Pandey Ashutosh, Dhingra Vandana K, Goswami Mayank, Mishra Prabhaker, Sharma Pankaj
Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Physics, Indian Institute of Technology (IIT) Roorkee, Roorkee, IND.
Cureus. 2024 Oct 17;16(10):e71740. doi: 10.7759/cureus.71740. eCollection 2024 Oct.
Introduction In nuclear medicine, there is a critical need to balance the control and optimization of radiation doses to ensure patient safety while achieving high-quality diagnostic outcomes. However, diagnostic reference levels (DRLs) for nuclear medicine imaging studies have not been established in India. This study aims to fill this gap by establishing institutional DRLs and assessing radiation dose data specifically for Nuclear Medicine SPECT examinations. Methods This research was a cross-sectional observational study conducted in a single tertiary care setting, involving 1,250 patients. Data on the administered activity for 18 common single photon emission computed tomography (SPECT) procedures were gathered from 2019 to 2021. The 75th percentile (Q3) was established as the baseline for the institutional DRLs. Furthermore, the study conducted comparative analyses with established international DRLs. Results The study proposed institutional DRLs based on 18 SPECT nuclear medicine imaging examinations. The highest Q3 DRLs were identified for 99mTc-sestamibi (1193 MBq), followed by 99mTc-methylene diphosphonate (747 MBq) and 99mTc-ethyl cysteinate dimer (608 MBq). The lowest DRL was recorded for 99mTc gastric emptying imaging (37 MBq). Comparisons with international DRLs indicated close alignment with European Association of Nuclear Medicine Medical Internal Radiation Dose guidelines, while DRLs set by the National Council on Radiation Protection and Measurements (NCRP) were identified as distinct in several key aspects when compared to other established DRLs. Conclusion This research marks a significant step toward standardizing SPECT procedure doses in India, contributing to improved patient safety and care in nuclear medicine. The established DRLs will enhance the optimization of administered activities, ensure adherence to international standards, and improve diagnostic quality while reducing radiation exposure. These institutional DRLs will serve as the foundation for developing a roadmap to establish national DRLs.
引言 在核医学中，迫切需要平衡辐射剂量的控制与优化，以确保患者安全，同时实现高质量的诊断结果。然而，印度尚未制定核医学成像研究的诊断参考水平（DRL）。本研究旨在通过建立机构DRL并专门评估核医学单光子发射计算机断层扫描（SPECT）检查的辐射剂量数据来填补这一空白。
方法 本研究是在一家三级医疗机构进行的横断面观察性研究，涉及1250名患者。收集了2019年至2021年期间18种常见单光子发射计算机断层扫描（SPECT）程序的给药活度数据。将第75百分位数（Q3）确定为机构DRL的基线。此外，该研究还与已确立的国际DRL进行了比较分析。
结果 该研究基于18种SPECT核医学成像检查提出了机构DRL。99mTc-司他米比（1193 MBq）的Q3 DRL最高，其次是99mTc-亚甲基二膦酸盐（747 MBq）和99mTc-半胱氨酸乙酯二聚体（608 MBq）。99mTc胃排空成像的DRL最低（37 MBq）。与国际DRL的比较表明，其与欧洲核医学医学内照射剂量协会的指南密切一致，而与其他已确立的DRL相比，美国国家辐射防护与测量委员会（NCRP）设定的DRL在几个关键方面有所不同。
结论 本研究标志着印度在规范SPECT程序剂量方面迈出了重要一步，有助于提高核医学中的患者安全和护理水平。已确立的DRL将加强给药活度的优化，确保符合国际标准，提高诊断质量，同时减少辐射暴露。这些机构DRL将作为制定国家DRL路线图的基础。
