Extravasation is a common problem in radiopharmaceutical administration and can result in significant radiation dose to underlying tissue and skin. The resulting radiation effects are rarely studied and should be more fully evaluated to guide patient care and meet regulatory obligations. The purpose of this work was to show that a dedicated radiopharmaceutical injection monitoring system can help clinicians characterize extravasations for calculating tissue and skin doses. We employed a commercially available radiopharmaceutical injection monitoring system to identify suspected extravasation of 18F-fluorodeoxyglucose and 99mTc-methylene diphosphonate in 26 patients and to characterize their rates of biological clearance. We calculated the self-dose to infiltrated tissue using Monte Carlo simulation and standard MIRD dosimetry methods, and we used VARSKIN software to calculate the shallow dose equivalent to the epithelial basal-cell layer of overlying skin. For 26 patients, injection-site count rate data were used to characterize extravasation clearance. For each, the absorbed dose was calculated using representative tissue geometries. Resulting tissue-absorbed doses ranged from 0.6 to 11.2 Gy, and the shallow dose equivalent to a 10 cm2 area of adjacent skin in these patients ranged from about 0.1 to 5.4 Sv. Extravasated injections of radiopharmaceuticals can result in unintentional doses that exceed well-established radiation protection and regulatory limits; they should be identified and characterized. An external injection monitoring system may help to promptly identify and characterize extravasations and improve dosimetry calculations. Patient-specific characterization can help clinicians determine extravasation severity and whether the patient should be followed for adverse tissue reactions that may present later in time.

中文翻译：

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使用摄取探针测量进行患者特异性外渗剂量测定。

外渗是放射性药物施用中的常见问题，可能导致皮下组织和皮肤受到显着的辐射剂量。由此产生的辐射效应很少被研究，应该更全面地评估，以指导患者护理并履行监管义务。这项工作的目的是表明专用的放射性药物注射监测系统可以帮助临床医生表征外渗，以计算组织和皮肤剂量。我们采用市售的放射性药物注射监测系统来识别 26 名患者体内疑似 18F-氟脱氧葡萄糖和 99mTc-亚甲基二膦酸盐的外渗，并描述其生物清除率。我们使用蒙特卡罗模拟和标准 MIRD 剂量测定方法计算了浸润组织的自身剂量，并使用 VARSKIN 软件计算了覆盖皮肤上皮基底细胞层的浅层剂量当量。对于 26 名患者，使用注射部位计数率数据来描述外渗清除的特征。对于每一个，吸收剂量都是使用代表性的组织几何形状计算的。由此产生的组织吸收剂量范围为 0.6 至 11.2 Gy，相当于这些患者邻近皮肤 10 cm2 区域的浅剂量范围为约 0.1 至 5.4 Sv。放射性药物的渗出注射可能会导致意外剂量超过既定的辐射防护和监管限值；应对它们进行识别和表征。外部注射监测系统可能有助于迅速识别和表征外渗并改进剂量测定计算。患者特异性特征可以帮助临床医生确定外渗的严重程度，以及是否应该对患者进行后续可能出现的不良组织反应的跟踪。