Patient Exposure From Nuclear Medicine in France: National Follow-Up and Influence of the Technology Through Diagnostic Reference Levels Data Analysis

Abstract

The Nuclear Safety and Radiation Protection French Institute (IRSN) presents its latest assessment from up-to-date diagnostic reference levels (DRL) national data in nuclear medicine (NM). NM departments annually send data to IRSN to estimate the representativeness of current DRLs. Complementary analyses of the data have been performed to evaluate the influence of equipment evolution on practice and patient radiation exposure. Based on data from almost 90% of the French NM departments, some DRL update are proposed. The analysis of positron emission tomography data show that the more the time of flight technology is available on equipment, the lower is the administered activity to the patient. IRSN recommends updating DRL regulation with current and relevant examination data. The influence of technology evolution appeared to be positive for patient exposure and the results showed an obvious involvement of professionals in the radiation dose optimisation process.

Diagnostic reference levels for 18F‐FDG whole body PET/CT procedures: Results from a survey of 12 centres in Australia and New Zealand

“…Compromises on image quality may be offset by increasing scan duration. Internationally, the reported AU QLD/WA DRL study and the proposed NZ NDRL study were within the range of previously published values (200–500 MBq) (Table ) . However, the reported AU QLD/WA DRL and the proposed NZ NDRL are higher than the France published NDRL based on TOF technology, which was 260 MBq .…”

“…The findings from this study show that the AU QLD/WA DRL and the proposed NZ NDRL for 18 F‐FDG whole‐body PET/CT were reduced from 385 MBq, as published by ANZSNM, to 333.75 and 332.87 MBq for AU QLD/WA, and NZ, respectively. This could be attributed to the current improvement in PET/CT clinical practises and the use of new PET/CT technology which enables improved sensitivity of scanners and so lower administered activity for sufficient image quality . However, the current study shows that DRL and achievable dose for the 18 F‐FDG AU QLD/WA DRL as well as the NDRL proposed for NZ were higher than the values reported in the ARPANSA NDRL study published in 2017, at 310 MBq and 250 MBq, respectively .…”

“…This could be due to the fact that the NDRL in France has been conducted on a regular basis since 2004, and up until the current publication in 2017. The trend in the average MBq/kg for French 18 F‐FDG whole‐body PET/CT examinations was reduced from 4.94 MBq/kg in 2004, to 3.43 MBq/kg in 2015, in comparison to AU QLD/WA and NZ (at 4 MBq/kg and 4.04 MBq/kg, respectively …”

“…Published articles reported 18 F‐FDG PET/CT DRL values for the administered activity or CT used for AC and anatomical localization purposes, with few authors reporting both radiation doses . PET/CT DRLs from both radiation sources should be reported to provide suitable guidelines for professionals .…”

“…Clinical facilities with a median emergent dose that is higher than the national 75 th percentile dose should consider methods of optimizing their clinical imaging protocols to minimize the radiation doses delivered to the patients. 10 Published articles reported 18 F-FDG PET/CT DRL values for the administered activity [11][12][13][14][15][16][17][18][19] or CT 20,21 used for AC and anatomical localization purposes, with few authors reporting both radiation doses. 6,22 PET/CT DRLs from both radiation sources should be reported to provide suitable guidelines for professionals.…”