Establishing a Local Diagnostic Reference Level for Bone Scintigraphy in a Nigerian Tertiary Hospital

It is of vital importance to optimize the radiation dose to patients undergoing radionuclide bone scanning. This is one of the most common nuclear medicine procedures in many parts of the world, including Nigeria, and the current study was performed as part of a national survey to establish diagnostic reference levels (DRLs) for common nuclear medicine procedures in Nigeria in order to optimize their use. Nuclear medicine was only recently introduced to the health-care system in Nigeria, with only 2 centers presently conducting these procedures. Methods: A retrospective, cross-sectional study was performed in the nuclear medicine department of a tertiary hospital in southwest Nigeria to determine the preliminary local DRL for radionuclide bone scanning. One hundred and nine patients who met the study criteria were included. Data were obtained from June 2017 to March 2019 and were analyzed to obtain the third quartile of the distributed administered activity and achievable dose (anthropometric variables and radiation dose to bone surface). Results: The mean administered activity, achievable dose, and DRL were 833.98 ± 106.93, 832.5, and 895.4 MBq, respectively. The calculated preliminary local DRL was larger than values reported in studies done in Sudan, the United Kingdom, and Australia or by the International Commission on Radiological Protection. Conclusion: The preliminary DRL from this first-of-its-kind study in Nigeria was high because of practitioners' lack of experience. However, the values were still within the international best-practice range, which when optimized will go a long way toward reducing medical exposure without compromising image quality.