Establishment of National Diagnostic Reference Level for bone Radiation Doses in Nuclear Medicine Department in Khartoum – Sudan

Abstract A diagnostic reference level (DRL) is an investigational level used to identify unusual high radiation doses in Nuclear Medicine procedures. DRLs are suggested action levels above which a facility should review its methods and determine if acceptable image quality can be achieved at lower doses. The high specific activity of 99mTc makes it suitable as a first pass agent, for multiple or sequential studies. Is preferred to 99mTc - pertechnetate. A certain amount of radiopharmaceuticals was injected into each patient and was immediately imaged with gamma camera to calculate the activity through the conjugated view method. According to the American Association of Physics in Medicine (AAPM) recommendation that the radiation dose for bone scan ( 99mTc –MDP) should be between 555 MBq (15 mCi) and 970 MBq (26 mCi) , this study showed that the patients received a radiation dose less than 26 mCi with acceptable image quality. Therefore this study can be considered as a basis for the establishment of dose reference level activity for bone scan of nuclear medicine departments in Sudan.

List of Contents

Title Page No

I اآلية

Dedication

II

Acknowledgment

III

List of Contents

IV

List of Table

VII

List of Figures

VIII

Abbreviations

IX

English Abstract

X

يهخص انثحث

XI

Chapter One

Introduction

1.1 Introduction

1

1.2 Problem of the study

3

1.3 Objective of study

3

1.4 Thesis outline

4

Chapter Two

Theoretical Background and Previous Studies

2.1 Skeleton Anatomy and Physiology 5

2.2 Radiopharmaceuticals and Imaging Techniques 7

V

2.3 Bone Imaging agents 8

2.4

99mTc99Mo Generator 9

2.5 Elution of the 99Mo → 99mTc generator 10

2.6 Properties of technetium – 99m 12

2.7 Technetium 99m-Labeled

Radiopharmaceuticals

16

2.8 Laboratory techniques 17

2.9 Quality control tests of radiopharmaceuticals 17

2.9.1 Molybdenum breakthrough test 18

2.9.2 Aluminum ion breakthrough test 19

Previous studies 20

Chapter Three

Material and methods

3.1 Materials of the study 23

3.1.1 Dose Calibrator 23

3.1.2

99mTc 23

3.1.3

99mTc -Phosphonate Radiopharmaceuticals

(MDP)

24

3.2 Methods of Data collection and data analysis 25

Chapter four

VI

Results

Results 26

Chapter Five

5.1 Discussion 30

5.2 Conclusion 32

5.3 Recommendations 33

References 34

Appendixes 37