Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey

Essam Alkhybari; Salman Albeshan; Bandar Alanazi; Raghad Alfarraj; Rakan Alduhaim; Intidhar El Bez Chanem; Rima Tulbah

doi:10.3390/tomography9010021

Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey

Tomography. 2023 Jan 30;9(1):264-273. doi: 10.3390/tomography9010021.

Authors

Essam Alkhybari¹, Salman Albeshan², Bandar Alanazi³, Raghad Alfarraj⁴, Rakan Alduhaim⁴, Intidhar El Bez Chanem⁴, Rima Tulbah⁴

Affiliations

¹ Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia.
² Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia.
³ Nuclear Medicine Department, King Khalid Hospital, Hail Health Cluster, Hail 55421, Saudi Arabia.
⁴ Nuclear Medicine Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia.

Abstract

Objective: This study aims to establish a local diagnostic reference level (LDRL) for single-photon emission tomography/computed tomography (SPECT/CT) and positron emission tomography/CT (PET/CT) with respect to myocardial perfusion imaging (MPI).

Materials and methods: The acquisition protocol and dosimetry data on the MPI procedures of five SPECT/CT scans and one PET/CT scan were collected. Data on technitum-99m sestamibi (^99mTc-sestamibi), ^99mTc-tetrofosmin, thallium-201 (²⁰¹Tl), and rubidium-82 (⁸²RB) were all collected from one centre via questionnaire booklets. Descriptive data analysis was used to analyse all variables, and the 50th percentile was used to analyse each radiation dose quantity.

Results: The reported 50th percentile dose for a one-day stress/rest protocol using ^99mTc-sestamibi (445/1147 MBq) and ^99mTc-tetrofosmin (445/1147 MBq) and for a two-day stress/rest protocol using ^99mTc-sestamibi (1165/1184 MBq) and ^99mTc-tetrofosmin (1221/1184 MBq) are in good agreement with reported national diagnostic reference levels (NDRLs). However, the dose from the study data on a one-day stress/rest protocol using ^99mTc-sestamibi was more than the 50th percentile dose from the Brazilian data (370/1110 MBq) on a similar protocol, and the dose from the study data on a two-day stress/rest protocol using ^99mTc-tetrofosmin was more than the 50th percentile dose (1084/1110 MBq) from the United States data on MPI scans. Regarding the computed tomography (CT) portion of the SPECT/CT framework, the 50th percentile doses were lower than all the identified doses in the data considered in the literature reviewed. However, regarding the CT component of the PET/CT MPI scans, the ⁸²RB dose was more than the recorded doses in the CT data in the published literature.

Conclusion: This study determined the LDRL of five SPECT/CT protocols and one PET/CT MPI protocol. The results suggest that there may be opportunities to optimise the patient radiation burden from administered activities in patients undergoing SPECT examinations and the CT components associated with ⁸²RB PET/CT scans without compromising diagnostic image quality.

Keywords: LDRL; PET/CT; SPECT/CT; diagnostic reference levels.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Organotechnetium Compounds*
Perfusion
Positron Emission Tomography Computed Tomography*
Radiation Dosage
Technetium Tc 99m Sestamibi
United States

Substances

technetium tc-99m tetrofosmin
Organotechnetium Compounds
Technetium Tc 99m Sestamibi
Thallium-201

Grants and funding

This research received no external funding.