Establishing typical diagnostic reference levels in a Peruvian nuclear medicine centre: a retrospective study

Area of Science:

• Nuclear Medicine
• Radiology
• Medical Physics

Background:

• Diagnostic reference levels (DRLs) are crucial for optimizing radiation doses in medical imaging.
• Establishing institutional DRLs ensures quality control and patient safety in scintigraphic examinations.

Purpose of the Study:

• To establish the first institutional diagnostic reference levels (DRLs) for eight common scintigraphic procedures at a Peruvian hospital.
• To compare institutional values with international DRLs and identify areas for dose optimization.

Main Methods:

• Retrospective analysis of 898 adult scintigraphic examinations (2018-2024).
• Defined typical values using median administered activity and action levels using 75th percentiles.
• Calculated weight-normalized activities and estimated effective doses for benchmarking.

Main Results:

• Established institutional DRLs for eight procedures, with weight-normalized activities ranging from 0.1 MBq·kg-1 (thyroid uptake) to 14.5 MBq·kg-1 (three-phase bone scintigraphy).
• Broad concordance with international DRLs was observed.
• Bone scintigraphy values exceeded international references by over 25%, indicating potential for optimization.

Conclusions:

• The study provides the first institutional DRLs in Peru, supporting local quality improvement initiatives.
• Identified bone scintigraphy as a key area for dose optimization.
• Emphasizes the importance of periodic DRL review within an optimization cycle.