Diagnostic Reference Levels for Adult Nuclear Medicine Imaging Established from the National Survey in Korea
- 19 Downloads
There is substantial need for optimizing radiation protection in nuclear medicine imaging studies. However, the diagnostic reference levels (DRLs) have not yet been established for nuclear medicine imaging studies in Korea.
Materials and Methods
The data of administered activity in 32 nuclear medicine imaging studies were collected from the Korean Society of Nuclear Medicine (KSNM) dose survey database from 2013 and 2014. Through the expert discussions and statistical analyses, the 75th quartile value (Q3) was suggested as the preliminary DRL values. Preliminary DRLs were subjected to approval process by the KSNM Board of Directors and KSNM Council, followed by clinical applications and performance rating by domestic institutes.
DRLs were determined through 32 nuclear medicine imaging studies. The Q3 value was considered as appropriate selection as it was generally consistent with the most commonly administered activity. In the present study, the final version of initial DRL values for nuclear medicine imaging in Korean adults is described including various protocols of the brain and myocardial perfusion imaging.
The first DRLs for nuclear medicine imaging in Korean adults were confirmed. The DRLs will enable optimized radiation protection in the field of nuclear medicine imaging in Korea.
KeywordsDiagnostic reference level Radiopharmaceutical Dose optimization Nuclear medicine imaging
We would like to thank the Korean Society of Nuclear Medicine Diagnostic Reference Level Task Force members including Drs. Min-Woo Kim (Presbyterian Medical Center), Byung Il Kim (Korean Institute of Radiological and Medical Sciences), Seong-Min Kim (Chungnam National University Hospital), Hyun-Yeol Nam (Samsung Changwon Hospital), Jin-Sook Ryu (Asan Medical Center), Ju Won Seok (Chung-Ang University Hospital), Byeong-Cheol Ahn (Kyungpook National University Hospital), Sun Young Oh (National Police Hospital), Young Hoon Ryu (Gangnam Severance Hospital), Ie Ryung Yoo (Seoul St. Mary’s Hospital), Yukyung Lee (National Medical center), Seok Tae Lim (Chonbuk National University Hospital), Ihnho Cho (Yeungnam University Hospital), Yun Young Choi (Hanyang University Medical Center), Joon Young Choi (Samsung Medical Center), Seung Jin Choi (Radiation Health Research Institute), Tae-Sung Kim (National Cancer Center), Eun Jeong Lee (Seoul Medical Center), Young Jin Jeong (Dong-A University Hospital), Young-Jun Heo (Suncheon St. Carollo Hospital), and the Nuclear Safety and Security Commission (NSSC) for a valuable contribution to establishing the first diagnostic reference level for nuclear medicine imaging in Korea.
This study was funded by the Nuclear Safety Research Program through the Korea Radiation Safety Foundation (KORSAFe) and the Nuclear Safety and Security Commission (NSSC), Republic of Korea (Grant No. 1305033).
Compliance with Ethical Standards
Conflict of Interest
Ho-Chun Song has received research grants from the Nuclear Safety Research Program through the Korea Radiation Safety Foundation (KORSAFe) and the Nuclear Safety and Security Commission (NSSC), Republic of Korea (Grant No. 1305033).
Myung Hwan Na, Jahae Kim, Sang-Geon Cho, Jin Kyung Park, Keon-Wook Kang, and the other members of the Korean Society of Nuclear Medicine Diagnostic Reference Level Task Force declare that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
The requirement to obtain informed consent was waived in this non-human-subject study.
- 1.ICRP. Radiological protection and safety in medicine. ICRP Publication 73. Ann ICRP 26 (2).Google Scholar
- 3.European Commission. Radiation protection 109: guidance on diagnostic reference level in medical exposures. 1999. https://ec.europa.eu/energy/sites/ener/files/documents/109_en.pdf. Accessed 19 Oct 2018.
- 4.European Commission. Radiation protection 180: diagnostic reference levels in thirty-six European countries. 2014. https://ec.europa.eu/energy/sites/ener/files/documents/RP180%20part2.pdf. Accessed 19 Oct 2018.
- 5.ICRP. Diagnostic reference levels in medical imaging: review and additional advice. Ann ICRP. 2001;31:33–52.Google Scholar
- 6.ICRP. Radiological protection in medicine. ICRP Publication 105. Ann. ICRP 37 (6).Google Scholar
- 7.ICRP. Diagnostic reference level in medical imaging. ICRP Publication 135. Ann ICRP 46(1).Google Scholar
- 11.Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). National diagnostic reference level fact sheet. 2011. http://emrc.gov.jo/images/pdffiles/drl.pdf. Accessed 19 Oct 2018.
- 12.Japan Network for Research and Information on Medical Exposures (J-RIME). Diagnostic reference levels based on latest surveys in Japan - Japan DRLs 2015. http://www.radher.jp/J-RIME/report/DRLhoukokusyoEng.pdf. Accessed 19 Oct 2018.
- 14.Brink JA, Boone JM, Feinstein KA, Michalski JM, Pizzutiello Jr. RJ, Spelic DC et al. NCRP Report No. 172 - Reference levels and achievable doses in medical and dental imaging: recommendations for the United States. https://ncrponline.org/shop/reports/report-no-172-reference-levels-and-achievable-doses-in-medical-and-dental-imaging-recommendations-for-the-united-states-2012. Accessed 3 Jan 2019.Google Scholar
- 19.EANM Pediatric and Dosimetry Committees. EANM Paediatric Dosage Card (Version 57.2016). 2016. https://www.eanm.org/content-eanm/uploads/2017/01/EANM_Dosage_Card_040214.pdf. Accessed 19 Oct 2018.
- 20.SNMMI. Pediatric Injected Activity Tool (Version 1.04; 13-Nov-2016). 2016. http://www.snmmi.org/ClinicalPractice/PediatricTool.aspx. Accessed 19 Oct 2018.
- 23.Kosuda S, Alam F, Yao Z, Kardinah K, Lee BN, Enkhthuya B et al. Report on the current nuclear medicine status of the Asian member states from the initial cooperative project meeting (RAS6061/9001/01) of International Atomic Energy Agency/Regional Cooperative Agreement (IAEA/RCA). Austral Asian J Cancer 2013;12:133–143.Google Scholar
- 24.National Institute of Food and Drug Safety Evaluation. Guidelines on patient dose for computed tomography. Administration of Radiation Safety Series No. 19. 2009. http://www.nifds.go.kr/brd/m_15/view.do?seq=2865&srchFr=&srchTo=&srchWord=&srchTp=&itm_seq_1=0&itm_seq_2=0&multi_itm_seq=0&company_cd=&company_nm=&page=83. Accessed 19 Oct 2018.