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Re: I-131 dose to pregnant woman





Bill -



Warning flags my derriere!  How dare you presume this information was

treated as coming from a black box.  The verification process has already

been justified and the software validated by experts



Your arrogant esoteric diatribe among that of others is the last straw.  I

have commented individually to folks I thought were mis-speaking, but this

one is going to the list.  I will not participate in a list that I joined

in hopes of learning and growing my knowledge of radiological issues.  And,

not just a little arrogance on my part, you and your ilk are missing out.

I am the kind of participant you should want and you have blown it.



RSAC the program I mentioned is not a 'shielding program' from your

experience.  It stands for Radiological Safety Analysis Computer program,

developed, scrutinized, and published for use in determining internal doses

from catastrophic and common events.  It has been perfected (incorporating

ICRP, DOE, & NRC guidance) over the last 30 years (unlike the software from

Bill Gates et al).



 Incidentally my very knowledgeable colleague has been in the field of

Health Physics for almost 30 years, is member of and advisory participant

on the board of directors of the NRRPT (National Registry of Radiation

Protection Technologists) for most of that time.  He is the 'go to guy for

the INEEL Radiological Control organization from Rad Engineers, to Rad Con

Techs, to individual Rad Workers.



The original question or concern did not include the dose recipient's

weight and if the dose was ingested or injected.  I was not even certain

the original post meant milli or micro Curies since most e-mail programs do

not transmit the Greek character mu accurately.  Yes assumptions were made,

as a science Health Physics is chock full of assumptions.



Based on the fractional depositions for various organs and tissues and dose

delivered resulted in the numbers as shown in the table.  These numbers

were verified by individual number crunching with a scientific calculator,

if you need to know the black box in question.   The numbers derived from

hard science provide you and the rest of your lot a focal point for you to

make random guesses and unsupported allegations.



Iodine 131 is taken up by the thyroid gland, hence it is a systemic

material.  That material is deposited in the recipient's thyroid, however

the radiation emitting from that material (basic but crucial difference) is

a whole body source of radiation.



Bottom line and most important the question was should the women consider

abortion, that is the question.



One last question, why haven't you verified the numbers that waved a flag

at you?



see ya wouldn't want to be ya -



sincerely



helen anna bailly





                                                                                                                                          

                    William V Lipton                                                                                                      

                    <liptonw@DTEENERGY.COM>       To:     "Michael G. Stabin" <michael.g.stabin@vanderbilt.edu>                           

                    Sent by:                      cc:     Peter.Thomas@health.gov.au, radsafe@list.vanderbilt.edu                         

                    owner-radsafe@list.vand       Fax to:                                                                                 

                    erbilt.edu                    Subject:     Re: I-131 dose to pregnant woman                                           

                                                                                                                                          

                                                                                                                                          

                    08/20/2002 07:22 AM                                                                                                   

                    Please respond to                                                                                                     

                    William V Lipton                                                                                                      

                                                                                                                                          

                                                                                                                                          









Warning flags always go up for me when I read that someone "ran the numbers

through a ... program."  This implies that the program is treated as a

black

box, with blind acceptance of the results.  The 3 key questions are:



1.  How well is the program validated?  Even if the program has the "Good

Housekeeping Seal of Approval" from a reputable group, is it being using

within

the range of the validation?  (My experience with shielding programs is

that the

results may not be valid for dose rates at the surface of the shielding.)

Does

the user periodically run test cases to verify that the program has not

become

corrupted?



2.  Is the input correct for the program requirements (gigo)?  Sometimes,

the

assumed units or other parameters are not what the user expects.  One

situation

I've run into is the issue of daughter activity.  Some programs default to

calculating daughter activities, while some programs do not include

daughter

activities unless the user requests this; e.g., Cs-137 would be treated as

a

pure beta emitter.  Although this is probably not a factor, here, there

could be

other "gotcha's" in the program.



3.  If this person is "a very knowledgeable colleague," why did he blindly

accept results that are so unusual?



The opinions expressed are strictly mine.

It's not about dose, it's about trust.

Curies forever.



Bill Lipton

liptonw@dteenergy.com





"Michael G. Stabin" wrote:



> > I've basically no experience in this matter but I was rather struck by

> some of

> > the numbers in this table.  The 2.4 rem (24 mSv, ca. 24 mGy) to the

uterus

> (and

> > therefore foetus?) seems to agree with what others have suggested.  I

note

> > however that the thyroid dose is "only" (quotes indicating my

uneducated

> > reaction) 2.6 rem, most other organs considered in the program seem to

get

> > greater doses.  Now my limited education includes the thought that

iodine

> is

> > supposed to concentrate in the thyroid and that the purpose of giving

> I-131 to

> > such a patient is to deliver a dose to the thyroid.  The numbers

produced

> below

> > would seem to suggest that in fact it is not very efficient.  Why is

this

> so?

> > Anyone care to educate me? (in brief I hope :-) )

>

> In brief, I think the numbers are not very good. The dose to the

esophagus

> and thymus are inexplicably high, and dose to the urinary bladder is way

too

> low, as is the dose to the thyroid, as you note. Carol Marcus suggests

the

> J. Nucl Med article for guidance, and I agree. These are the same numbers

> that I referred you to on the RADAR web page. The article gives doses to

a

> number of organs, with dependence on the degree of hyperthyroidism. The

dose

> to the uterus is representative of the dose to the fetus in the first few

> weeks of pregnancy.

>

> 20% thyroid uptake

> Urinary Bladder 540 mGy

> Ovaries 20 mGy

> Red Marrow 40 mGy

> Thyroid 200,000 mGy

> Uterus 30 mGy

>

> 40% thyroid uptake

> Urinary Bladder 430 mGy

> Ovaries 20 mGy

> Red Marrow 50 mGy

> Thyroid 400,000 mGy

> Uterus 30 mGy

>

> 60% thyroid uptake

> Urinary Bladder 350 mGy

> Ovaries 20 mGy

> Red Marrow 70 mGy

> Thyroid 550,000 mGy

> Uterus 30 mGy

>

> 80% thyroid uptake

> Urinary Bladder 320 mGy

> Ovaries 15 mGy

> Red Marrow 90 mGy

> Thyroid 660,000 mGy

> Uterus 20 mGy

>

> I rounded these to 1 or 2 sig figs, and took a rough average of the

"fast"

> and "slow" thyroid uptake numbers from Table 2 of the JNM article (if you

> want the dose in rads, divide the above numbers by 10). These are just

rough

> estimates for a given patient, more specific thyroid dose calculations

> should be done, but they give you an idea of more reasonable numbers for

the

> other important organs. I will note, however, that the numbers given in

the

> JNM article for fetal dose at later stages of pregnancy are not reliable,

as

> fetal uptake has not been considered. See Health Phys 73(5):756-769, 1997

> for better numbers in later pregnancy.

>

> Mike

>

> Michael G. Stabin, PhD, CHP

> Assistant Professor of Radiology and Radiological Sciences

> Department of Radiology and Radiological Sciences

> Vanderbilt University

> 1161 21st Avenue South

> Nashville, TN 37232-2675

> Phone (615) 343-0068

> Fax   (615) 322-3764

> e-mail     michael.g.stabin@vanderbilt.edu

> internet   www.doseinfo-radar.com

>

> ----- Original Message -----

> From: <Peter.Thomas@health.gov.au>

> To: <radsafe@list.vanderbilt.edu>

> Sent: Monday, August 19, 2002 8:21 PM

> Subject: Re: I-131 dose to pregnant woman

>

> >

> >

> > Peter Thomas

> > ARPANSA

> >

> >

> >

> > I took this question to a very knowledgeable colleague who ran the

numbers

> > through an internal dosimetry program called RSAC using ICRP 39 model

of

> > the human body this is the info he came up with.

> >

>

> >

> >





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