U.S. Diagnostic Reference Levels and Achievable Administered Activities for Adult Renal Scintigraphy: An Analysis of the Intersocietal Accreditation Committee Nuclear Laboratories

Abstract

The goal of this work was to determine U.S. diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for adult renal scintigraphy. Methods: Under an Institutional Review Board–approved protocol, data were collected from the Intersocietal Accreditation Commission during one 3-y accreditation cycle encompassing 110 facilities. Elements included radiopharmaceutical, administered activity, practice type, and examination volume. DRLs and AAAs were calculated and compared with non-U.S. values and societal recommendations as available. Results: Ninety-three facilities provided data on ^99mTc-mercaptoacetyltriglycine (^99mTc-MAG3), and 15 provided data on ^99mTc-diethylenetriaminepentaacetic acid (^99mTc-DTPA) for adult renal scintigraphy exams. Analysis demonstrated a DRL of 392.2 MBq (10.6 mCi) for ^99mTc-MAG3 and 531.7 MBq (14.4 mCi) for ^99mTc-DTPA, with an AAA of 370 MBq (10 mCi) for ^99mTc-MAG3 and 445.9 MBq (12.1 mCi) for ^99mTc-DTPA. Conclusion: The resultant calculated novel U.S. DRLs and AAAs may serve as benchmarks that nuclear medicine facilities may use to refine renal scintigraphy protocols, reduce patient doses, and potentially guide future societal guideline recommendations.