RT Journal Article
SR Electronic
T1 Using Clinical Audits and Algorithms in the Scintigraphic Imaging of Infection
JF Journal of Nuclear Medicine Technology
JO J. Nucl. Med. Technol.
FD Society of Nuclear Medicine
SP 262
OP 266
VO 23
IS 4
A1 Childs, Julie
A1 Buscombe, John
A1 Marshall, David
A1 Ryan, Paul
YR 1995
UL http://tech.snmjournals.org/content/23/4/262.abstract
AB Objective: We describe how using an audit of clinical practice and producing a clinical algorithm can provide a logical approach to using nuclear medicine in a defined group of patients. In this case, patients are undergoing a scintigraphic study for the investigation of focal infection or inflammation. Methods: A retrospective review was performed on two years of scintigraphic studies used for the localization of infection or inflammation in a community hospital. In each case the indication for the study and the agent used was determined. From this data and a review of current literature, a clinical algorithm was produced which was then applied to all scintigraphic studies over the next year. Changes in the number and pattern of studies performed were then reassessed. Results: In the first two years of the study a total of 94 scintigraphic studies were performed to localize infection or inflammation. The majority of patients had been studied with 67Ga citrate- or 111In-labeled leukocytes. This gave a mean radiation burden to the patient of 8.1 mSv (0.81 rad) per patient. After application of the algorithm most studies were performed with 99mTc-labeled leukocytes or 99mTc human immunoglobulin. This resulted in an increase in use of the service to 82 studies performed in a single year. The mean radiation dose to the patient was reduced to 3.9 mSv (0.39 rad) per patient. Conclusion: In those areas of nuclear medicine where a choice of agents exists, it is possible to use a combination of clinical audit and algorithm to help decide which is the best agent for each patient, thus providing a better clinical service and, in our case, reducing the mean radiation burden to the patient.