterus from this cumulated activity in the liver can also be
estimated. From MIRD Pamphlet no. 11, S (uterus liver) = 3.9 × 10-7 rad/µCi . h (2.9 ×
-11
10
Gy/MBq . sec). The uterine dose from activity in the liver is then D = Ã × S = 7344
µCi . h × 3.9 × 10–7 rad/µCi . h = 0.0029 rad = 2.9 mrad (29 µGy). Of course, a full
determination of the dose to the uterus must include contributions from all source organs,
especially the excretory organs (and their radioactive contents) more proximal to the uterus.
(ii) Dose due to
131
I in thyroid
Next consider the dose to the thyroid gland due to ingestion of 10 µCi (0.37 MBq) of
131
I. Assume a euthyroid uptake f = 25%. For simplicity, assume that this uptake happens
instantaneously. The biologic half-time for iodine in the thyroid is 65 days and the physical
half-life of
131
I is 8 days, so that the effective half-time is (65 × 8)/(65 + 8) = 7.1 days.
The cumulated activity over all time is à = 1.44 × 0.25 × 10 µCi × 7.1 days × 24 h/d = 613
µCi . h (8.15 × 104 MBq . sec). From MIRD Pamphlet no. 11, S(thyroid thyroid) for
131
= 2.2 × 10-2 rad/µCi . h (1.7 × 10-6 Gy/MBq . sec). The dose is then D = Ã × S = 613 µCi .
h × 2.2 × 10-2 rad/µCi . h = 13.5 rad (135 mGy).
-9
I
Patient specific dosimetry
Fundamental assumptions in MIRD approach of dose assessment are that the activity
distribution in source region is uniform and dose to the target is an average or mean value.
In addition as is already mentioned the dose is to a model, which is a population averaged,
such as to a Reference Man, or Reference Child or Reference Pregnant Woman, or to their
organs. Thus in view of various assumptions in population models the assessed dose values
could be in error by a factor of two. However, when one is interested in patient specific
dosimetry, particularly for therapeutic applications of radiopharmaceuticals, the acceptable
accuracy in dose estimation has to be more stringent, near about ± 5%, comparable to
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Dosimetry of Internally Administered Radionuclides
75
external beam therapy. This would be possible only if patient specific information like nonuniformity of activity distribution in the source region; and kinetics of the radiopharmaceutical
in the form of time-activity curves at the level of voxel or group of voxels in tumor or tissue
or organ; mass of tumor or tissue or normal organ from 3 D density maps; voxel by voxel Svalues, etc., is used for the dose estimation rather than the population averaged reference
values.
Studies on assessment of dose from therapeutic internal emitters
1. Patient-Specific, 3-Dimensional Methods for SPECT Reconstruction and Absorbed
Dose Calculation were employed by Dewaraja et al (30) in the
radioimmunotherapy of non-Hodgkin’s lymphoma (NHL) and high-dose
metaiodobenzylguanidine (
chemotherapy and hematopoietic stem cell rescue in the treatment of children with
relapsed or metastatic neuroblastoma. Clinically relevant voxel phantom with tumor
sizes varying from 7 ml to 135 ml was simulated with the software called DPM
(Dose Planning Method) for assessing the accuracies in the computed S-factors and
in the quantification of cumulated activities in the tumors and normal organs like
liver, kidney, spleen. The activities in tumor sizes larger than 14 ml were estimated
to be better than 12 % whereas in smallest tumor simulated, that is, 7 ml the
accuracy was not better than 35 %. This methodology was applied to the case of a
lymphoma patient who was treated with 4 GBq of
48 h afterwards with SPECT for time-activity estimates. Contribution to the tumor
dose from the radioactivity in the rest of the body of this patient was found to be
around 12 % as compared to 7 % estimated from conventional reference phantom
computations. Tables 1 and 2 are from Dewaraja et al (30) and list out the S-factors
and absorbed doses estimated using DPM and conventional dosimetry.
Table 1: Comparison of
131
I-MIBG) therapy in combination with myeloblative
131
I-tositumomab and was imaged
131
I S-factors from software packages DPM and MIRDOSE
S-factor (mGy/MBq.s)
131
131
I
I-
Source Target DPM MIRDOSE
Liver Liver 2.15E-05* 2.12E-05
Kidney Kidney 1.19E-04* 1.17E-04
Spleen Spleen 2.00E-04* 1.93E-04
Liver Kidney 1.18E-06 8.13E-07
Liver Spleen 2.71E-07 2.14E-07
Kidney Liver 1.17E-06 8.13E-07
*Adjusted to account for organ mass difference between the Zubal Voxel phantom and the Reference
Man phantom.
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76
Table 2: Comparison of mean absorbed dose (cGy) for a patient tumor between DPM and conventional
dosimetric methods
Mean tumor absorbed dose (cGy)
Component DPM* Conventional*
Tumor to tumor 485 (88) 488 (95)
Rest of body to tumor 69 (12) 28 ( 5)
Total 554 516
*Values in parentheses are percentage.
Dosimetry of Internally Administered Radionuclides
2. Radiation dose estimates were carried out, by Ferrari et al according to the MIRD
formalism, for
90
Y-labeled compounds, injected into a brain neocavity, after surgery
(31). S-values were computed to the rim of tissue surrounding the surgical resection
cavity, considering different radiopharmaceutical distributions and using Monte Carlo
computations with an anthropomorphic phantom. These S-values were applied for
90
Y-labeled [DOTA0,D-Phe1,Tyr3]octreotide (90Y-DOTATOC) treated patients having
gliomas. Table 3 lists absorbed doses to different areas of the head phantom. The
values were averaged over all cavity volumes and source distributions of 90YDOTATOC. Mean absorbed doses to red marrow, urinary bladder wall, and total
body were 0.03±0.01, 1.22±0.27, and 0.006±0.002 mGy/MBq respectively.
Table 3: Absorbed doses (mean ± SD) in different areas of Head phantom for 90Y-DOTATOC
Region Absorbed dose (Gy/MBq)*
Right eye 5.3 ± 0.9
Right optical nerve 8.3 ± 2.3
Left eye 3.3 ± 0.7
Left optical nerve 4.4 ± 1.4
Normal brain (right hemisphere) 20.2 ± 9.7
Normal brain (left hemisphere) 8.9 ± 1.0
Skull 13.2 ± 0.7
*Values averaged over all cavity volumes and source distributions
Summary
Dose estimation of internal emitters is normally done for assessing risk versus benefit in
diagnostic nuclear medicine, or for prescribing a therapeutic dose to a patient in therapeutic
nuclear medicine. Estimation of average absorbed dose is considered sufficient based on
normal population based reference data for the purposes of diagnostic nuclear medicine
since the projected risk is probabilistic in nature and is generally acceptable.
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Dosimetry of Internally Administered Radionuclides
77
In case of therapeutic applications of radionuclides, for instance, dose to tumor is to be
estimated specifically. However, while doing tumor therapy normal tissues surrounding the
tumor should be spared from radiation injury. Hence estimating the dose to patient’s normal
tissues that might receive unacceptable dose (for example the blood or bone-marrow dose in
case of radioiodine therapy of thyroid cancer) and the dose to the tumor tissue that is to be
treated therapeutically using patient specific data rather than population averaged reference
data are essential. Such normal tissue dose sometimes would then become the limiting
factor to prescribe the therapeutic dose.
The physical component of the dose equation, that is, the S-values are available for large
number of radionuclides uniformly distributed in mathematically defined reference dosimetric
phantoms for adults, children of different age groups, embryo/fetus, and for cells and
subcellular structures. S-values for non-uniform distribution of radionuclide have been
computed using Monte Carlo techniques for Voxel based dosimetric phantoms generated by
3-D imaging with CT / MRI systems. Biological information (that is the biological component
of dose equation, the cumulated activity, Ã is at best available at tissue level from imaging
instrumentation. Hence patient dosimetry is possible only at resolution levels available from
the imaging systems used for the patient in nuclear medicine. 3-D imaging with SPECT /
PET gives time-activity curves (or time integrals, that is, the cumulated activities) in the
regions of interest either in the tumor or in normal tissues or organs. Number of 3-D dose
estimation software packages that use the above physical and biological information for
obtaining mean, minimum and maximum absorbed doses and dose-volume histograms are
developed. Isodose contours for treatment planning in radionuclide therapy in nuclear medicine
is a possibility in the coming years.
References
1. ICRP Publication 26 (1977) Recommendations of the ICRP. Pergamon Press, Oxford.
2. ICRP Publication 60 (1991) 1990 recommendations of the ICRP. Pergamon Press, Oxford.
3. Cristy M and Eckerman KF. Specific absorbed fractions of energy at various ages from internal
photon sources: I. Methods, II. One year old, III. Five year old, IV ten year old, V fifteen year old
male and adult female, VI newborn, VII adult male. Reports ORNL/TM-8381/VI to ORNL/TM-8381/
V7, Oak Ridge National Laboratory, Oak Ridge, TN, 1987.
4. Stabin M, Watson E, Cristy M et al. Mathematical models and specific absorbed fractions of photon
energy in the nonpregnant adult female and at the end of each trimester of pregnancy. ORNL/TM12907, Oak Ridge National Laboratory, 1995.
5. Stabin MG. MIRDOSE: personal computer software for internal dose assessment in nuclear medicine.
J Nucl Med 1996; 37: 538-546.
6. Marinelli LD. Dosage determination with radioactive isotopes. Am J Roentgenol 1942; 47: 210-216.
7. Marinelli LD, Quimby EH and Hine GJ. Dosage determination with radioactive isotopes: Part 2.
Practical considerations in therapy and protection. Am J Roentgenol 1948; 59: 260-281.
8. Ellett, WH, Callahan AB and Brownell GL. Gamma ray dosimetry of internal emitters. I. Monte
Carlo calculations of absorbed dose from point sources. Br J Radiol 1964; 37: 45-52.
GSPant\Newbook\Final-2007\5-chp\77
78
Dosimetry of Internally Administered Radionuclides
9. Ellett WH, Callahan AB and Brownell GL. Gamma ray dosimetry of internal emitters. II. Monte
Carlo calculations of absorbed dose from uniform sources. Br J Radiol 1965; 38: 541-544.
10. Loevinger R, Holt JG and Hine GJ. Radiation Dosimetry, eds. Hine G J and Brownell G L, 801-873,
Academic Press, New York, 1956.
11. Focht EH, Quimby EH and Gershowitz ZM. Radiology 1965; 85: 151-152.
12. Greenfield MA and Lane RG. Radioisotope Geometry in Nuclear Medicine, 109, McGraw Hill, New
York, 1971.
13. Gupta MM, Reddy AR, Gupta PC and Nagaratnam A. Br J Radiol 1976; 49: 71-75.
14. Reddy AR, Mehta SC. Photon absorbed fractions for low energies and small spherical targets. Health
Physics 1979; 36: 175-182.
15. Snyder WS, Ford MR, Warner GG, Fisher HL. Estimates of specific absorbed fractions for
monoenergetic photon sources uniformly distributed in various organs of a heterogeneous phantom.
Radionuclide decay schemes and nuclear parameters for use in radiation dose estimation. MIRD
Pamphlet No.5. J Nucl Med 1969; (suppl 3): 5-52.
16. Ellett WH, Callahan AB and Brownell GL. Absorbed Fractions for Photon Dosimetry, MIRD Pamphlet
No. 3. J Nucl Med 1968; 9(suppl 1): 27-39.
17. Snyder WS, Ford MR, Warner GG, Watson SB. “S”, absorbed dose per unit cumulated activity for
selected radionuclides and organs. MIRD Pamphlet No.7. J Nucl Med 1971; (suppl 5): 5-23.
18. Snyder WS, Ford MR, Warner GG. Estimates of specific absorbed fractions for photon sources
uniformly distributed in various organs of a heterogeneous phantom. MIRD pamphlet No.5 (revised).
New York: Society of Nuclear Medicine, 1978.
19. Coffey JL, Cristy M, Warner GG. Specific absorbed fractions for photon sources uniformly distributed
in the heart chambers and heart wall of a heterogeneous phantom. MIRD Pamphlet No.13. J Nucl Med
1981; 22: 65-71.
20. Bourchet LG, Bolch WE, Weber SA, Atkins HL, Poston JW. Radionuclide S values in a revised
dosimetric model of the adult head and brain. MIRD Pamphlet No.15. J Nucl Med, 1999; 40: 62S101S.
21. Thomas SR, Stabin MG, Chen C, Samaratunga RC. A dynamic urinary bladder model for radiation
dose calculations. MIRD Pamphlet No.14. J Nucl Med 1999; 40: 102S-123S.
22. Bolch WE, Bouchet LG, Robertson JS, Wessels BW, Siegel JA, Howell RW, Erdi AK, Aydogan B,
Costes S, Watson EE. The dosimetry of nonuniform activity distributions - radionuclide S values at
the voxel level. MIRD Pamphlet No.17. J Nucl Med, 40, 11S-36S. (useful for patient dosimetry at
voxel level for radionuclide therapy), 1999.
23. Johnson TK, McClure D, McCourt S. MABDOSE. I: characterization of a general purpose dose
estimation code. Med Phys 1999: 26: 1389-1395.
24. Johnson TK, McClure D, McCourt S. MABDOSE. II: validation of a general purpose dose estimation
code. Med Phys 1999: 26: 1396-1403.
25. Kolbert KS, Hamacher KA, Jurcic JG, et al. Parametric images of antibody pharmacokinetics in
Bi213-HuM195 therapy of leukemia. J Nucl Med 2001; 42: 27-32.
26. Sgouros G, Kolbert KS. The three-dimensional internal dosimetry software package, 3D-ID. In: Zaidi
H, Sgouros G, eds. Therapeutic Applications of Monte Carlo Calculations in Nuclear Medicine.
Philadelphia, PA: Institute of Physics, 2002.
27. Ljungberg M, Sjogreen K, Liu X, et al. A 3-dimensional absorbed dose calculation method based on
quantitative SPECT for radionuclide therapy: evaluation for
131
I using Monte Carlo simulation. J Nucl
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Dosimetry of Internally Administered Radionuclides
Med 2002; 43: 1101-1109.
28. Ljungberg M, Frey E, Sjogreen K, et al. 3D absorbed dose calculations based on SPECT: evaluation
for 111-In/90-Y therapy using Monte Carlo simulations. Cancer Biother Radiopharm 2003; 18: 99-
107.
29. Simpkin DJ. Radiation Interactions and Internal Dosimetry in Nuclear Medicine. Radiographics
1999; 19: 155-167.
30. Dewaraja YK, Wilderman SJ, et al. Accurate Dosimetry in
Specific, 3-Dimensional Methods for SPECT Reconstruction and Absorbed Dose Calculation. J Nuc
Med 2005; 46: 840-849.
31. Ferrari M, Cremonesi M, et al. Dosimetric Model for Locoregional Treatments of Brain Tumors with
90
Y-Conjugates: Clinical Application with 90Y-DOTATOC. J Nucl Med 2006; 47: 105-112.
131
I Radionuclide Therapy Using Patient-
79
Appendix A
A list of MIRD pamphlets; MIRD dose estimate reports; and other
important publications relevant for dosimetry at different levels
General MIRD schema valid for all levels of dosimetry:
1. Loevinger R, Berman M. 1976. A revised schema for calculating the absorbed dose from biologically
distributed radionuclides. MIRD Pamphlet No.1 Revised. New York: The Society of Nuclear Medicine.
2. Loevinger R, Budinger T F, Watson E E. 1991. MIRD primer for absorbed dose calculations, Revised.
New York: The Society of Nuclear Medicine.
Important publications useful for Dosimetry at different levels, viz., at Organ, sub-organ, cell and
sub-cellular Level:
Absorbed fractions and S values:
3. Berger M J. Energy deposition in water by photons from point isotropic sources. 1968. MIRD Pamphlet
No.2. J Nucl Med, (suppl 1), 15-25.
4. Berger M J. 1971. Distribution of absorbed doses around point sources of electons and beta particles
in water and other media. MIRD Pamphlet No.7. J Nucl Med, (suppl 5), 5-23.
5. Ellett W H, Humes R M. 1971. Absorbed fractions for small volumes containing photon emitting
radioactivity. MIRD Pamphlet No.7. J Nuc Med, (suppl 5), 25-32.
6. Snyder W S, Ford M R, Warner G G, Watson S B. 1971. “S”, absorbed dose per unit cumulated
activity for selected radionuclides and organs. MIRD Pamphlet No.7. J Nucl Med, (suppl 5), 5-23.
7. Snyder W S, Ford M R, Warner G G. 1978. Estimates of specific absorbed fractions for photon
sources uniformly distributed in various organs of a heterogeneous phantom. MIRD pamphlet No.5
(revised). New York: Society of Nuclear Medicine.
S values for sub-organs:
8. Coffey J L, Cristy M, Warner G G. 1981. Specific absorbed fractions for photon sources uniformly
distributed in the heart chambers and heart wall of a heterogeneous phantom. MIRD Pamphlet No.13.
J Nucl Med, 22, 65-71.
GSPant\Newbook\Final-2007\5-chp\79
80
9. Thomas S R, Stabin M G, Chen C, Samaratunga R C. 1999. A dynamic urinary bladder model for
radiation dose calculations. MIRD Pamphlet No.14. J Nucl Med, 40, 102S-123S.
10. Bourchet L G, Bolch W E, Weber S A, Atkins H L, Poston J W. 1999. Radionuclide S values in a
revised dosimetric model of the adult head and brain. MIRD Pamphlet No.15. J Nucl Med, 40, 62S101S.
11. Bolch, W. E., Brill, A.B., et al. 2001. Administered Cumulated Activity for Ventilation Studies.
MIRD Pamphalet No. 18. J Nuc Med, 42, 520-528.
12. Bouchet, L.G., Bolch, E.E., et al. 2003. Absorbed Fraction and Radionuclide S values for Six Age-
Dependent Multiregion Models for the Kidney. MIRD Pamphalet No. 19. J Nuc Med, 44, 1113-1147.
Dosimetry of Internally Administered Radionuclides
S values for nonuniform activity distributions:
13. Bolch W E, Bouchet L G, Robertson J S, Wessels B W, Siegel J A, Howell R W, Erdi A K, Aydogan
B, Costes S, Watson E E. 1999. The dosimetry of nonuniform activity distributions - radionuclide S
values at the voxel level. MIRD Pamphlet No.17. J Nucl Med, 40, 11S-36S. (useful for patient
dosimetry at voxel level for radionuclide therapy)
S values for cellular and subcellular structures:
14. Goddu S, Howell R, Bouchet I, et al. 1997. MIRD cellular S factors: self absorbed dose per unit
cumulated activity for selected radionuclides and monoenergetic electrons and alpha particles emitters
incorporated into different cell compartments. Reston VA: Society of Nuclear Medicine. (for dosimetry
at cell and subcellular level)
Radionuclide data and decay schemes:
15. Dillman L T. 1969. Radionuclide decay schemes and nuclear parameters for use in radiation dose
estimation. MIRD Pamphlet No.4. J Nucl Med, 10, 5-32.
16. Dillman L T. 1970. Radionuclide decay schemes and nuclear parameters for use in radiation dose
estimation. Part 2. MIRD Pamphlet No.6. J Nucl Med, 11, 5-32.
17. Dillman L T, von der Lage F C. 1975. Radionuclide decay schemes and nuclear parameters for use in
radiation dose estimation. MIRD Pamphlet No.10. New York: The Society of Nuclear Medicine.
18. Weber D A, Eckerman K F, Dillman L T, Rayman J C. 1989. MIRD radionuclide data and decay
schemes. New York: The Society of Nuclear Medicine.
Kinetics of radionuclides to estimate cumulated radioactivity:
19. Berman M. 1977. Kinetic models for absorbed doses calculations. MIRD Pamphlet No.12. New York:
The Society of Nuclear Medicine. (compartment models for deriving cumulated activities)
20. Siegel J A, Thomas S R, Stubbs J B, Stabin M G, Hays M T, Koral K F, Robertson J S, Howell R W,
Wessels B W, Fisher D R, Weber D A, Brill A B. 1999. Techniques for quantitative radiopharmaceutical
distribution data acquisition and analysis for use in human radiation dose estimates. MIRD Pamphlet
No.16. J Nucl Med, 40, 37S-61S. (estimation of cumulated activities for patients from time-activity
distributions obtained from imaging systems)
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81
MIRD Dose Estimate Reports:
21. Lathrop K A, Johnston R E, Blau M, Rothschild E O. 1972. Radiation dose to humans from Se-75-L-
selenomethionine. MIRD Pamphlet No.9. J Nucl Med, 13, 7-30.
22. Lathrop K A, Johnston R E, Blau M, Rothschild E O, Smith E M. 1973. Selenium-75-L-
selenomethionine. MIRD Dose Estimate Report No.1: J Nucl Med, 14, 49-50.
23. Cloutier R J, Watson E E, Hays R L, Nelson B, Smith E M. 1973. Gallium-66-, gallium-67-, gallium-
68-, and gallium-72-citrate. MIRD Dose Estimate Report No.2: J Nucl Med, 14, 755-6.
24. Atkins H L, Cloutier R J, Lathrop K A, Freeman L M, McAfee J G, Nelp W B, Patton D D, Smith E
M. 1975. Technetium-99m-sulfur colloid in various liver conditions. MIRD Dose Estimate Report
No.3: J Nucl Med, 16, 108A-B.
25. Cloutier R J, Freeman L M, McAfee J G, McCormack D R, Patton D D, Rosenthall L, Smith E M.
1975. Au-198-colloidal gold in various liver conditions. MIRD Dose Estimate Report No.4: J Nucl
Med, 16, 173-4.
26. Berman M, Braverman L E, Burke J, de Groot L, McCormack K R, Oddie T H, Rohrer R H, Wellman
H N, Smith E M. 1975. I-123, I-124, I-125, I-126, I-1230, I-131, and I-132 as sodium iodide. MIRD
Dose Estimate Report No.5: J Nucl Med, 16, 857-60.
27. Blau M, McAfee J G, Rohrer R H, Snyder W H, Smith E M. 1975. Hg-197-, and Hg-203-labeled
chlormerodrin. MIRD Dose Estimate Report No.6: J Nucl Med, 16, 1095-8.
28. Freeman L M, Patton D D, Rosenthall L, Taplin G V, Smith E M.1975. I-123, I-124, I-126, I-130, I-
131 as sodium Rose Bengal. MIRD Dose Estimate Report No.7: J Nucl Med, 16, 1214-17.
29. Lathrop K A, Atkins H L, Berman M, Hays M T, Smith E M. 1976. Tc-99m as sodium pertechnetate.
MIRD Dose Estimate Report No.8: J Nucl Med, 17, 74-7.
30. Atkins H L, Robertson J S, Croft B Y, Tsui B, Susskind H, Ellis J, Loken M K, Treves S. 1980.
Radioxenon in lung imaging. MIRD Dose Estimate Report No.9: J Nucl Med, 21, 459-65.
31. Blau M, Wicks R, Thomas S R, Lathrop K A. 1982. Albumin microspheres labeled with Tc-99m.
MIRD Dose Estimate Report No.10: J Nucl Med, 23, 915-17.
32. Robertson J S, Price R R, Budinger T F, Fairbanks V F, Pollykove M. 1983. Fe-52, Fe-55 and Fe-59
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