Alkhybari Essam Mohammed, McEntee Mark F, Willowson Kathy P, Brennan Patrick C, Kitsos Theo, Kench Peter L
1 Faculty of Health Sciences, Discipline of Medical Radiation Science, The University of Sydney , Sydney, NSW , Australia.
2 Faculty of Applied Medical Sciences, Department of Radiology and Medical Imaging, Prince Sattam Bin Abdulaziz University , Al kharj , Saudi Arabia.
Br J Radiol. 2019 Apr;92(1096):20180879. doi: 10.1259/bjr.20180879. Epub 2019 Mar 5.
: The aim of this study is to report a local diagnostic reference level (DRL) for paediatric whole-body (WB) fludeoxyglucose (F-FDG) positron emission tomography (PET) CT examinations.
: The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) national DRL (NDRL) age category (0-4 years and 5-14 years), the International Commission on Radiological Protection age category (ICRP age) (<1, >1-5, >5-10, and >10-15 years), and European guideline weight category ( EG weight) (<5, 5-<15, 15-<30, 30-<50, and 50-<80 kg) were used to determine a local DRL for WB F FDG PET/CT studies. Two-structured questionnaires were designed to collect dose data, patient demographics, equipment details, and acquisition protocols for WB F-FDG PET/CT procedures. The local DRL was based on the median F-FDG administered activity (MBq), dose-length product (DLP), and the CT dose index volume (CTDI), values. The effective dose (E) was also calculated and reported.
: The local DRLs for F-FDG administered activity, CTDI and DLP values based on ARPANSA age and ICRP age were increased from lower to higher age categories. For the EG weight category, the local DRL for F-FDG administered activity, CTDI and DLP values were increased from the low EG weight category to the high EG weight category. The mean administered activity in our study based on ICRP age category >1-5, >5-10, and >10-15 years is 79.97, 119.40, and 176.04 MBq, which is lower than the mean administered activity reported in the North American Consensus guideline published in 2010 (99, 166, and 286 MBq) and European Association of Nuclear Medicine and Dosage Card (version 1.5.2008) (120, 189, and 302 MBq). However, the mean administered activity in our study based on ICRP age category <1 year was 55 MBq compared to the EANM Dosage card (version 1.5.2008) (70 MBq) and the NACG 2010 (51 MBq). Our study shows that the finding for ICRP age category <1 year was similar to the NACG 2010 value.
: The determined local DRL values for the radiation doses associated with WB F FDG PET/CT examinations are differed considerably between the ARPANSA and ICRP age category and EG weight category. Although, the determined F-FDG value for ICRP < 1 year is in good agreement with available publish data, it is preferable to optimise the F-FDG administered activity while preserving the diagnostic image quality.
: The local DRL value determined from WB F-FDG PET/CT examinations may help to establish the ARPANSA NDRL for WB FDG F-PET/CT examinations.
本研究旨在报告儿童全身氟脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）CT检查的局部诊断参考水平（DRL）。
采用澳大利亚辐射防护与核安全局（ARPANSA）的国家DRL年龄类别（0至4岁和5至14岁）、国际放射防护委员会年龄类别（ICRP年龄）（<1岁、>1至5岁、>5至10岁和>10至15岁）以及欧洲指南体重类别（EG体重）（<5 kg、5至<15 kg、15至<30 kg、30至<50 kg和50至<80 kg）来确定全身F-FDG PET/CT研究的局部DRL。设计了两份结构化问卷，用于收集WB F-FDG PET/CT检查的剂量数据、患者人口统计学信息、设备细节和采集方案。局部DRL基于F-FDG给药活度（MBq）、剂量长度乘积（DLP）和CT剂量指数容积（CTDI）值的中位数。还计算并报告了有效剂量（E）。
基于ARPANSA年龄和ICRP年龄的F-FDG给药活度、CTDI和DLP值的局部DRL随着年龄类别从低到高而增加。对于EG体重类别，F-FDG给药活度、CTDI和DLP值的局部DRL从低EG体重类别到高EG体重类别增加。我们研究中基于ICRP年龄类别>1至5岁、>5至10岁和>10至15岁的平均给药活度分别为79.97、119.40和176.04 MBq，低于2010年发布的北美共识指南（99、166和286 MBq）以及欧洲核医学与剂量卡协会（版本1.5.2008）（120、189和302 MBq）中报告的平均给药活度。然而，我们研究中基于ICRP年龄类别<1岁的平均给药活度为55 MBq，而欧洲核医学协会剂量卡（版本1.5.2008）为70 MBq，北美共识指南2010年为51 MBq。我们的研究表明，ICRP年龄类别<1岁的结果与北美共识指南2010年的值相似。
在ARPANSA和ICRP年龄类别以及EG体重类别之间，与全身F-FDG PET/CT检查相关的辐射剂量的局部DRL值存在很大差异。尽管ICRP<1岁的F-FDG值与现有已发表数据吻合良好，但在保持诊断图像质量的同时优化F-FDG给药活度更为可取。
由全身F-FDG PET/CT检查确定的局部DRL值可能有助于建立ARPANSA全身FDG F-PET/CT检查的国家DRL。
