Clinical Audit of A Joint Commission Accredited PET/CT Facility in Pakistan: Standardization is Need Not Desire

Maseeh uz Zaman, Nosheen Fatima, Mukhtiar Memon, Areeba Zaman, Rabia Tahseen, Unaiza Zaman

Abstract


Aim: Aga Khan University Hospital has recently embarked into PET/CT imaging and we have tailored standard operating procedures (SOP) as per recent guidelines.  This clinical audit was done to ensure good clinical practice as per defined bench marks. Material Methods: This clinical audit was conducted from 1st July till 5th August 2016 and we did audit of 11 parameters related to demographics, patient preparation, acquisition protocol, qualitative and semiquantitative parameters, reporting and radiation dose from PET/CT study. The compliance of these parameters was checked against predefined benchmarks. Results: 100% compliance was found for demographic, height and weight entries, fasting blood glucose level, pregnancy, intravenous contrast and low dose CT scan. Non-compliance was found for dose of 18FDG (71% for 3 MBq/kg benchmark), uptake time (25% against 55-75 minute benchmark), mean hepatic uptake (19% against 1.3-3% benchmark) and addenda in reporting (4% against 0.5% benchmark). Conclusions: This clinical audit finds an over-all good compliance to departmental protocol which is tailored as per recent guidelines to achieve a global standardization in PET/CT imaging. Although radiation dose is significantly low, attempts should be taken to minimize the magnitude of non-compliance. Similarly, work flow must be strategized to prevent avoidable reasons resulting in non-compliance in uptake time.

 

Key Words: PET/CT; standardized; FDG Dose; Uptake Time; dosimetry; addendum

 

 

 


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References


. Larson SM, Schwartz LH. 18F-FDG PET as a candidate for “qualifiedbiomarker”: functionalassessment of treatment response inoncology. J Nucl Med. 2006; 47(6):901–3.

. Grégoire V, Chiti A. PET in radiotherapy planning: particularlyexquisite test or pending and experimental tool? Radiother Oncol.2010; 96(3):275–6.

. Thorwarth D, Beyer T, Boellaard R. Integration of FDG-PET/CT into external beam radiation therapy planning: technical aspectsand recommendation on methodological approaches.Nuklearmedizin. 2012; 51(4):140–53.

. Thie JA. Understanding the Standardized Uptake Value, Its Methods, and Implications for Usage.J Nucl Med 2004; 45: 1431-34

. Busemann SE, Plachcinska A, Britten A. Acceptance testing for nuclear medicine instrumentation. Eur J Nucl Med Mol Imaging.2010; 37(3):672–81.

.Graham MG, Wahl RL, Hoffman JM, Yap JF, Sunderland J, Boellaard R, Perlman ES, Kinahan PE. Summary of the UPICT Protocol for FDG PET/CT Imaging in Oncology Clinical Trials. J Nucl Med (published on April 16, 2015 as doi:10.2967/jnumed.115.158402)

. Belohlavek O, Jaruskova M. [18F]FDG-PET scan in patients with fasting hyperglycaemia. Q J Nucl Med Mol Imaging. 2014 [Epub ahead of print]

. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, TatschK, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015; 42:328–54.

. Jallow N, Christian P, Sunderland J, et al. Diagnosticreference levels of CT radiation dose in whole-body PET/CT. J Nucl Med 2016; 57: 238-41

. Christner J, Kofler J, McCollough C. Estimating effectivedose for CT using dose-length product compared withusing organ doses: consequences of adopting InternationalCommission on Radiological Protection Publication 103 orDual-Energy Scanning. Am J Radiology 2010; 194: 881-9

. ICRP.Radiation dose to patients from radiopharmaceuticals.Addendum 3 to ICRP Publication 53.ICRP Publication 106.Approved by the Commission inOctober 2007. Ann ICRP 2008; 38: 1-197.

. Andrew B. Rosenkrantz, Neil K. Bansal. Diagnostic errors in abdominopelvic CT interpretation: characterization based on reportaddenda. Abdom Radiol 2016: DOI: 10.1007/s00261-016-0741-8

. Mirzaei S, Maffioli L, Hilson A. Clinical audit in nuclear medicine. Eur J Nucl Med Mol Imaging 2011; 38:3–4

. Zaman MU, Fatima N, Zaman A, Zaman U, Tahseen R. Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better". Asian Pac J Cancer Prev. 2016; 17: 3465-8.

. Mahmud M, Nordin A, Saad A, Azman F. Estimationof patient radiation dose from whole body 18FFDGPET/CT examination in cancer imaging: a preliminary study. J Physics: Conference Series 2014; 546: 12008-13.


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