[Establishment and application of diagnostic reference levels for nuclear medicine procedures in Germany]

Diagnostic reference levels (DRL) were introduced in Germany by a publication in the Bundesanzeiger Nr. 143 from August 5, 2003. Thereby a recommendation of the International Commission on Radiological Protection (ICRP) from 1996 and a demand by the EU Guideline 97/43/EURATOM from 1997 is converted into national law. AIM of this paper is to acquaint with and to justify the determined DRL as well as to provide information on the practical use of the concept of the DRL.

DRL were established by experts on the basis of a national survey conducted in hospitals and private practices as well as of national and international recommendations and published by the Federal Office for Radiation Protection. Besides the data basis the dosimetric principles are described for the estimation of the effective doses of the various examinations.

DRL were established for 10 frequent and dose-relevant examinations constituting more than 80% of all nuclear medicine examinations currently performed in Germany. For some examinations two different DRL were given to take into account clinical conditions. For paediatric examinations fractions of the activities to be administered to adults are given dependent on the body weight.

The published DRL are in agreement with the majority of national and international recommendations and with the present practice of nuclear medicine examinations in Germany. They are related to average activities for groups of patients with standard sizes and, moreover, to typical examinations with current standard equipment. It is planned to check and to reconsider the DRL about every 2-3 years.