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ABSTRACT
Background
Background and objectives. Fluorine-18-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is essential for management of patients in oncology. Whole 18F-FDG PET/CT imaging facilitates concurrent imaging of organs and lesions allowing successful evaluation of disease. However, high patient dose due to x-rays from CT component and 18F-FDG dose is a concern. Diagnostic reference levels were proposed as a tool for optimization of patient doses. This study reports on proposed diagnostic reference levels for whole-body 18F-FDG PET/CT examinations at a South African (SA) tertiary hospital
Method
Materials and Methods: Data for patients aged 18 years and over with weight 70 ± 10 kg who underwent whole-body 18F- FDG PET/CT examinations from January 2023 to June 2024 was purposively sampled. Data included demographics (age, gender and weight), radiation parameters (volume computed tomography dose index (CTDIv), dose length product (DLP) and 18F- FDG dose. Local DRLs (LDRLs) for the PET and CT component were calculated as the 50th percentile of 18F- FDG dose and 50th percentile of CTDIv and DLP respectively. For national DRLs (NDRLs) the 75th percentile was calculated. Results were compared with international values.
Result
Results: Established local DRLs (249.48 MBq) for 18F- FDG examinations compared well with international values (Saudi Arabia – 306.75 MBq, Austria – 272.00 MBq and Japan – 220.20MBq). Similarly, NDRLs (398.6 MBq) benchmarked well (Saudi Arabia - 259 MBq and Japan – 451 MBq). The established LDRLs for the CT component (CTDIv (3.99 mGy) and DLP (398.60 mGy) while the NDLs were (CTDIv (4.51 mGy) and DLP (458.00 mGy). Both compared well international values (LDRLs SA - CTDIv (3.99 mGy) and DLP (398.60 mGy vs Japan - CTDIv (4.2 mGy) and DLP (451) mGy.
Conclusion
Conclusion: LDRLs and NDRLs were introduced for South African context. These compared well with international values. Patient safety can be improved by aligning with DRLs with Japanese standards.