Selvam Haniff Shazwan Safwan, Yusof Ahmad Khairuddin Mohamed, Nazri Muhammad Azuan, Omar Norizan, Harizan Ali Hazizi Jamal, Mois Norizam, Rahman Muhd Zaidi Ab
Imaging Centre, Institut Jantung Negara, No 145 Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia.
Sci Rep. 2025 Apr 11;15(1):12372. doi: 10.1038/s41598-025-96838-2.
This study aims to establish the diagnostic reference level (DRL), achievable dose (AD), and effective dose (ED) estimation for adult hybrid SPECT myocardial perfusion imaging (MPI) procedures at Institut Jantung Negara (IJN). 737 subjects referred for MPI studies from January to June 2024 were included in the analysis. These subjects underwent either a one-day or two-day Tc-99 m tetrofosmin protocol using a cardiac-dedicated single-photon emission computed tomography (SPECT), either GE SPECT Discovery NM530c or GE SPECT Ventri. All subjects also underwent a cardiac CT scan via an external positron emission tomography/computed tomography (PET/CT) system, GE Discovery MI Digital Ready for either CT attenuation correction (CTAC) or CT coronary artery calcium score (CAC) protocol, depending on their clinical condition. The one-day protocol showed AD of 240.50 MBq and 691.90 MBq for the first and second injections, respectively, with corresponding DRL of 263.63 MBq and 777.93 MBq. The two-day protocol involved higher ADs of 1106.30 MBq and 1073.00 MBq for the first and second injections, with DRL of 1239.50 MBq and 1221.00 MBq, respectively. In the CTAC protocol, the AD for CT dose index volume (CTDI) was 2.8 mGy, with a DRL of 4.3 mGy. The dose length product (DLP) had an AD of 53.1 mGy.cm, compared to a DRL of 78.6 mGy.cm. For the CAC protocol, the CTDI had an AD of 4.8 mGy, matching the DRL of 4.8 mGy. The DLP showed an AD of 67.8 mGy.cm, with a DRL of 77.5 mGy.cm. The mean cumulated effective dose (ED) for one-day/CTAC, one-day/CAC, two-day/CTAC, and two-day/CAC was 6.69 ± 1.76 mSv, 7.32 ± 1.37 mSv, 10.13 ± 5.31 mSv, and 13.99 ± 3.24 mSv respectively. The average ED relative contribution by SPECT and CT were found to be 78.3% and 21.7% respectively. The DRL, AD, and ED data were successfully established for local MPI practice, contributing to global efforts to harmonize and enhance radiation safety in MPI practices.
本研究旨在确定马来西亚国家心脏研究所（IJN）成人混合单光子发射计算机断层扫描心肌灌注成像（MPI）程序的诊断参考水平（DRL）、可达到剂量（AD）和有效剂量（ED）估计值。纳入分析的对象为2024年1月至6月转诊进行MPI研究的737名受试者。这些受试者使用心脏专用单光子发射计算机断层扫描（SPECT）（GE SPECT Discovery NM530c或GE SPECT Ventri），接受了为期一天或两天的锝-99m替曲膦方案。所有受试者还通过外部正电子发射断层扫描/计算机断层扫描（PET/CT）系统GE Discovery MI Digital Ready进行了心脏CT扫描，根据其临床情况，用于CT衰减校正（CTAC）或CT冠状动脉钙化评分（CAC）方案。一天方案中，第一次和第二次注射的AD分别为240.50 MBq和691.90 MBq，相应的DRL分别为263.63 MBq和777.93 MBq。两天方案中，第一次和第二次注射的AD较高，分别为1106.30 MBq和1073.00 MBq，DRL分别为1239.50 MBq和1221.00 MBq。在CTAC方案中，CT剂量指数容积（CTDI）的AD为2.8 mGy，DRL为4.3 mGy。剂量长度乘积（DLP）的AD为53.1 mGy.cm，而DRL为78.6 mGy.cm。对于CAC方案，CTDI的AD为4.8 mGy，与DRL 4.8 mGy匹配。DLP的AD为67.8 mGy.cm，DRL为77.5 mGy.cm。一天/CTAC、一天/CAC、两天/CTAC和两天/CAC的平均累积有效剂量（ED）分别为6.69±1.76 mSv、7.32±1.37 mSv、10.13±5.31 mSv和13.99±3.24 mSv。发现SPECT和CT的平均ED相对贡献分别为78.3%和21.7%。成功确定了当地MPI实践的DRL、AD和ED数据，为全球协调和加强MPI实践中的辐射安全做出了贡献。
