Diagnostic Reference Levels for Adult Nuclear Medicine Imaging Established from the National Survey in Korea

Song, Ho‐Chun; Na, Myung Hwan; Kim, Jahae; Cho, Sang-Geon; Park, Jin Kyung; Kang, Keon Wook

doi:10.1007/s13139-019-00585-y

Cited by 18 publications

(15 citation statements)

References 14 publications

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“…In contrast, the activity amounts used for the patients undergoing PET/CT via GE was only congruous with the current North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities which recommended 3.7-5.2 MBq/kg (0.10-0.14 mCi/kg) for a body 18 F -FDG PET/CT scan [14]. Moreover, the average activity of our population (421 MBq) was closer to the diagnostic reference levels (DRLs) in UK and Austria (400 MBq), while it was relatively higher than both Korea with DRL of 370 MBq in 2019 and Japan which has recently reported DRL of 240 MBq in 2020 [15,16,17]. In consideration of these factors, it is unlikely that in other countries in Europe or in OECD countries, the rate of occurrence of multiple imaging and doses may be lesser than ours.…”

Section: Discussionsupporting

confidence: 48%

Patients Undergoing Multiple 18F-FDG PET/CT Scans: 11-Year Study At A High-Capacity Center

Abuqbeitah

Demır

Sönmezoğlu

et al. 2021

Preprint

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Purpose To assess frequency, clinical indications, and cumulative effective dose (CED) of patients undergoing multiple 18F-FDG PET/CT imaging. Methods Retrospective analysis of 18F-FDG PET/CT scans performed at a University hospital for 11 years was done. Effective dose was computed from activity administered and dose-length-product. Results A total of 55,424 18F-FDG PET/CT scans were performed in 32,658 patients. The average injected activity was 421 MBq and median 417 MBq. 24.2% of the patients were scanned 2-5 times in a year, 16.7% of them being unique patients (not counted as separate patient in different years). The maximum PET/CT scans in a year was five. 23571 (72.2 %) patients underwent a single 18F-FDG PET/CT scan, while 9087 (27.8%) unique patients underwent 2 - 23 scans during 11 years. 82% of the scanned patients had malignant disease, 2.4% among the patients with ≥ 2 18F-FDG PET/CT scans in a year were with non-malignant indications. 1.4% of patients received CED ≥100 mSv in one year from multiple 18F-FDG PET/CT scans and 0.8% of them received ≥ 100 mSv in a year more than one time, the CED of 27.8% (9087 patients) who underwent 2 to 23 18F-FDG PET/CT scans over 11-years ranged from 38 to 575 mSv (median: 271 mSv). Conclusion This first and largest ever study covering analysis of 11-years’ data of 18F-FDG PET/CT patients showed that a sizeable number of patients, largely (82%) with malignant disease undergo recurrent imaging during one year and non-ignorable fraction exceed 100 mSv in one year.

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Section: Discussionsupporting

confidence: 48%

Patients Undergoing Multiple 18F-FDG PET/CT Scans: 11-Year Study At A High-Capacity Center

Abuqbeitah

Demır

Sönmezoğlu

et al. 2021

Preprint

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“…The mean administered activity, 833.98 6 106.93 MBq, translated to a mean dose of 52.54 6 6.31 mGy to the bone surface. Figure 1 compares this mean administered activity with the mean values in Sudan (8), Brazil (13), France (14), and Korea (15) and with the 1996 basic safety standard (16) and the 2008 standard of the United Nations Scientific Committee on the Effects of Atomic Radiation (17). The Nigerian mean value was lower than the United Nations standard and the Brazilian mean value but higher than the other mean values and standard.…”

Section: Resultsmentioning

confidence: 90%

Establishing a Local Diagnostic Reference Level for Bone Scintigraphy in a Nigerian Tertiary Hospital

Dambele

Sikiru

Ahmad

et al. 2021

J. Nucl. Med. Technol.

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It is of vital importance to optimize the radiation dose to patients undergoing radionuclide bone scanning. This is one of the most common nuclear medicine procedures in many parts of the world, including Nigeria, and the current study was performed as part of a national survey to establish diagnostic reference levels (DRLs) for common nuclear medicine procedures in Nigeria in order to optimize their use. Nuclear medicine was only recently introduced to the health-care system in Nigeria, with only 2 centers presently conducting these procedures. Methods: A retrospective, crosssectional study was performed in the nuclear medicine department of a tertiary hospital in southwest Nigeria to determine the preliminary local DRL for radionuclide bone scanning. One hundred and nine patients who met the study criteria were included. Data were obtained from June 2017 to March 2019 and were analyzed to obtain the third quartile of the distributed administered activity and achievable dose (anthropometric variables and radiation dose to bone surface). Results: The mean administered activity, achievable dose, and DRL were 833.98 6 106.93, 832.5, and 895.4 MBq, respectively. The calculated preliminary local DRL was larger than values reported in studies done in Sudan, the United Kingdom, and Australia or by the International Commission on Radiological Protection. Conclusion: The preliminary DRL from this first-of-its-kind study in Nigeria was high because of practitioners' lack of experience. However, the values were still within the international best-practice range, which when optimized will go a long way toward reducing medical exposure without compromising image quality.

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“…This is because the majority of NDRL reports focus on reporting administered activity from only MPI SPECT or MPI PET scans, with only a few identified studies reporting NDRLs for the CT component of these examinations [ 9 ]. Furthermore, the literature review highlighted that variation in NDRL value for the administered activities related to the stress and rest one-day protocol range from 407 MBq and 740 MBq to 555 MBq and 1184 MBq for 99m Tc-Tetrofosmin /Sestamibi, respectively [ 8 , 11 , 12 ]. Regarding CT components, a few articles reflect the change of variation in NDRL related to the CT dose, for instance, the CTDI vol value ranges from 2.2 mGy to 36 mGy and the DLP value ranges from 36 mGy.cm to 380 mGy.cm [ 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey

et al. 2023

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Objective: This study aims to establish a local diagnostic reference level (LDRL) for single-photon emission tomography/computed tomography (SPECT/CT) and positron emission tomography/CT (PET/CT) with respect to myocardial perfusion imaging (MPI). Materials and Methods: The acquisition protocol and dosimetry data on the MPI procedures of five SPECT/CT scans and one PET/CT scan were collected. Data on technitum-99m sestamibi (99mTc-sestamibi), 99mTc-tetrofosmin, thallium-201 (201Tl), and rubidium-82 (82RB) were all collected from one centre via questionnaire booklets. Descriptive data analysis was used to analyse all variables, and the 50th percentile was used to analyse each radiation dose quantity. Results: The reported 50th percentile dose for a one-day stress/rest protocol using 99mTc-sestamibi (445/1147 MBq) and 99mTc-tetrofosmin (445/1147 MBq) and for a two-day stress/rest protocol using 99mTc-sestamibi (1165/1184 MBq) and 99mTc-tetrofosmin (1221/1184 MBq) are in good agreement with reported national diagnostic reference levels (NDRLs). However, the dose from the study data on a one-day stress/rest protocol using 99mTc-sestamibi was more than the 50th percentile dose from the Brazilian data (370/1110 MBq) on a similar protocol, and the dose from the study data on a two-day stress/rest protocol using 99mTc-tetrofosmin was more than the 50th percentile dose (1084/1110 MBq) from the United States data on MPI scans. Regarding the computed tomography (CT) portion of the SPECT/CT framework, the 50th percentile doses were lower than all the identified doses in the data considered in the literature reviewed. However, regarding the CT component of the PET/CT MPI scans, the 82RB dose was more than the recorded doses in the CT data in the published literature. Conclusion: This study determined the LDRL of five SPECT/CT protocols and one PET/CT MPI protocol. The results suggest that there may be opportunities to optimise the patient radiation burden from administered activities in patients undergoing SPECT examinations and the CT components associated with 82RB PET/CT scans without compromising diagnostic image quality.

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Diagnostic Reference Levels for Adult Nuclear Medicine Imaging Established from the National Survey in Korea

Cited by 18 publications

References 14 publications

Patients Undergoing Multiple 18F-FDG PET/CT Scans: 11-Year Study At A High-Capacity Center

Patients Undergoing Multiple 18F-FDG PET/CT Scans: 11-Year Study At A High-Capacity Center

Establishing a Local Diagnostic Reference Level for Bone Scintigraphy in a Nigerian Tertiary Hospital

Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey

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