Cumulative radiation doses due to nuclear medicine examinations: a systematic review

2021 ◽  
pp. 20210444
Author(s):  
Marco Brambilla ◽  
Agnieszka Kuchcińska ◽  
Roberta Matheoud ◽  
Alfredo Muni
Keyword(s):  
Systematic Review ◽  
Nuclear Medicine ◽  
Cumulative Exposure ◽  
Published Data ◽  
Single Episode ◽  
Episode Of Care ◽  
Diagnostic Nuclear Medicine ◽  
Number Of Patients ◽  
Nuclear Medicine Procedures ◽  
Short Time

Objectives: To systematically review the published data regarding the cumulative exposure to radiation in selected cohorts of adults or paediatric patients due to diagnostic nuclear medicine examinations. Methods: We conducted PubMed/Medline searches of peer-reviewed papers on cumulated effective dose (CED) from diagnostic nuclear medicine procedures published between 01 January 2010 until 31 January 2021. Studies were considered eligible if the contribution of nuclear medicine examinations to total CED was >10%. Studies reporting cumulative doses in a single episode of care or in a limited time (≤1 year) were excluded. The main outcomes for which data were sought were the CED accrued by patients, the period in which the CED was accrued, the percentage of patients with CED > 100 mSv and the percentage contribution due to nuclear medicine procedures to the overall CED. Results: The studies included in the synthesis were 18 which enrolled a total of 1,76,371 patients. Eleven (1,757 patients), three (1,74,079 patients) and four (535 patients) were related to oncological, cardiologic and transplanted patients, respectively. All the studies were retrospective; some of the source materials referred to small number of patients and some of the patients were followed for a short time. Not many studies accurately quantified the contribution of nuclear medicine procedures to the overall radiation exposure due to medical imaging. Finally, most of the studies covered an observation period which extended mainly in the 2000–2010 decade. Conclusions: There is a need of prospective, multicentric studies enrolling a greater number of patients, followed for longer period in selected groups of patients to fully capture the cumulative exposure to radiation in these settings Advances in knowledge: This systematic review allows to identify selected group of patients with a specific health status in which the cumulated exposure to radiation may be of concern and where the contribution of nuclear medicine procedures to the total CED is significant.

Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine I. Survey of Diagnostic Nuclear Medicine Procedures in Bulgaria in 1980

1982 ◽  
Vol 21 (03) ◽  
pp. 85-91 ◽  
Author(s):  
R. Poppitz
Keyword(s):  
Nuclear Medicine ◽  
Radiation Risk ◽  
Patient Exposure ◽  
Diagnostic Nuclear Medicine ◽  
Nuklearmedizinische Diagnostik ◽  
Nuclear Medicine Procedures

Um die Strahlenexposition und das Strahlenrisiko für die Bevölkerung durch die nuklearmedizinische Diagnostik in Bulgarien zu ermitteln, wurde eine Erhebung für das Jahr 1980 über die Arten und Anzahl der Applikationen von Radiopharmaka, über die verwendeten Aktivitäten und über die Geschlechts- und Altersverteilung der untersuchten Patienten durchgeführt. Die Gesamtzahl diagnostischer in vivo Applikationen betrug 116418 (davon 40,5% bei Männern und 59,5% bei Frauen), d.h. 13,1 Applikationen per 1000 Einwohner. Die applizierte Gesamtaktivität aller 44 verwendeter Radiopharmaka betrug ca. 2,1 TBq (56 Ci). Die Geschlechts- und Altersverteilung der untersuchten Patienten war ähnlich jener in anderen Ländern: nur 17,4% aller Patienten waren im reproduktionsfähigen Alter, 52,7% waren über 45 Jahre alt. Im Vergleich zu anderen entwickelten Ländern war in Bulgarien im Jahr 1980 der Anteil der 131J-Jodid-Untersuchungen verhältnismäßig hoch.

scholarly journals Patient radiation dose assessment system for diagnostic nuclear medicine procedures: Implementation and first results

2020 ◽  
Vol 35 (4) ◽  
pp. 380-385
Author(s):  
Dea Dundara-Debeljuh ◽  
Slaven Jurkovic ◽  
Ivan Pribanic ◽  
Neva Girotto ◽  
Svjetlana Grbac-Ivankovic ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Radiation Dose ◽  
Radiation Risk ◽  
Assessment System ◽  
Dose Assessment ◽  
Medical Documentation ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures ◽  
Radiation Dose Assessment ◽  
Patient Radiation Dose

Dose assessment of diagnostic nuclear medicine procedures is necessary to further optimize respective procedure, estimate radiation risk, improve radiation safety and verify compliance of local practice with guidelines. In line with Council Directive 2013/59/EURATOM, patient medical documentation should include information related to radiation exposure. The aim of this work is to present the patient radiation dose assessment system designed for routine clinical use, that uses in-house designed worksheets for dose calculation based on relevant parameters introduced by the ICRP publications. Dose reports provide information about the absorbed dose delivered to the target and non-target organs of interest and the effective dose for each diagnostic procedure. The data from the dose reports was used to investigate average patient exposure levels during a one-year period and the results are presented. The implemented system has improved the quality of services provided and understanding of radiation risks. Moreover, the presented results have stimulated further optimization of nuclear medicine processes.

Diagnostic nuclear medicine procedures in Germany between 1996 and 2002

2006 ◽  
Vol 45 (01) ◽  
pp. 1-9 ◽  
Author(s):  
D. Noßke ◽  
P. Schnell-Inderst ◽  
M. Hacker ◽  
K. Hahn ◽  
G. Brix ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Effective Dose ◽  
Insurance Companies ◽  
German Population ◽  
Diagnostic Nuclear Medicine ◽  
Public Health Information ◽  
Health Insurance Companies ◽  
Effective Doses ◽  
Application Frequency ◽  
Nuclear Medicine Procedures

Summary Aim: 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. Material and methods: 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. Results: 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) ⋅103 manSv 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. Conclusion: 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 201Tl-labeled radiopharmaceuticals by 99mTc-labeled compounds.

POPULATION RADIATION EXPOSURE FROM DIAGNOSTIC NUCLEAR MEDICINE PROCEDURES IN TEHRAN 2011–14; TRENDS IN THE LAST 3 DECADES

2017 ◽  
Vol 179 (2) ◽  
pp. 151-157
Author(s):  
Faraj Tabeie ◽  
Parisa Honari ◽  
Isa Neshandar Asli ◽  
Mahasti Amoei ◽  
Mohammad Eftekhari ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Radiation Exposure ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures

scholarly journals SOLLID – a single centre study to develop methods to investigate the effects of low radiation doses within nuclear medicine, to enable multicentre epidemiological investigations

2020 ◽  
pp. 20200072
Author(s):  
Glenn Flux ◽  
Iain Murray ◽  
Dominic Rushforth ◽  
Paul Gape ◽  
Carla Abreu ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Large Scale ◽  
Current Model ◽  
Standard Of Care ◽  
Diagnostic Procedures ◽  
Radiation Doses ◽  
Relative Risks ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures ◽  
Low Levels

There is continuing debate concerning the risks of secondary malignancies from low levels of radiation exposure. The current model used for radiation protection is predicated on the assumption that even very low levels of exposure may entail risk. This has profound implications for medical procedures involving ionising radiation as radiation doses must be carefully monitored, and for diagnostic procedures are minimised as far as possible. This incurs considerable expense. The SOLLID study (ClinicalTrials.gov Identifier: NCT03580161) aims to develop the methodology to enable a large-scale epidemiological investigation of the effect of radiopharmaceutical administrations to patients undergoing diagnostic nuclear medicine procedures. Patients will undergo a series of scans in addition to that acquired as standard of care to enable the radiation doses delivered to healthy organs to be accurately calculated. Detailed analysis will be performed to determine the uncertainty in the radiation dose calculations as a function of the number and type of scans acquired. It is intended that this will inform a subsequent long-term multicentre epidemiological study that would address the question definitively. Secondary aims of the study are to evaluate the range of absorbed doses that are delivered from diagnostic nuclear medicine procedures and to use current risk models to ascertain the relative risks from these administrations.

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