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In the study by Bodei et al. [ 23], in 12 of 51 patients the calculated bone marrow dose was 0.03 mGy/MBq with a cumulative dose in the range 0.5 1.3 Gy.
The estimated collective dose to red bone marrow, based on a one year lag period, was 4000 Gy, and the average estimated red bone marrow dose was 4.6 mGy per scan.
For the bone marrow, all bony structures in the field of view were segmented and the bone marrow dose was calculated as the weighted sum of the doses to these structures with the percentage of bone marrow in these compartments as weighting factor [ 21].
In a cohort study of second cancers after radiotherapy for invasive cancer of the uterine cervix among 182,040 women (average bone marrow dose was estimated as 7,100 mSv), Boice et al. (1985) examined the observed and expected (O/E) numbers of second cancers.
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The fact that several biological parameters influence the haematological response may explain why strong correlations with absorbed bone marrow dose are difficult to find.
A poor correlation between the toxicity grade and administered radioactive dose has been reported, leading to the conclusion that factors other than the total administered activity or the bone marrow dose are important [ 32].
The coefficient of variation (CV) for the individual mean absorbed bone marrow doses was 0.08.
When the SMN was a leukaemia, the mean active bone-marrow dose was estimated as a weighted mean of the doses received by 20 bone sites.
Bone marrow dose calculations were based on clearance and activity measures from the blood samples.
Especially with In used as radionuclide, if a limit of 100 GBq or 3 Gy bone marrow dose had been exceeded, patients developed myelodisplastic syndrome [ 68].
Dose to the red bone marrow is usually assumed to be proportional to the blood dose, where marrow dose is equivalent to blood dose×0.4 (Siegel et al, 1990).
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