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A survey of PET activity in Germany during 1999
Gunnar Brix1, Dietmar Nosske, Gerhard Glatting
1Federal ffice for Radiaton Protectin, Institute of Radiaton Hygiene, Department of Medical Radiation Hygeine, Neuherberg, Germany. gbrix@bfs.de
Abstract:
Positron emission tomography (PET) is the most powerful molecular imaging technique currently available for clinical use. The aim of this study was to provide public health information on PET procedures carried out in Germany - a country with a very high number of PET installations. To this end, all facilities that in 1999 were running at least one dedicated PET system were contacted and requested to provide information in a questionnaire on the radiopharmaceuticals applied, the total number and age distribution of patients and volunteers examined, the main diagnostic applications and the range of administered activities. Based on the information provided by 48 of the 60 PET facilities in Germany, an annual frequency of about 0.34 PET procedures per 1,000 inhabitants was estimated, associated with an annual per capita effective dose of about 1.9 micro Sv. Averaged over all PET procedures, the mean effective dose to patients was 5.6 mSv. The age distribution of patients and volunteers was skewed markedly towards higher ages; only a very small fraction (<3%) of patients were children younger than 15 years while older patients, and especially those in the age group between 41 and 65 years, were overrepresented relative to the general population. In total, 28 different PET radiopharmaceuticals were used, with only half of these having been administered to more than 20 patients each. The most frequently applied radiotracer was the glucose analogue 2-[(18)F]fluoro-2-deoxy- D-glucose (FDG), which was utilised in more than 84% of all PET procedures. For this tracer, the median value for activities applied for examinations in the three-dimensional (3D) acquisition mode was only half of that used for two-dimensional (2D) measurements. Based on a statistical analysis of the distribution of mean FDG activities administered to patients in the 48 PET facilities who responded to our inquiry, diagnostic reference levels of 370 and 200 MBq are proposed for the 2D and the 3D mode, respectively.