[en] This diagnosis and/or treatment method consists in using an aqueous solution of a glycoprotein, the hyaluronectin, on which a radioisotope is fastened. This solution is injected. The radioisotope will be gamma rays emitting for the radiodiagnosis like Indium III, Technetium 99, Iode 123 and Iode 131, or beta rays emitting used in cancer radiotherapy like iode 131

[en] This paper reviews the published data relating to radiation hazards to the family and close friends or the members of the public, associated with nuclear medicine patients. The new annual dose limit of 1 mSv proposed by the ICRP for members of the public and the concept of dose constraints should modify the French legislation and the radioprotection guidance. Dose constraints are set prospectively and are not expected to be exceeded. They are no legal dose limits. They can be higher in the case of the family and close friends than the dose limit of 1 mSv. The European Commission proposes dose constraints values of 3 mSv for the family and close friends (adults) and 0.3 mSv for the members of the public, as the United Kingdom's recommendations are respectively 5 mSv and 1 mSv. For diagnostic studies, the quantities of radioactivity currently administered do not necessitate any special precautions or restrictions to be place on the patient. The main exception was found in the situation of an out patient given ¹¹¹In who had to look after a fretful infant with close contact time of 9 hours per day. For breast-feeding, comprehensive set of recommendations, including no interruption or interruption during only a few hours were proposed to ensure that the effective dose to the infant does not exceed 1 mSv. Nevertheless, as a precaution, breast-feeding interruption should be recommended, whatever the radiopharmaceutical, or if possible, to defer the medical exploration. The main radiation protection problem occurs for therapeutic treatment with gamma ray emitters such as ¹³¹I for the treatment of thyroid pathology. There is a range of published recommendations for limiting the exposure of close friends and the members of the public. These advises include private and public transports, return to work, sleeping with partner and close contact with children. The recommendations proposed by the European Commission for the members of the public are quite restrictive if compared with the British recommendations. For instance, the European Commission instruction is that travelling by public transport should be restricted to about two hours per trip, the first week. The recommendation occurs whatever the administered activity. As the British guidance indicates that it is extremely unlikely that any person could receive a radiation dose exceeding 0.3 mSv as a result of travelling with a patient released from hospital with a residual activity of less than 800 MBq of iodine 131. It is therefore unnecessary to recommend restrictions on the use of public transport, except in the case of transport longer than 3 hours on the day of leaving the hospital. For partners, the main exposition occurs during the night, and recommendation to use separate rooms during a period of time depending on residual activity has been proposed. Patient should be advised to refrain from close contact with children and pregnant women during a period of time depending on the residual activity. Particular consideration needs to be given to children aged 3 years or younger. Considering the discrepancies between the published radioprotection guidances, it is very important that the French nuclear medicine community proposes dose constraints values and its own recommendations. (author)

[en] Background. In at least 15 % of dilated urinary tracts, diuresis renography fails to assess the presence or absence of urinary obstruction. Objective. To determine the shortcomings of ^99mTc-DTPA frusemide diuresis renography by reference to pressure flow studies. Materials and methods. Thirty-four patients, aged 1 month to 20 years, with questionable obstruction were evaluated by diuresis renography and pressure flow studies (the Whitaker test) as the reference method during the same short period of time. Discrepancies were analysed. Results. In patients with type I or IIIa renographic response, pressure flow studies never led to any change in management. Poor function, major dilatation and prior surgery were found to be risk factors of inaccurately obstructive pattern (type II) on renography (n = 6). In patients with type IIIb response, pressure flow studies could show low-grade (n = 3) or intermittent obstruction (n = 2). Intermittent obstruction was also demonstrated in two patients with type II response. Conclusion. In patients with risk factors, type II response was sometimes inaccurate, and urodynamic evaluation showed absence of obstruction and led to conservative management. Type IIIb response should be considered equivocal rather than partially obstructive, and pressure flow studies could be considered in such patients. (orig.)