Radiation dose assessment and establishment of diagnostic reference levels for MDP Tc-99m bone scans: A multi-hospital study in Saudi Arabia.

Background: Bone scans using technetium-99m methylene diphosphonate (99mTc-MDP) are widely used in nuclear medicine for diagnosing various bone disorders. However, the radiation exposure associated with these procedures necessitates careful consideration and optimization.

Aim: This study aimed to evaluate radiation doses in terms of Effective Dose (ED) and establish Diagnostic Reference Levels (DRLs) for 99mTc-MDP bone scans in Saudi Arabia.

Method: Data were collected from 345 bone scan procedures across three hospitals in Saudi Arabia. Patient demographics, administered activities, and CT dose indicators were recorded. EDs were calculated using the RADAR Medical Procedure Radiation Dose Calculator. DRLs were established using the 75th percentile of administered activities.

Results: The study revealed variations in EDs across the three hospitals, with means ranging from 4.14 to 5.46 mSv for 99mTc-MDP bone scans. CT dose indicators were generally lower than those reported in some international studies. The established DRLs (75th percentile) for administered activities were 771 MBq, 841 MBq, and 1006.4 MBq for the three hospitals, respectively. These values were within the range of international DRLs but showed some variation compared to other Saudi Arabian studies.

Conclusion: This study provides valuable insights into current practices for 99mTc-MDP bone scans in Saudi Arabia. The observed variations in doses and established DRLs highlight the need for standardization and optimization of protocols across hospitals. These findings can serve as a benchmark for nuclear medicine facilities in Saudi Arabia, promoting radiation safety while maintaining diagnostic quality.