Albahiti Sarah K, Khafaji Mawya, Batawil Nadiya, Catipay Norwin, Alsafi Khalid
Radiology, King Abdulaziz University Hospital, Jeddah, SAU.
Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Feb 15;16(2):e54230. doi: 10.7759/cureus.54230. eCollection 2024 Feb.
Diagnostic reference levels (DRLs) were initially introduced by the International Commission on Radiation Protection (ICRP). It refers to the measured quantity of administered activity (MBq) in nuclear medicine imaging studies and is a type of investigation level. DRL is recommended to prevent excessive radiation exposure to patients while maintaining adequate image quality. It should not be implemented as a dose constraint or dose limit. The Saudi Food and Drug Authority (SFDA) is the primary government body responsible for reporting national diagnostic reference levels (NDRLs) for diagnostic medical imaging technologies in Saudi Arabia. Only NDRLs for computed tomography, general X-ray, and mammography have been published and enforced locally. This study aims to establish local DRLs for nuclear medicine imaging procedures at King Abdulaziz University Hospital, Saudi Arabia, preparing for compliance proof once required by local authorities.
Data were collected from all machines, and six common protocols were studied, with data from 50 patients of standard body size for each identified protocol. The study was conducted retrospectively, and the 50th percentile was then calculated for each scan.
Both protocols for renal scans administered the lowest doses to patients (130 MBq and 148 MBq), respectively. The highest dose administered to patients was found to be in bone scans (1110 MBq).
The study establishes local DRLs for nuclear medicine imaging in our institution. Median activity dosages in renal, thyroid, and parathyroid imaging were comparable to locally and internationally published DRLs. However, they are higher in cardiac and bone imaging compared to local Saudi DRL and DRL in the European Union and the USA, likely due to the adopted protocols. These highlight the need for modifying the protocols to fulfill optimization efforts. These findings serve as a foundation for compliance with future regulatory requirements, ensuring patient safety and maintaining imaging quality in Saudi healthcare.
诊断参考水平（DRLs）最初由国际辐射防护委员会（ICRP）提出。它指的是核医学成像研究中所施用活度的测量量（MBq），是一种调查水平。推荐使用诊断参考水平是为了在保持足够图像质量的同时防止患者受到过度辐射暴露。它不应被用作剂量约束或剂量限值。沙特食品药品管理局（SFDA）是负责报告沙特阿拉伯诊断医学成像技术的国家诊断参考水平（NDRLs）的主要政府机构。目前仅已发布并在当地实施了计算机断层扫描、普通X射线和乳腺摄影的国家诊断参考水平。本研究旨在为沙特阿拉伯阿卜杜勒阿齐兹国王大学医院的核医学成像程序建立当地的诊断参考水平，为将来当地政府要求时提供合规证明做准备。
从所有机器收集数据，并研究了六种常见协议，针对每种确定的协议收集了50名标准体型患者的数据。该研究采用回顾性研究方法，然后计算每次扫描的第50百分位数。
两种肾脏扫描协议分别给患者施用了最低剂量（130 MBq和148 MBq）。发现给患者施用的最高剂量出现在骨扫描中（1110 MBq）。
本研究为我们机构的核医学成像建立了当地的诊断参考水平。肾脏、甲状腺和甲状旁腺成像的活度剂量中位数与当地和国际公布的诊断参考水平相当。然而，与沙特当地的诊断参考水平以及欧盟和美国的诊断参考水平相比，心脏和骨成像中的剂量更高，这可能是由于所采用的协议。这些结果凸显了修改协议以实现优化的必要性。这些发现为未来符合监管要求奠定了基础，确保了沙特医疗保健中患者的安全并维持了成像质量。
