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Published on: January 30, 2020
U.S. PET/CT and Gamma Camera Diagnostic Reference Levels and Achievable Administered Activities for Noncardiac
Murray D Becker1, Priscilla F Butler1, Mazen Siam1
1From the Department of Radiology, Rutgers Robert Wood Johnson Medical School, MEB 404, PO Box 19, New Brunswick, NJ 08903-0019 (M.D.B.); University Radiology, East Brunswick, NJ (M.D.B.); Department of Quality and Safety, American College of Radiology, Reston, Va (P.F.B., M.S., D.A.G.); Department of Radiology, NYU School of Medicine, New York, NY (M.G.); Department of Radiology, Henry Ford Health System, Detroit, Mich (B.A.H.); Department of Diagnostic Imaging, Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y.); and Department of Radiology, University of Kentucky College of Medicine and UK Healthcare, Lexington, KY (M.E.O.).
Abstract:
Existing surveys of radiopharmaceutical doses for U.S. nuclear medicine laboratories are of limited scope and size. Dose data are important because they can be used to benchmark individual laboratories, understand geographic variations in practice, and provide source data for societal guidelines and appropriateness criteria. Diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for 13 noncardiac adult gamma camera and PET/CT examinations were derived retrospectively from American College of Radiology accreditation data (January 1, 2015, to December 31, 2017). The calculated DRL and AAA are consistent with previously published surveys. The distributions of radiopharmaceutical doses across facilities are in general consistent but show variation within a particular examination. Analysis of dose distribution suggests this variation results from differences in clinical protocols, educational gaps, and/or equipment factors. The AAA for the surveyed facilities exceeds dose ranges proposed in societal practice guidelines for several common nuclear medicine studies. Compared with similar surveys from Europe and Japan, geographic variation is observed, with some doses greater and others lower than used in the United States. Overall, radiopharmaceutical dose variation within the United States and internationally, and deviation from societal guidelines, imply that these dose-related benchmarks may be used to further standardize and improve clinical practice.
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