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Kamiya T, Iimori T, Maeda Y, Yada N, Hayashi N, Iguchi H, Narita M. Administered dosage and effective dose estimated from 81Rb-rubidium hydroxide for lung ventilation scintigraphy using 81mKr noble gas. RADIATION PROTECTION DOSIMETRY 2024; 200:149-154. [PMID: 37987214 DOI: 10.1093/rpd/ncad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
The aim of this study was to estimate the administered dosage of 81mKr noble gas as calculated by the radioactivity of 81Rb-rubidium hydroxide (81RbOH). The administered dosage was regarded as the total amount of 81mKr noble gas. The radioactivity of 81mKr was calculated using the radioactivity of 81RbOH at the examination, the beginning of inhalation, the inhalation duration and the attenuation volume from the generator to the patient for 81mKr noble gas. In addition, we created an Internet survey and asked National University Hospital in Japan to respond to questions regarding the parameters of concern. Survey responses were provided by 38 hospitals (response rate was 90.5%). Twenty-seven hospitals (64.3%) examined lung ventilation scintigraphy using 81mKr noble gas. The mean administered dosage and the effective dose of lung ventilation scintigraphy using 81mKr noble gas were 35.8 ± 22.1 GBq and 0.97 ± 0.60 mSv, respectively.
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Affiliation(s)
- Takashi Kamiya
- Department of Medical Technology, Osaka University Hospital, Suita 5650871, Japan
| | - Takashi Iimori
- Department of Radiology, Chiba University Hospital, Chiba 2608677, Japan
| | - Yukito Maeda
- Department of Clinical Radiology, Kagawa University Hospital, Kita-gun 7610793, Japan
| | - Nobuhiro Yada
- Department of Radiology, Shimane University Hospital, Izumo 6938501, Japan
| | - Naoya Hayashi
- Department of Medical Technology, Kochi Medical School Hospital, Nankoku 7830043, Japan
| | - Harumi Iguchi
- Department of Radiology, Shiga University of Medical Science Hospital, Otsu 5202192, Japan
| | - Masataka Narita
- Department of Radiology, Hirosaki University Hospital, Hirosaki 0368563, Japan
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Al-Qahtani SM, Alidasroos MA, Alkhybari EM, Althomali MA, Alomari AH, Bawazeer OA, Hawsawi HB, Aamry AI, Asiri JA, Aloufi AA, Aljehani AD, Al-Osaimi MB, Alosaimi AK, Alsulami AK, Sabi AY, Kamli TM, Sulieman AA, Ajlouni AW. The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:031505. [PMID: 37406624 DOI: 10.1088/1361-6498/ace452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/05/2023] [Indexed: 07/07/2023]
Abstract
This study aims to introduce national diagnostic reference levels (NDRLs) for adult hybrid single photon emission computed tomography (SPECT-CT) in nuclear medicine (NM) departments in the Kingdom of Saudi Arabia. The administered activity (AA) of radiopharmaceuticals, volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) for ten hybrid SPECT/CT examinations were collected and analysed for one year. The median of AA, CTDIvoland DLP for each dose quantity was derived and the suggested national DRLs were determined based on the 75thpercentile for all identified SPECT-CT examinations. A comparison of the defined adult NDRLs in Saudi Arabia with the published data of other countries was performed. Although there are no significant variations of the proposed NDRL of AA between countries, the proposed NDRLs of the integrated CT metrics exceed the published data in most procedures. NM departments are urged to consider optimisation for both image quality and radiation protection.
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Affiliation(s)
- Saeed Mueed Al-Qahtani
- Physics Department, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Essam M Alkhybari
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Marwan Ahmed Althomali
- Physics Department, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ali Hamed Alomari
- Physics Department, Al-Qunfudah University College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Omemh Abdullah Bawazeer
- Physics Department, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hassan B Hawsawi
- Administration of Medical Physics, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Ali Ibrahim Aamry
- Nuclear Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Ahmed Yahya Sabi
- Nuclear Medicine Department, King Fahad Central Hospital, Jazan, Saudi Arabia
| | - Talal Mosa Kamli
- Nuclear Medicine Department, King Fahd Central Hospital, Madinah, Saudi Arabia
| | - Abdelmoneim Adam Sulieman
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Abdul-Wali Ajlouni
- Physics Department, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
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Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey. Tomography 2023; 9:264-273. [PMID: 36828373 PMCID: PMC9963323 DOI: 10.3390/tomography9010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/06/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
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.
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Jose A, Zhou C, Baker R, Walker J, Kurek N, O'Donnell RE, Elwing JM, Gerson M. Predictive value of incidental right ventricular abnormalities identified on SPECT for mortality and pulmonary hypertension. J Nucl Cardiol 2022; 29:1903-1914. [PMID: 33851355 PMCID: PMC8043660 DOI: 10.1007/s12350-021-02612-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The clinical significance of incidentally found RV abnormalities on low-risk SPECT studies is not well-defined. The objective of this study was to determine the predictive value of incidental right ventricular (RV) abnormalities identified on single photon emission computed tomography (SPECT) scans for mortality and pulmonary hypertension (PH). METHODS We retrospectively analyzed all low-risk SPECT studies in patients without known coronary artery or pulmonary vascular disease, performed at our institution, from 2007-2020. Adjusted Cox proportional hazards models were used to evaluate the association between incidental RV abnormalities on low-risk SPECT studies and outcomes. RESULTS Of the 4761 patients included in the analysis, mortality events were present in 494, and echocardiographic PH was present in 619. Incidental RV abnormalities on low-risk SPECT studies were significantly and independently associated with all-cause mortality (HR = 1.41, CI [1.07-1.86], P = 0.0152) and echocardiographic PH (HR = 2.06, CI [1.64-2.60], P < 0.0001). CONCLUSIONS These data suggest incidental RV abnormalities found on low-risk SPECT imaging studies are significantly and independently associated with increased mortality and risk of developing echocardiographic PH, and could identify high-risk patients for closer monitoring and additional diagnostic testing.
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Affiliation(s)
- Arun Jose
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, 6352-A, Medical Sciences Building, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
| | - Christine Zhou
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rachel Baker
- Undergraduate Studies, University of Cincinnati College of Arts and Sciences, Cincinnati, OH, USA
| | - Jackson Walker
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nicholas Kurek
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert E O'Donnell
- Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jean M Elwing
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, 6352-A, Medical Sciences Building, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA
| | - Myron Gerson
- Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Cho SG, Kong EJ, Kang WJ, Paeng JC, Bom HSH, Cho I. KSNM60 in Cardiology: Regrowth After a Long Pause. Nucl Med Mol Imaging 2021; 55:151-161. [PMID: 34422125 PMCID: PMC8322215 DOI: 10.1007/s13139-021-00702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/09/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
The Korean Society of Nuclear Medicine (KSNM) is celebrating its 60th anniversary in honor of the nuclear medicine professionals who have dedicated their efforts towards research, academics, and the more comprehensive clinical applications and uses of nuclear imaging modalities. Nuclear cardiology in Korea was at its prime time in the 1990s, but its growth was interrupted by a long pause. Despite the academic and practical challenges, nuclear cardiology in Korea now meets the second leap, attributed to the growth in molecular imaging tailored for many non-coronary diseases and the genuine values of nuclear myocardial perfusion imaging. In this review, we describe the trends, achievements, challenges, and perspectives of nuclear cardiology throughout the 60-year history of the KSNM.
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Affiliation(s)
- Sang-Geon Cho
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Eun Jung Kong
- Department of Nuclear Medicine, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu, 42415 Republic of Korea
| | - Won Jun Kang
- Department of Nuclear Medicine, Yonsei University Severance Hospital, Seoul, Republic of Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee-Seung Henry Bom
- 5Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea
| | - Ihnho Cho
- Department of Nuclear Medicine, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu, 42415 Republic of Korea
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Reducing Radiation While Improving the Quality and Efficiency of Nuclear Cardiology Procedures. JACC Cardiovasc Imaging 2021; 14:1829-1831. [PMID: 34274264 DOI: 10.1016/j.jcmg.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022]
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Hirschfeld CB, Mercuri M, Pascual TNB, Karthikeyan G, Vitola JV, Mahmarian JJ, Better N, Bouyoucef SE, Hee-Seung Bom H, Lele V, Magboo VPC, Alexánderson E, Allam AH, Al-Mallah MH, Dorbala S, Flotats A, Jerome S, Kaufmann PA, Luxenburg O, Shaw LJ, Underwood SR, Rehani MM, Paez D, Dondi M, Einstein AJ. Worldwide Variation in the Use of Nuclear Cardiology Camera Technology, Reconstruction Software, and Imaging Protocols. JACC Cardiovasc Imaging 2021; 14:1819-1828. [PMID: 33454257 DOI: 10.1016/j.jcmg.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study sought to describe worldwide variations in the use of myocardial perfusion imaging hardware, software, and imaging protocols and their impact on radiation effective dose (ED). BACKGROUND Concerns about long-term effects of ionizing radiation have prompted efforts to identify strategies for dose optimization in myocardial perfusion scintigraphy. Studies have increasingly shown opportunities for dose reduction using newer technologies and optimized protocols. METHODS Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study) registry, a multinational, cross-sectional study comprising 7,911 imaging studies from 308 labs in 65 countries. The study compared regional use of camera technologies, advanced post-processing software, and protocol characteristics and analyzed the influence of each factor on ED. RESULTS Cadmium-zinc-telluride and positron emission tomography (PET) cameras were used in 10% (regional range 0% to 26%) and 6% (regional range 0% to 17%) of studies worldwide. Attenuation correction was used in 26% of cases (range 10% to 57%), and advanced post-processing software was used in 38% of cases (range 26% to 64%). Stress-first single-photon emission computed tomography (SPECT) imaging comprised nearly 20% of cases from all world regions, except North America, where it was used in just 7% of cases. Factors associated with lower ED and odds ratio for achieving radiation dose ≤9 mSv included use of cadmium-zinc-telluride, PET, advanced post-processing software, and stress- or rest-only imaging. Overall, 39% of all studies (97% PET and 35% SPECT) were ≤9 mSv, while just 6% of all studies (32% PET and 4% SPECT) achieved a dose ≤3 mSv. CONCLUSIONS Newer-technology cameras, advanced software, and stress-only protocols were associated with reduced ED, but worldwide adoption of these practices was generally low and varied significantly between regions. The implementation of dose-optimizing technologies and protocols offers an opportunity to reduce patient radiation exposure across all world regions.
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Affiliation(s)
- Cole B Hirschfeld
- Department of Medicine, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA
| | - Mathew Mercuri
- Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Thomas N B Pascual
- Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ganesan Karthikeyan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - John J Mahmarian
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Nathan Better
- Department of Nuclear Medicine, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | | | - Henry Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Vikram Lele
- Department of Nuclear Medicine and PET-CT, Jaslok Hospital and Research Centre, Mumbai, India
| | - V Peter C Magboo
- Department of Physical Sciences and Mathematics, University of the Philippines, Manila, the Philippines; Department of Nuclear Medicine, University of Santo Tomas Hospital, Manila, the Philippines
| | - Erick Alexánderson
- Departamento de Cardiología Nuclear, Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City, Mexico
| | - Adel H Allam
- Cardiology Department, Al Azhar University, Cairo, Egypt
| | - Mouaz H Al-Mallah
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Sharmila Dorbala
- Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Albert Flotats
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Scott Jerome
- Intersocietal Accreditation Commission, Ellicott City, Maryland; Division of Cardiology, University of Maryland, Baltimore, Maryland, USA
| | - Philipp A Kaufmann
- Department of Nuclear Medicine and Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Osnat Luxenburg
- Medical Technology, Health Information and Research Directorate, Ministry of Health, Israel; Israeli Center for Technology Assessment in Health Care, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Leslee J Shaw
- New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA
| | - S Richard Underwood
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Department of Nuclear Medicine, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Madan M Rehani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Diana Paez
- Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Maurizio Dondi
- Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Andrew J Einstein
- Seymour, Paul, and Gloria Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA; Department of Radiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA.
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Gimelli A, Aimo A. The Relativity of Reference Values for Myocardial Perfusion Imaging. JACC Cardiovasc Imaging 2020; 14:666-668. [PMID: 32828769 DOI: 10.1016/j.jcmg.2020.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
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