Low-energy characteristic x-rays emitted by 111In and 123I sources are easily absorbed by the containers of the sources, affecting radioactivity measurements using a dose calibrator. We examined the effects of different containers on the estimated activities. The radioactivities of 111In, 123I, 201Tl, and 99mTc were measured in containers frequently employed in clinical practice in Japan. The 111In measurements were performed in the vials A and B of the 111In-pentetreotide preparation kit and in the plastic syringe. The activities of 123I-metaiodobenzylguanidine and 201Tl chloride were measured in the prefilled glass syringes and plastic syringes. The milking vial, vial A, vial B, and plastic syringe were used to assay 99mTc. For 111In and 123I, measurements were performed with and without a copper filter. The filter was inserted into the well of the dose calibrator to absorb low-energy x-rays. The relative estimate was defined as the ratio of the activity estimated with the dose calibrator to the standard activity. The estimated activities varied greatly depending on the container when 111In and 123I sources were assayed without the copper filter. The relative estimates of 111In were 0.908, 1.072, and 1.373 in the vial A, vial B, and plastic syringe, respectively. The relative estimates of 123I were 1.052 and 1.352 in the glass syringe and plastic syringe, respectively. Use of the copper filter eliminated the container-dependence in 111In and 123I measurements. Container-dependence was demonstrated in neither 201Tl nor 99mTc measurements. The activities of 111In and 123I estimated with a dose calibrator differ greatly among the containers. Accurate estimation may be attained using the container-specific correction factor or using the copper filter.
Subcommittee for Safety Issues of Radiopharmaceuticals, Medical Science and Pharmaceutical Committee, Japan Radioisotope Association, Hiroshi MATSUDA, Tomoya UEHARA, Hidehiko OKAZAWA, Sunao MIZUMURA, Kunihiko YOKOYAMA, Mana YOSHIMURA
This survey was performed to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2015 in Japan. It was based on the responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 981 institutions among 1,274 to which the questionnaire had been sent. Fifteen cases of adverse reactions were reported. A total of 1,056,828 radiopharmaceutical administrations were reported. The incidence of adverse reactions per 100,000 cases was 1.4. No case of deficient products was reported.
Internal radiation therapy using radium (223Ra) chloride injection (223Ra injection) is already being applied in actual clinical practice, however the NHI medical technical fee for the use of 223Ra injection has not yet been set. The Japanese Society of Nuclear Medicine surveyed health resource use for internal radiation therapy using 223Ra via questionnaires sent to medical institutions that have used 223Ra injection. Results showed that the necessary cost per patient is 1,005,567 JPY, based on the Draft Proposal for Medical Examination Value (Ver. 7.1) of the Japanese Health Insurance Federation for Surgery. 223Ra injection is supposed to be administered 6 times to each patient at 4-week intervals, and the fee per treatment was calculated to be 167,595 JPY. The appropriate NHI medical technical fee is thus considered to be 16,759 points per patient per treatment, which can be claimed 6 times per patient.