The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia.

This study aims to introduce national diagnostic reference levels (NDRLs) for adult hybrid single photon emission computed tomography (SPECT-CT) in nuclear medicine (NM) departments in the Kingdom of Saudi Arabia. The administered activity (AA) of radiopharmaceuticals, volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) for ten hybrid SPECT/CT examinations were collected and analysed for one year. The median of AA, CTDIvoland DLP for each dose quantity was derived and the suggested national DRLs were determined based on the 75thpercentile for all identified SPECT-CT examinations. A comparison of the defined adult NDRLs in Saudi Arabia with the published data of other countries was performed. Although there are no significant variations of the proposed NDRL of AA between countries, the proposed NDRLs of the integrated CT metrics exceed the published data in most procedures. NM departments are urged to consider optimisation for both image quality and radiation protection.

99mTc-Pertechnetate in Diagnosis of Meckel Diverticulum in an Adult.

One of the most common malformations of the gastrointestinal tract is Meckel diverticulum (MD). MD complications can range from minor to major, such as intestinal obstruction, intussusception, hemorrhage, ulceration, vesicodiverticular fistulae, and tumors. Bleeding from ectopic gastric mucosa is more common in children than in adults. In the current case, MD in a 25-y-old man was diagnosed by 99mTc-pertechnetate scanning. 99mTc-pertechnetate scanning helps to diagnose MD noninvasively and has a potential role in the evaluation of MD even in adults.

Evaluation occupationally radiation exposure during diagnostic imaging examinations.

Occupational radiation exposure can occur due to various human activities, including the use of radiation in medicine. Occupationally exposed personnel surpassing 7.4 millions, and respresent the biggest single group of employees who are exposed to artificial radiation sources at work. This study compares the occupational radiation dose levels for 145 workers in four different hospitals located in the Aseer region in Saudi Arabia. The occupational exposure was quantified using thermoluminescence dosimeters (TLD-100). The levels of annual occupational exposures in targeted hospitals were calculated and compared with the levels of the international atomic energy agency (IAEA) Safety Standards. An average yearly cumulative dose for the two consecutive years. The average, highest and lowest resulted occupational doses under examination in this work is 1.42, 3.9 mSv and 0.72 for workers in various diagnostic radiology procedures. The resulted annual effective dose were within the IAEA approved yearly dose limit for occupational exposure of workers over 18, which is 20 mSv. Staff should be monitored on a regular basis, according to current practice, because their annual exposure may surpass 15% of the annual effective doses.

Sensing mammographic density using single-sided portable Nuclear Magnetic Resonance.

This research paper presents a quantitative approach to sensing mammographic density (MD) using single-sided portable Nuclear Magnetic Resonance (NMR). It focuses on three main techniques: spin-lattice relaxation (recovery) time (T1), spin-spin relaxation (decay) time (T2), and Diffusion (D) techniques by testing whether or not the aforementioned techniques are in agreement with the gold standard and with each other when used for scanning breast tissue specimens with a variety of mammographic densities (MDs). The high mammographic density (HMD), intermediate MD, and low mammographic density (LMD) regions of each slice were identified according to the mammogram images. Subsequently, the grayscale values for these regions were quantified. One region was measured from the first sample while the remaining ones were measured from the second sample. The same areas were then exposed to portable NMR, and the sequences used as following: the stimulated echo sequence for diffusion (D), the Carr-Purcell-Meiboom-Gill (CPMG) sequence for T2, and saturation recovery sequence for T1. The correlations between the grayscale values and NMR techniques were strongly correlated. The Pearson correlation coefficient, R, of T1 (%) versus grayscale value, D (%) versus grayscale value, and T2 (%) versus grayscale value, was 0.91, 0.91, and 0.93, respectively. Furthermore, the relative water content of the breast slices based on T1, T2, and diffusion (D) measurements were strongly in agreement with each other. The Pearson correlation coefficient, R, of D (%) versus T1 (%), D (%) versus T2 (%), and T1 (%) versus T2 (%), was 0.984, 0.966, and 0.9868, respectively. The three pulse sequences can be employed in a portable NMR device to deliver continuous quantitative measurements of MD in breast tissue samples. As a result, the method demonstrated to be acceptable for determining the distribution of MDs among breast tissue samples without the need for additional qualitative analysis.

Evaluation of the annual occupational effective doses in a SPECT/CT department.

Staff occupational radiation exposure is limited to 20 mSv annually to preclude tissue reaction and lower risk of cancer effect. Staff occupational exposure arises during the preparation, injection, and scanning of the patients. Recent studies reported that nuclear medicine personnel might exceed the annual dose limit in high workload and poor radiation protection circumstances. Therefore, an accurate estimation of the annual dose limit is recommended. The goal of this research is to calculate the cumulative external effective dose (mSv) per year for nuclear medicine physicians, technologists, and nurses at SPECT/CT department. A total of 15 staff worked in the nuclear medicine department at King Saud Medical City (KSMC), Riyadh, Saudi Arabia were evaluated for the last six years. 99mTc is used more frequently for most of the patients. The procedures include renal, cardiac scintigraphy procedures. Staff dose was quantified using calibrated thermoluminecnt dosimeters (TLD-100) with an automatic TLD reader (Harshaw 6600). Exposure to ionizing radiation was evaluated in terms of deep doses (Hp(10) were evaluated. The overall average and standard deviation of the external doses for nuclear medicine physicians, technologists' and nurses were 1.8 ± 0.7, 1.9 ± 0.6, 2.0 ± 0.9, 2.2 ± 0.8, 6.0 ± 2.8, and 3.6 ± 1.3 for the years 2015,2016,2017,2018,2019, and 2020, respectively. Technologists and nurses received higher doses of compared to the nuclear medicine physicians. Technologists and nurses involved in radionuclide preparation, patients' injection, and image acquisition. Staff annual exposure is below the annual dose limits; however, this external dose is considered high compared to the current workload.

99mTc-Sulfur Colloid SPECT/CT in Diagnosis of Splenogonadal Fusion.

A congenital abnormal connection between an accessory spleen and a gonad is called splenogonadal fusion. The parent of a 3-y-old boy brought him to King Saud Medical City because he had left scrotal swelling that had begun 1 y previously. 99mTc-sulfur colloid (SC) imaging has superior sensitivity and specificity in targeting the liver, spleen, and bone marrow, in that these are the only organs that 99mTc-SC can visualize. Furthermore, if these tissues appear anywhere other than their usual locations, such as in the case of an accessory spleen, 99mTc-SC imaging can identify them even without biopsy or-in the case of splenogonadal fusion-orchiectomy. In the current case, the patient underwent laparoscopy, the masses were removed, and orchiectomy was avoided. Histopathologic examination confirmed normal splenic tissue, matching the imaging results.

The suitability of smartphone camera sensors for detecting radiation.

The advanced image sensors installed on now-ubiquitous smartphones can be used to detect ionising radiation in addition to visible light. Radiation incidents on a smartphone camera's Complementary Metal Oxide Semiconductor (CMOS) sensor creates a signal which can be isolated from a visible light signal to turn the smartphone into a radiation detector. This work aims to report a detailed investigation of a well-reviewed smartphone application for radiation dosimetry that is available for popular smartphone devices under a calibration protocol that is typically used for the commercial calibration of radiation detectors. The iPhone 6s smartphone, which has a CMOS camera sensor, was used in this study. Black tape was utilized to block visible light. The Radioactivity counter app developed by Rolf-Dieter Klein and available on Apple's App Store was installed on the device and tested using a calibrated radioactive source, calibration concrete pads with a range of known concentrations of radioactive elements, and in direct sunlight. The smartphone CMOS sensor is sensitive to radiation doses as low as 10 µGy/h, with a linear dose response and an angular dependence. The RadioactivityCounter app is limited in that it requires 4-10 min to offer a stable measurement. The precision of the measurement is also affected by heat and a smartphone's battery level. Although the smartphone is not as accurate as a conventional detector, it is useful enough to detect radiation before the radiation reaches hazardous levels. It can also be used for personal dose assessments and as an alarm for the presence of high radiation levels.