U.S. PET/CT and Gamma Camera Diagnostic Reference Levels and Achievable Administered Activities for Noncardiac Nuclear Medicine Studies

Published Online:https://doi.org/10.1148/radiol.2019190623

On the basis of American College of Radiology survey data from 2015 to 2017, diagnostic reference level and achievable administered activity benchmarks are presented for gamma camera and PET/CT examinations. These data may be used to optimize radiotracer dose in nuclear medicine facilities and potentially reduce radiation dose.

Existing surveys of radiopharmaceutical doses for U.S. nuclear medicine laboratories are of limited scope and size. Dose data are important because they can be used to benchmark individual laboratories, understand geographic variations in practice, and provide source data for societal guidelines and appropriateness criteria. Diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for 13 noncardiac adult gamma camera and PET/CT examinations were derived retrospectively from American College of Radiology accreditation data (January 1, 2015, to December 31, 2017). The calculated DRL and AAA are consistent with previously published surveys. The distributions of radiopharmaceutical doses across facilities are in general consistent but show variation within a particular examination. Analysis of dose distribution suggests this variation results from differences in clinical protocols, educational gaps, and/or equipment factors. The AAA for the surveyed facilities exceeds dose ranges proposed in societal practice guidelines for several common nuclear medicine studies. Compared with similar surveys from Europe and Japan, geographic variation is observed, with some doses greater and others lower than used in the United States. Overall, radiopharmaceutical dose variation within the United States and internationally, and deviation from societal guidelines, imply that these dose-related benchmarks may be used to further standardize and improve clinical practice.

© RSNA, 2019


Article History

Received: Mar 18 2019
Revision requested: Apr 23 2019
Revision received: May 23 2019
Accepted: June 26 2019
Published online: Aug 13 2019
Published in print: Oct 2019