engleski

Diagnostic reference levels in nuclear medicine single photon emission imaging in Croatia

Purpose: To introduce the concept of diagnostic reference levels (DRLs) in the national nuclear medicine practice a survey was prepared and performed through nuclear medicine departments in Croatia. This work was motivated by the fact that the current Croatian DRLs were prescribed by the national regulation as maximum activity per procedure without surveying the national practice. An additional aim was to increase the awareness of importance of quality assurance (QA) and to encourage full implementation of a comprehensive QA programme that includes devices used in the nuclear medicine. Materials and Method: Data were collected for more than 30 nuclear medicine single photon emission procedures performed by the application of various radiopharmaceuticals based on the radionuclides 99mTc, 131I, 123I and 67Ga. National DRLs (NDRL) as administered activity and also as administered activity per unit mass were calculated in accordance with International Commission on Radiological Protection (ICRP) recommendations. Additionally, to estimate patient radiation risk in more detail, typical effective dose to the standard patient from administered radiopharmaceutical was estimated using either factors related to a set of mathematical models of the adult human body designed by the ICRP or those provided in the certificate of respective radiopharmaceutical. Results: Data acquired by ten participating nuclear medicine departments were analysed and NDRLs for nuclear medicine single photon emission procedures were proposed. For procedures performed in a sole department typical values were taken as a reference. In almost 40% of the single photon emission procedures the proposed DRL was larger than maximum activity per procedure used as a current NDRL. Activities administered at different nuclear medicine departments for the same type of procedure were rather heterogeneous, demonstrating values that differ over 10 times between minimum and maximum typical values for respective procedures. Differences in administered activity per unit mass indicate wide range of methods used at the national level which calls for optimization and harmonization. Typical effective doses of investigated examinations vary from less than 0.1 mSv to 35.5 mSv. Conclusions: Proposed NDRLs represent an actual status of nuclear medicine practice in Croatia and have been recognised by the regulatory body as official NDRLs. Departments have set their own typical values to be used as one of the tools for further optimization process. Drawback of the DRL concept in nuclear medicine is lack of the image quality parameters involved. Therefore, a quantity that considers both radiation protection and image quality should be introduced.

diagnostic reference level, nuclear medicine, administered activity, administered activity per unit mass

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