Patient and staff dose optimisation in nuclear medicine diagnosis methods

Complete test of publication follows. The implementation of the Basic Safety Standards (BSS) Directive 96/29 on the protection of workers and general population against the danger arising from ionising radiation and the Directive 97/43 on health protection of individuals against dangers of ionising radiation in relation to medical exposure, known as the Medical Exposure Directive (MED), they started in Poland some years ago with the Polish Atomic Law and executive orders published by the Polish Government and Polish Health Minister. Poland's Government has applied for several years transitory period to complete implementation of the Directive 97/43/Euratom because of the technical, organising and economical problems related with this procedure. The most important task has arisen to prepare procedures according with the current state of knowledge in the area of Quality Assurance (QA) and Quality Control (QC) of medical equipment using ionising radiation in diagnosis. QA and QC in X-ray diagnosis equipment started to be introduced since several years ago and nowadays they are put in common practice in almost each X-ray laboratory in Poland. As result, the nuclear medicine departments must follows the new legislation which has imposed also obligatory necessity of regular Quality Assurance and Quality Control of equipment and procedures for preparing and using radiopharmaceuticals. Documentation for QA system in nuclear medicine includes, among others, quality book, general procedures applied in diagnosis, description of specific procedures prepared in accordance with the rules in current legislation. The physical parameters of equipment (gamma camera, SPECT) undergo the basic tests and some special ones. The basic tests are carried out by staff of the nuclear medicine department. Units with accreditation perform special tests annually. The basic test for planar gamma camera includes: measurement of radioactivity, measurement of background, estimation of photons energy, control of detector uniformity. The test for rotating gamma camera additionally demands controlling precision of rotation and image system resolution. The radioisotope and chemical purity of the radiopharmaceuticals are controlled, too. The process of 99mTc elution efficacity from 99Mo-generator is tested and the contents of 99Mo radioisotope in eluate is measured. The radioisotope diagnosis of brain, heart, thyroid, stomach, liver, kidney and bones as well as lymphoscintigraphy are performed. The procedure used for patient and staff's dose optimisation consists of: 1) control dose measurement performed with dosemeter on the tissue-like phantom including selected radiopharmaceutical of the same radioactivity as the one which will be applied to patient, 2) calculation of the patient dose rate, 3) calculation of the staff dose based on the results of personnel dosemeters (films or TLD), 4) preparation of the Quality Assurance instruction for the staff responsible for patient's safety. Independently of the patient and staff dose optimisation, the Quality Control of gamma camera equipments e.g. SPECT X-Ring Nucline (MEDISO) is checked for uniformity of the image from a radiopharmaceutical sample and center of rotation according to the producer's manual instruction. In addition, special lectures and courses for staff are organized several times per year to ensure a Continuous Professional Development (CPD) in the field of Quality Assurance and Quality Control.