Diagnostic Reference Levels for nuclear medicine imaging in Austria: A nationwide survey of used dose levels for adult patients

David Wachabauer, Thomas Beyer, Manfred Ditto, Hans-Jürgen Gallowitsch, Michael Hinterreiter, Bettina Ibi, Phillipp Malle, Siroos Mirzaei, Florian Smetana, Anton Staudenherz, Boris Warwitz, Georg Zettinig, Ivo Rausch

Research output: Journal article (peer-reviewed)Journal article

1 Citation (Scopus)

Abstract

PURPOSE: To assess dose levels in routine nuclear medicine (NUC) procedures in Austria as a prior to a legislative update of the National Diagnostic Reference Levels (NDRL).

METHOD: As part of a nationwide survey of common NUC-examinations between June 2019 and November 2019, data sets were collected from 33 Austrian hospitals with NUC equipment. All hospitals were asked to report the NUC imaging devices in use (model, type, year of manufacture, detector material, collimators), the standard protocol parameters for selected examinations (standard activity, collimator, average acquisition time, reconstruction type, use of time-of-flight) and to report data from 10 representative examinations (e.g. injected activity, weight), incl. the most common NUC-examinations for planar imaging/SPECT and PET. Median/mean values for injected activity were calculated and compared to current Austrian and international NDRL. A Pearson correlation coefficient was computed comparing different variables.

RESULTS: In total, all 33 hospitals (100% response rate) reported data for this study for 60 SPECT devices, 21 PET/CT devices and 23 scintigraphy devices. Fixed activity values for scintigraphy/SPECT and PET were employed by about 90% and 56% of the hospitals, respectively. The most widely performed examinations for scintigraphy/SPECT are bone imaging, thyroid imaging, renal imaging (with MAG3/EC) and lung perfusion imaging (in 88% of the hospitals) and F-18 FDG-PET studies for oncology indications (in 100% of the hospitals). Significant correlations were found for patient weight and injected activity (scintigraphy/SPECT), use of iterative reconstruction and injected activity (PET) as well as size of field-of-view and injected activity (PET).

CONCLUSIONS: The reported injected activity levels were comparable to those in other countries. However, for procedures for which NDRL exist, deviations in injected activities of >20% compared to the NDRL were found. These deviations are assumed to result mainly from advances in technology but also from deviations between NDRL and prescribed activities as given in the information leaflets of the radiopharmaceuticals.

Original languageEnglish
Pages (from-to)283-295
Number of pages13
JournalZeitschrift fur Medizinische Physik
Volume32
Issue number3
Early online date20 Jan 2022
DOIs
Publication statusPublished - Aug 2022

Keywords

  • Diagnostic reference levels
  • Nuclear medicine
  • Radiation Protection
  • Austria
  • Humans
  • Tomography, Emission-Computed, Single-Photon
  • Adult
  • Fluorodeoxyglucose F18
  • Nuclear Medicine
  • Positron Emission Tomography Computed Tomography/methods
  • Radiopharmaceuticals
  • Diagnostic Reference Levels

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Radiology, Nuclear Medicine and Imaging

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