Nuclear medicine studies provide functional, physiological and molecular insights into the diagnosis, staging, restaging, and assessment of treatment efficacy in adults and children. Multiple practice guidelines and appropriate use criteria have been published to guide healthcare providers on performing the right test on the right patient at the right time while minimizing the risk of radiation exposure. Radiation dose from medical imaging can be reduced before testing by applying appropriate use criteria, at the time of testing by using weight-based and low-dose protocols, and after testing by minimizing layered testing and ensuring appropriate quality control and optimized image quality protocols are instituted. Administered activity is the primary contributor to nuclear medicine study statistics and the quality of the information obtained. Ensuring the number of counts needed to provide the statistical content necessary for an adequate clinical result is important while maintaining the radiation dose as low as possible. Less than optimal counts may lead to uncertain results and additional testing. Other factors also contribute to reducing radiation exposure, including the individual patient, imaging equipment, image processing, and procedure requirements. Pediatric and adult patients present unique and different challenges for optimizing nuclear medicine studies while minimizing radiation exposure. Appropriateness of the procedure, administered doses, imaging protocols, technological advances, and the role of the computed tomography scan are important when optimizing the study and minimizing radiation dose. Approaches to address some of these challenges in each population is reviewed.
After reading this article, the participant should be able to:
- Identify nuclear medicine studies that expose patients, adults, and children to the highest radiation doses.
- Describe hardware and software advances that help to reduce radiation exposure.
- Explain how appropriate use criteria can impact radiation dose.
Categories: Nuclear Medicine, Radiation Safety/Protection