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Optimization of the CT component of SPECT-CT and establishment of local CT diagnostic reference levels for clinical practice

Dennis, Jennifer L.; Gemmell, Alastair J.; Nicol, Alice J.

Nuclear Medicine Communications: June 2018 - Volume 39 - Issue 6 - p 493–499
doi: 10.1097/MNM.0000000000000831
ORIGINAL ARTICLES
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Objective The aim of this study was to perform a process of optimization and establish local diagnostic reference levels (DRLs) for the computed tomography (CT) component of single-photon emission computed tomography (SPECT)-CT imaging, for use in clinical practice.

Methods A multidisciplinary group defined categories for the clinical purpose of the CT component of local SPECT-CT examinations. Each of the examinations were assigned a category, and optimization of acquisition and reconstruction parameters was performed to achieve the required image quality. Dose data were collated for 754 SPECT-CT scans performed on three systems over 10 months. The third quartile values for volume CT dose index and dose length product were calculated and established as local DRLs.

Results Four categories of CT examinations were defined: attenuation correction; localization and attenuation correction; localization, characterization and attenuation correction; and diagnostic and attenuation correction. Local DRLs were established for 11 examinations. Reference was made to the proposed national DRLs set by a recent UK survey.

Conclusion This work describes a process of optimization and the creation of practical and effective local DRLs. These can be used in local audit of practice. In future, improved descriptors and standardization of SPECT-CT use would allow more practicable UK national DRLs to be created.

Department of Nuclear Medicine, Queen Elizabeth University Hospital, Glasgow, UK

Correspondence to Alice J. Nicol, PhD, Department of Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK Tel: +44 141 452 3664; e-mail: alice.nicol@ggc.scot.nhs.uk

Received October 19, 2017

Received in revised form January 7, 2018

Accepted March 6, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.