A study of adult diagnostic reference levels (DRLs) for bone and thyroid scintigraphy in Hospital Pakar USM

• 第一著者: Roddy, Ezzradyeana Mayang Anak
• フォーマット: 学位論文
• 言語: 英語
• 出版事項: 2025
• 主題: R Medicine; RC71-78.7 Examination. Diagnosis Including raiography
• オンライン･アクセス: http://eprints.usm.my/62968/

Introduction: Diagnostic Reference Levels (DRLs) are important in nuclear medicine imaging procedures, especially in commonly performed examinations such as bone and thyroid scintigraphy. DRLs function as the benchmarks to improve patient safety and optimize the use of radiopharmaceuticals. However, there are no established DRLs for these imaging procedures in the Hospital Pakar USM, or even in Malaysia. Currently, only national Achievable Doses (ADs) have been established for nuclear medicine imaging, resulting in limited understanding regarding the administered radiopharmaceutical activities of the current clinical practices in Hospital Pakar USM. Objectives: This study focuses to determine the administered radiopharmaceutical activities in adult patients undergoing bone and thyroid scintigraphy in Hospital Pakar USM, in order to propose DRLs for these imaging procedures. The comparisons were carried out between the proposed DRLs and established international DRLs, as well as between the proposed ADs and established national ADs. Methodology: A retrospective observational design was conducted in this study using patient data within five years, starting from January 2020 to December 2024. A total of 158 patient cases, consisting of 104 bone scintigraphy cases using Tc-99m MDP and 54 thyroid scintigraphy cases using Tc-99m pertechnetate, were collected. The administered radiopharmaceutical activities were analyzed, followed by calculating the 50th and 75th percentiles for these imaging procedures to represent the values of the proposed DRLs and ADs. Results: For proposed ADs, the administered radiopharmaceutical activities calculated at the 50th percentile (median) for bone scintigraphy was 763.68 MBq, while for thyroid scintigraphy was 187.71 MBq. For proposed DRLs, the administered radiopharmaceutical activities calculated at the 75th percentile for bone scintigraphy was 793.28 MBq, while for thyroid scintigraphy was 196.08 MBq. Conclusion: Both proposed DRLs and ADs obtained for this study were consistent with international and national standards, where these values were within the ranges of administered radiopharmaceutical activities after the comparison had been made. This study also supports the ongoing efforts for the development of the national DRLs for nuclear medicine imaging procedures in Malaysia.