Chapter6 3 6. Applications of Diagnostic Reference Levels of Standard Doses in Nuclear Medicine

Abstract The concepts of diagnostic reference levels (DRLs) and achievable doses (ADs) have been developed to optimize the imaging procedures, both diagnostic and interventional, involving ionizing radiation. These are not dose limits but are used to evaluate the performance of clinical exams. Most countries have developed their own DRLs and ADs depending on the medical practice of administrating radioactivity to patients. In this project, the intent was to establish these quantities in nuclear medicine according to the prevailing practices of our country. Data were collected for all gamma ray imaging procedures both for adults as well as for children. An attempt was made to include as many hospitals and patients as possible to get good statistics. The survey data showed the range of minimum and maximum administered activities is quite large for many commonly performed nuclear medicine studies. DRLs and ADs are selected at the 75th and 50th percentiles of the survey data to represent state-of-the-practice. DRLs are not regulatory limits or to establish legal standards of care. In addition, DRLs are not applicable to the doses for individual patients. It is essential to ensure that the appropriate clinical information is available in the image throughout the optimization process.