Diagnostic nuclear medicine procedures in Germany between 1996 and 2002: application frequencies and collective...

Man-made radiation exposure to the German population predominantly results from the medical use of ionizing radiation. It was therefore the aim of the present study, to provide public health information concerning diagnostic nuclear medicine procedures carried out in Germany between 1996 and 2002.

Application frequencies for 10 groups of procedures were estimated from official reimbursement data provided by the German health insurance companies. Mean effective doses for these examinations were estimated from data provided by 14 clinics and 10 practices concerning the radiopharmaceuticals in use and the activities administered.

During the period 1996-2002, a total of (3.83 +/- 0.31) million nuclear medicine procedures were performed in average per year, which corresponds to a mean annual application frequency of approximately 47 examinations per 1 000 inhabitants. More than 90% of the examinations were scintigraphies of the thyroid (37%), skeleton (25%), myocardium (13%), lungs (8%) and kidneys (8%). The averaged collective effective dose was (10.2 +/- 1.4) . 10(3) mSv per year, which corresponds to a mean annual per caput effective dose of about (0.12 +/- 0.02) mSv. Three types of procedures were responsible for about 80% of the total collective effective dose: scintigraphies of the myocardium (36%), skeleton (33%) and thyroid (10%). Averaged over all procedures carried-out, the mean effective dose per examination was (2.7 +/- 0.8) mSv.

The average effective dose per inhabitant and year caused by nuclear medicine examinations is markedly lower than that resulting from medical X-ray procedures (0.12 vs. 1.8 mSv). Reduction of patient exposure may be achieved, for example, by replacing (201)Tl-labeled radiopharmaceuticals by (99m)Tc-labeled compounds.