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Carol Ko, Staff Writer | September 05, 2013
"It'll be more of a challenge on the nuclear medicine side because we've been trying to administer the minimum dose all along. I don't think we'll see factor of 10 dose reduction — more like factor of two," said Fahey.
Furthermore, data is really the key to understanding how to use dose correctly, but collecting it is a particular challenge for the molecular imaging industry.
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Unlike CT, where dose levels are automatically recorded in the scanner in the DICOM header and sent to the ACR National Radiology Data Registry, the biomarkers, or the radioactive component of molecular scanners, are injected by technologists into patients.
This means that the dose data is recorded manually by the technologist into an online log, or sometimes even on paper or in a book, meaning that there's much more difficulty sending that data over to the proper channels to be analyzed.
"In the ACR dose registry, nobody's having to type or write anything," said Fahey. "It's easier to fix things when you know exactly what you're doing."
Global bridges
Finally, the society has developed a global initiative involving 12 other nuclear medicine societies around the world, including national organizations from Japan, Korea, China, Australia, South Africa, and Canada.
Its first project was pediatric dose optimization, which builds on the Image Gently campaign to raise awareness on dose optimization across different countries.
Due to its recent radiation scare in 2011, Japan, which has one of the largest imaging markets in the world, has seen a surge of focus on dose reduction, spurring practitioners in the country to proactively seek out and develop guidelines to keep dose at a reasonable level.
The SNNMI is also interested in working closely with societies in Europe to develop better dose guidelines and protocols.
"They came out with their pediatric dose statement in 2007 and we came out with ours in 2011. By 2014 they will be pretty much the same, which is a good thing," said Fahey.
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Mohan Doss
Dose reduction efforts in nuclear medicine are misguided
September 05, 2013 05:02
For diagnostic nuclear medicine, there has not been even a single report that has shown increased cancer risk from radiotracer usage. So, what are the dose reduction efforts going to gain us in terms of reduced cancers? Reduction of excess cancers from zero to zero? How can anyone justify all the dose reduction efforts, with no health benefit to patients?
Though dose reduction has been recommended by many leading scientists, government agencies, and the various professional organizations as being prudent based on the linear no-threshold (LNT) model, there is increasing amount of evidence for the invalidity of the LNT model and for the beneficial effects of low dose radiation including prevention of cancer and neurodegenerative diseases. So, there is no benefit to patients in terms of reduced cancer risks from these dose reduction efforts. Aggressive dose reduction efforts can result in poorer image quality, and this has been described in reports of dose reduction efforts in a recent meeting.
Such dose reduction efforts also tend to validate the current popular superstitious belief about the carcinogenicity of low dose radiation, and discourages and prevents study of its beneficial effects.
In view of the above, I would suggest suspending the current dose monitoring/reduction efforts, and return our focus to improving the image quality and diagnosis.
Mohan Doss
mohan.doss@fccc.edu
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