National Diagnostic Reference Levels for Nuclear Medicine in Kuwait

Abstract

The diagnostic reference level (DRL) is a patient-exposure optimization tool used to evaluate and provide guidance for radiation doses in medical imaging. In the past few decades, there has been a global increase in the number of diagnostic imaging procedures, including nuclear medicine procedures, and consequently in patient radiation exposure. This increase has encouraged international and national health-care organizations to take action and keep up with such changes to meet the expectation of increasing use of ionizing radiation in medicine. Methods: DRLs in Kuwait were established by investigating the administered activity of radiopharmaceuticals and CT radiation doses in hybrid imaging systems. The DRLs were determined on the basis of the 75th percentile of radiopharmaceutical administered activity distribution as recommended by the International Commission on Radiological Protection. Results: The DRLs determined in Kuwait agree well with other published DRLs in Europe, Japan, Korea, Australia, and the United States. Conclusion: This study presents the establishment process and the results of the first national DRLs for nuclear medicine procedures in Kuwait as a way to optimize radiation exposure.

The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia

“…Table 5 shows the comparison of the proposed NDRLs, for the CT components of hybrid imaging of SPECT-CT devices, with other countries [10,12,21,24,25] for bone scan, parathyroid scan, cardiac scan and lung scan. The results indicate higher values of CTDI vol and DLP in Saudi Arabia with respect to others published data.…”

Enhancing Nuclear Medicine Practice in Saudi Arabia: Advocating for Comprehensive Guidelines and Local Diagnostic Reference Levels

“…The most recent publication, ICRP 135, details the existing guidelines and various aspects of DRL establishment, including considerations for conducting national surveys, clinical applications of DRLs, and updating intervals for DRLs [8]. In many countries, DRLs have been established by these instructions [9][10][11][12][13][14][15][16][17][18]. While efforts to establish DRLs start with the basic diagnostic imaging protocols that are commonly used in daily practice, more advanced and complex modalities are also needed for DRLs for practice optimization.…”

“…Over 5,000 nuclear medicine procedures are conducted annually in Kuwait, and the amount of delivered radiopharmaceutical activity varies up to 20 times among various nuclear medicine departments [14]. In 2021, this variation prompted Alnaaimi et al to establish NDRLs [14].…”