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

Abstract

This study aims to introduce national diagnostic reference levels )NDRLs) for adult hybrid SPECT/CT in nuclear medicine (NM) departments in the Kingdom of Saudi Arabia. The Adminis-tered Activity (AA) of radiopharmaceuticals, volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) for ten hybrid SPECT/CT examinations were collected and analyzed for one year. The median of AA, CTDIvol and DLP for each dose quantity was derived and the suggested national DRLs were determined based on the 75th percentile for all identified SPECT/CT examinations. A comparison of the defined adult NDRLs in Saudi Arabia with the pub-lished data of other countries was performed. Although there are no significant variations of the proposed NDRL of AA between countries, the proposed NDRLs of the integrated CT metrics ex-ceed the published data in most procedures. NM departments are urged to consider optimization for both image quality and radiation protection.

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

“…In medical imaging, there exists a notable variation in patient doses among service providers, with nuclear medicine procedures showing a potential eightfold variation depending on factors such as protocol, machine, and staff experience [27].…”

“…Acceptable variation in DRLs exists, provided that it does not compromise patient safety or image quality. It has been reported as high as eight times, depending on the protocol, machine, and staff experience [27].…”

“…Efforts to establish DRLs for all medical imaging procedures in Saudi Arabia are relatively recent, necessitating the optimization of practices to achieve higher patient safety standards [26]. Al-Qahtani et al [27] surveyed 10 nuclear medicine departments in different Saudi Arabian hospitals in 2021 and suggested NDRLs for SPECT/CT scans using administration activity (AA) in MBq and SPECT/CT protocols. They compared their proposed NDRL with those of Croatia, the United Kingdom, Korea, Australia, Brazil, and Japan for AA in MBq and also with those of Japan, Nordic countries, the UK, Kuwait, and Switzerland for the CT components of hybrid imaging SPECT/CT devices.…”