Skip to main content
Log in

Estimation of the total effective dose from low-dose CT scans and radiopharmaceutical administrations delivered to patients undergoing SPECT/CT explorations

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Hybrid imaging, such as SPECT/CT, is used in routine clinical practice, allowing coregistered images of the functional and structural information provided by the two imaging modalities. However, this multimodality imaging may mean that patients are exposed to a higher radiation dose than those receiving SPECT alone.

Objectives

The study aimed to determine the radiation exposure of patients who had undergone SPECT/CT examinations and to relate this to the Background Equivalent Radiation Time (BERT).

Methods

145 SPECT/CT studies were used to estimate the total effective dose to patients due to both radiopharmaceutical administrations and low-dose CT scans. The CT contribution was estimated by the Dose-Length Product method. Specific conversion coefficients were calculated for SPECT explorations.

Results

The radiation dose from low-dose CTs ranged between 0.6 mSv for head and neck CT and 2.6 mSv for whole body CT scan, representing a maximum of 1 year of background radiation exposure. These values represent a decrease of 80–85 % with respect to the radiation dose from diagnostic CT. The radiation exposure from radiopharmaceutical administration varied from 2.1 mSv for stress myocardial perfusion SPECT to 26 mSv for gallium SPECT in patients with lymphoma. The BERT ranged from 1 to 11 years.

Conclusions

The contribution of low-dose CT scans to the total radiation dose to patients undergoing SPECT/CT examinations is relatively low compared with the effective dose from radiopharmaceutical administration. When a CT scan is only acquired for anatomical localization and attenuation correction, low-dose CT scan is justified on the basis of its lower dose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med. 2007;48(Suppl 1):78S–88S.

    PubMed  CAS  Google Scholar 

  2. Von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology. 2006;238:405–22.

    Article  Google Scholar 

  3. Núñez R, Erwin WD, Wendt RE 3rd, Stachowiak A, Mar M, Stevens D, et al. Acquisition parameters for oncologic imaging with a new SPECT/multislice CT scanner. Mol Imaging Biol. 2010;12:110–38.

    Article  PubMed  Google Scholar 

  4. Chen J, Caputlu-Wilson SF, Shi H, Galt JR, Faber TL, Garcia EV. Automated quality control of emission–transmission misalignment for attenuation correction in myocardial perfusion imaging with SPECT-CT systems. J Nucl Cardiol. 2006;13:43–9.

    Article  PubMed  Google Scholar 

  5. The 2007 Recommendations of the International Commission On Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37:1–332.

    Google Scholar 

  6. International Commission on Radiological Protection. Recommendations of the International Commission on Radiological Protection. ICRP Publication 26. Ann ICRP 1(3). Oxford: Pergamon Press; 1971.

  7. 1990 Recommendations of the International Commission on Radiological Protection. Ann ICRP 1991;21:1–201.

  8. ICRP Publication 106: Radiation dose to patients from radiopharmaceuticals: Addendum 3 to ICRP Publication 53. Ann ICRP. 2008;38:1–197.

    Google Scholar 

  9. ICRP Publication 80: Radiation dose to patients from radiopharmaceuticals, Addendum to ICRP Publication 53. Ann ICRP. 1998;28:1–126.

    Google Scholar 

  10. ICRP Publication 53: Radiation dose to patients from radiopharmaceuticals. Ann ICRP. 1987;18:1–377.

    Google Scholar 

  11. Pujades MC, Martí JF, Olivas C, Bello P, Mateo A. Application of ICRP-103 in the calculation of effective dose associated to nuclear medicine tests. Rev Esp Med Nucl. 2010;29:114–21.

    Article  Google Scholar 

  12. Jessen KA, Panzer W, Shrimpton PC. European guidelines on quality criteria for computed tomography. Brussels, Belgium: European Commission, 2000: EUR 16262.

  13. Bongartz G, Golding SJ, Juriket AG. European guidelines for multislice computed tomography. Brussels, Belgium: European Commission, 2004: FIGM-CT2000-20078-CT-TIP.

  14. Christner JA, Kofler JM, McCollough CH. Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting international commission on radiological protection publication 103 or dual-energy scanning. AJR Am J Roentgenol. 2010;194:881–9.

    Article  PubMed  Google Scholar 

  15. Deak P, Smal Y, Kalender WA. Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology. 2010;257:158–66.

    Article  PubMed  Google Scholar 

  16. United Nations Scientific Committee on the effects of Atomic Radiation. Sources and effects of ionizing radiation UNSCEAR 2008 report vol. I sources of ionizing radiation. Vienna: United Nations; 2008.

    Google Scholar 

  17. Gregory KJ, Bibbo G, Pattison JE. On the uncertainties in effective dose estimates of adult CT head scans. Med Phys. 2008;35:3501–10.

    Article  PubMed  Google Scholar 

  18. Sawyer LJ, Starritt HC, Hiscock SC, Evans MJ. Effective doses to patients from CT acquisitions on the GE Infinia Hawkeye: a comparison of calculation methods. Nucl Med Commun. 2008;29:144–9.

    Article  PubMed  Google Scholar 

  19. Nagel HD. Radiation exposure in computed tomography. Fundamentals, influencing parameters, dose assessment, optimization, scanner data, terminology. 4th ed. Hamburg: CTB Publications; 2002.

    Google Scholar 

  20. Kalender WA, Schmidt B, Zankl M, Schmidt M. A PC program for estimating organ dose and effective dose values in computed tomography. Eur Radiol. 1999;9:555–62.

    Article  PubMed  CAS  Google Scholar 

  21. Myronakis M, Perisinakis K, Tzedakis A, Gourtsoyianni S, Damilakis J. Evaluation of a patient-specific Monte Carlo software for CT dosimetry. Radiat Prot Dosimetry. 2009;133:248–55.

    Article  PubMed  CAS  Google Scholar 

  22. Brix G, Lechel U, Glatting G, Ziegler SI, Münzing W, Müller SP, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005;46:608–13.

    PubMed  CAS  Google Scholar 

  23. Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248:254–63.

    Article  PubMed  Google Scholar 

  24. Larkin AM, Serulle Y, Wagner S, Noz ME. Friedman K quantifying the increase in radiation exposure associated with SPECT/CT compared to SPECT alone for routine nuclear medicine examinations. Int J Mol Imaging. 2011;2011:897202.

    PubMed  Google Scholar 

  25. Khamwan K, Krisanachinda A, Pasawang P. The determination of patient dose from (18)F-FDG PET/CT examination. Radiat Prot Dosimetry. 2010;41:50–5.

    Article  Google Scholar 

  26. Administration of Radioactive Substances Advisory Committee. Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. London: Health Protection Agency; 2006.

    Google Scholar 

  27. Venero CV, Heller GV, Bateman TM, McGhie AI, Ahlberg AW, Katten D, et al. A multicenter evaluation of a new post-processing method with depth-dependent collimator resolution applied to full-time and half-time acquisitions without and with simultaneously acquired attenuation correction. J Nucl Cardiol. 2009;16:714–25.

    Article  PubMed  Google Scholar 

  28. Kumar S, Pandey AK, Sharma P, Malhotra A, Kumar R. Optimization of the CT acquisition protocol to reduce patient dose without compromising the diagnostic quality for PET-CT: a phantom study. Nucl Med Commun. 2012;33:164–70.

    Article  PubMed  Google Scholar 

  29. Xia T, Alessio AM, De Man B, Manjeshwar R, Asma E, Kinahan PE. Ultra-low dose CT attenuation correction for PET/CT. Phys Med Biol. 2012;57:309–28.

    Article  PubMed  Google Scholar 

  30. Martin CJ. Effective dose: how should it be applied to medical exposures? Br J Radiol. 2007;80:639–47.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlos Montes.

Additional information

C. Montes and P. Tamayo contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montes, C., Tamayo, P., Hernandez, J. et al. Estimation of the total effective dose from low-dose CT scans and radiopharmaceutical administrations delivered to patients undergoing SPECT/CT explorations. Ann Nucl Med 27, 610–617 (2013). https://doi.org/10.1007/s12149-013-0724-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-013-0724-6

Keywords

Navigation