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Tracking patient radiation exposure: Challenges to integrating nuclear medicine with other modalities

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  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency’s Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray-based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the US, currently lags behind x-ray-based procedures with respect to reporting of radiation dosimetric information. This article discusses qualitative differences between nuclear medicine and x-ray-based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying, monitoring, and reporting strategies used in x-ray-based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists, and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested.

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Notes

  1. In this article, the term “exposure” is used in a qualitative manner, and the magnitude of exposure is expressed as dose, which is a quantitative term. Also, the term “radiologic” is used for x-ray-based imaging.5

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Acknowledgments

Dr. Einstein was supported in part by National Institute of Health Grant 1R01 HL109711.

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Authors and Affiliations

  1. McMaster University, Hamilton, Canada

    Mathew Mercuri PhD(C)

  2. Radiation Protection of Patients Unit, International Atomic Energy Agency, P.O. Box 200, 1400, Vienna, Austria

    Madan M. Rehani PhD

  3. Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Medical Center, New York, NY, USA

    Andrew J. Einstein MD, PhD

Authors
  1. Mathew Mercuri PhD(C)
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  2. Madan M. Rehani PhD
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  3. Andrew J. Einstein MD, PhD
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Correspondence to Madan M. Rehani PhD.

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Mercuri, M., Rehani, M.M. & Einstein, A.J. Tracking patient radiation exposure: Challenges to integrating nuclear medicine with other modalities. J. Nucl. Cardiol. 19, 895–900 (2012). https://doi.org/10.1007/s12350-012-9586-x

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  • DOI: https://doi.org/10.1007/s12350-012-9586-x

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