RESUMO
Objective To suggest a national value for the diagnostic reference level (DRL) in terms of activity in MBq.kg–1, for nuclear medicine procedures with fluorodeoxyglucose (18F-FDG) in whole body positron emission tomography (PET) scans of adult patients. Materials and Methods A survey on values of 18F-FDG activity administered in Brazilian clinics was undertaken by means of a questionnaire including questions about number and manufacturer of the installed equipment, model and detector type. The suggested DRL value was based on the calculation of the third quartile of the activity values distribution reported by the clinics. Results Among the surveyed Brazilian clinics, 58% responded completely or partially the questionnaire; and the results demonstrated variation of up to 100% in the reported radiopharmaceutical activity. The suggested DRL for 18F-FDG/PET activity was 5.54 MBq.kg–1 (0.149 mCi.kg–1). Conclusion The present study has demonstrated the lack of standardization in administered radiopharmaceutical activities for PET procedures in Brazil, corroborating the necessity of an official DRL value to be adopted in the country. The suggested DLR value demonstrates that there is room for optimization of the procedures and 18F-FDG/PET activities administered in Brazilian clinics to reduce the doses delivered to patients. It is important to highlight that this value should be continually revised and optimized at least every five years. .
RESUMO
(18)FDG, an analogue of glucose labelled with the radionuclide (18)F, is the most widely used radiopharmaceutical in positron emission tomography/computed tomography technique. In Brazil, there are currently eight (18)FDG plants in operation and other facilities are expected to start their production in the near future. The growth in the production and clinical use of (18)FDG represents an increasing risk of worker exposures. According to national regulations and international recommendations, internal exposures should be effectively controlled in order to keep doses as low as possible. The implementation of a routine monitoring programme towards the estimation of internal doses related to the incorporation of (18)F is difficult, mainly due to its short physical half-life, the cost of a bioassay laboratory and the need of a monitoring service promptly available near the production plant. This paper describes the implementation and evaluation of a methodology for in vivo brain monitoring of (18)F to be applied in cases of suspected incorporation of (18)FDG. The technique presented a minimum detectable effective dose in the order of nanoSieverts, which allows its application for occupational monitoring purposes.
