Enhancing Nuclear Medicine Practice in Saudi Arabia: Advocating for Comprehensive Guidelines and Local Diagnostic Reference Levels.

INTRODUCTION:  Diagnostic reference levels (DRLs) were initially introduced by the International Commission on Radiation Protection (ICRP). It refers to the measured quantity of administered activity (MBq) in nuclear medicine imaging studies and is a type of investigation level. DRL is recommended to prevent excessive radiation exposure to patients while maintaining adequate image quality. It should not be implemented as a dose constraint or dose limit. The Saudi Food and Drug Authority (SFDA) is the primary government body responsible for reporting national diagnostic reference levels (NDRLs) for diagnostic medical imaging technologies in Saudi Arabia. Only NDRLs for computed tomography, general X-ray, and mammography have been published and enforced locally. This study aims to establish local DRLs for nuclear medicine imaging procedures at King Abdulaziz University Hospital, Saudi Arabia, preparing for compliance proof once required by local authorities. METHOD:  Data were collected from all machines, and six common protocols were studied, with data from 50 patients of standard body size for each identified protocol. The study was conducted retrospectively, and the 50th percentile was then calculated for each scan. RESULTS: Both protocols for renal scans administered the lowest doses to patients (130 MBq and 148 MBq), respectively. The highest dose administered to patients was found to be in bone scans (1110 MBq). CONCLUSION: The study establishes local DRLs for nuclear medicine imaging in our institution. Median activity dosages in renal, thyroid, and parathyroid imaging were comparable to locally and internationally published DRLs. However, they are higher in cardiac and bone imaging compared to local Saudi DRL and DRL in the European Union and the USA, likely due to the adopted protocols. These highlight the need for modifying the protocols to fulfill optimization efforts. These findings serve as a foundation for compliance with future regulatory requirements, ensuring patient safety and maintaining imaging quality in Saudi healthcare.

Environmental risk assessment associated with acidic volcanics in Egypt.

The present work aims to study gamma rays emitted by radionuclides such as 238U, 232Th and 40K from acidic Monqul volcanics. The studied volcanics are represented by a thick stratified lava flows interbanded with their pyroclastics. They are composed of thick lava flows of andesite and, to a lesser extent of basalt, and acidic volcanics including rhyolite and dacite. The average values of 238U, 232Th and 40K are (46 ± 24 Bq kg-1), (62 ± 11 Bq kg-1) and (1227 ± 318 Bq kg-1) in the rhyolite-dacite samples are greater than the worldwide average. The variation of radioactive bearing minerals observed inside granite faults produced the great amounts of radioactivity perceived in the samples. Calculating radiological risks is used to assess the public's radioactive risk from radionuclides revealed in the studied Rhyolite-dacite samples. The acceptable limit for excess lifetime cancer (ELCR) evaluations has been exceeded. As a result, Rhyolite-dacite are inappropriate for apply in building materials.

Potentially harmful elements in urban surface deposited sediment of Ekaterinburg, Russia: Occurrence, source appointment and risk assessment.

In this study, the human health risks of potentially harmful elements (PHEs) in urban surface deposited sediments (USDS) were examined by collecting urban dust samples, measuring their PHE concentrations, and using index evaluation. About 35, 12 and 16 samples are represented a green zones, roads, driveways and sidewalks in residential areas of Ekaterinburg, respectively. The dust fraction (0.002-0.1 mm) was obtained by sieving, filtration, and decantation process. Total concentrations of 10 PHEs were measured using inductively coupled plasma mass spectrometry. The highest concentrations of Pb were found in USDS from green zones, while Fe, V, Mn, Co, Ni, Sn, and Sb on roads, Cu and Zn on driveways and sidewalks. The contamination levels in the investigated land-use areas were studied, where the highest contamination was contributed from Sb in the driveways and sidewalk. Moreover, the pollution in the studied zones was a high load, contributing to anthropogenic activities and traffic emissions. No non-cancerogenic risk was attributed from the PHEs based on the results of health indices (HI < 1) for both adult and children, except Co and Ni which has HI > 1 for children. The total carcinogenic risk (TLCR) in all urban landscape areas is defined as a high potential inhalation exposure and a low potential ingestion and dermal exposure.

Excess Lifetime Cancer Risk Associated with Granite Bearing Radioactive Minerals and Valuable Metals, Monqul Area, North Eastern Desert, Egypt.

The present work is concerned with assessing the cancer risk contributed by the studied granite types including valuable metals, such as Cu, Au, and Ba mineralization, as well as radioactive-bearing mineralization, such as monazite and zircon, in south Monqul at Wadi Makhrag El Ebel, north Eastern Desert, Egypt. The mineralization analyses illustrated that copper mineralization containing chrysocolla and tenorite minerals were restricted to the alteration zone, especially (argillic, phyllic, and propylitic) in monzogranite. However, barite veinlets had an ENE-WSW trend, while gold mineralization was confined to quartz veins having NE-SW trends. Monazite and zircon are radioactive-bearing minerals recorded in monzogranite causing high radioactive zones in south Monqul. The radionuclide activity concentrations were detected in the studied monzogranites. The mean values of AU (103 ± 91 Bq kg-1), ATh (78 ± 19 Bq kg-1), and AK (1484 ± 334 Bq kg-1) in the monzogranite samples were higher than the recommended worldwide average. The change in radioactive-transporting minerals found inside granite faults caused the high amounts of radioactivity seen in the samples. Due to the monzogranites being applied in building materials, the radiological hazards were assessed by calculating risk indices such as annual effective dose (AED) and excess lifetime cancer risk (ELCR). The acceptable limit for the ELCR readings was surpassed. As a result, the investigated monzogranite samples are not suitable for use in infrastructure materials.

Radiological Risk to Human and Non-Human Biota Due to Radioactivity in Coastal Sand and Marine Sediments, Gulf of Oman.

Natural and 137Cs radioactivity in coastal marine sediment samples was measured using gamma spectrometry. Samples were collected at 16 locations from four beaches along the coastal area of Muscat City, Gulf of Oman. Radioactivity in beach sand was used to estimate the radiological risk parameters to humans, whereas the radioactivity in marine sediments was used to assess the radiological risk parameters to non-human biota, using the ERICA Tool. The average radioactivity concentrations (Bqkg-1) of 226Ra, 232Th, 40K, 210Pb and 137Cs in sediments (sand) were as follows: 16.2 (16.3), 34.5(27.8), 54.7 (45.6), 46.8 (44.9) and 0.08 (0.10), respectively. In sand samples, the estimated average indoor (Din) and outdoor (Dout) air absorbed dose rates due to natural radioactivity were 49.26 and 27.4 and the total effective dose (AEDTotal; µSvy-1) ranged from 150.2 to 498.9 (average: 275.2). The measured radioactivity resulted in an excess lifetime cancer risk (ELCR) in the range of 58-203 (average: 111) in and an average gonadal dose (AGD; µGy.y-1) ranged from 97.3 to 329.5 (average: 181.1). Total dose rate per marine organism ranged from 0.035 µGy h-1 (in zooplankton) to 0.564 µGy h-1 (in phytoplankton). The results showed marine sediments as an important source of radiation exposure to biota in the aquatic environment. Regular monitoring of radioactivity levels is vital for radiation risk confinement. The results provide an important radiological risk profile parameter to which future radioactivity levels in marine environments can be compared.

MRI-Related Geometric Distortions in Stereotactic Radiotherapy Treatment Planning: Evaluation and Dosimetric Impact.

In view of their superior soft tissue contrast compared to computed tomography, magnetic resonance images are commonly involved in stereotactic radiosurgery/radiotherapy applications for target delineation purposes. It is known, however, that magnetic resonance images are geometrically distorted, thus deteriorating dose delivery accuracy. The present work focuses on the assessment of geometric distortion inherent in magnetic resonance images used in stereotactic radiosurgery/radiotherapy treatment planning and attempts to quantitively evaluate the consequent impact on dose delivery. The geometric distortions for 3 clinical magnetic resonance protocols (at both 1.5 and 3.0 T) used for stereotactic radiosurgery/radiotherapy treatment planning were evaluated using a recently proposed phantom and methodology. Areas of increased distortion were identified at the edges of the imaged volume which was comparable to a brain scan. Although mean absolute distortion did not exceed 0.5 mm on any spatial axis, maximum detected control point disposition reached 2 mm. In an effort to establish what could be considered as acceptable geometric uncertainty, highly conformal plans were utilized to irradiate targets of different diameters (5-50 mm). The targets were mispositioned by 0.5 up to 3 mm, and dose-volume histograms and plan quality indices clinically used for plan evaluation and acceptance were derived and used to investigate the effect of geometrical uncertainty (distortion) on dose delivery accuracy and plan quality. The latter was found to be strongly dependent on target size. For targets less than 20 mm in diameter, a spatial disposition of the order of 1 mm could significantly affect (>5%) plan acceptance/quality indices. For targets with diameter greater than 2 cm, the corresponding disposition was found greater than 1.5 mm. Overall results of this work suggest that efficacy of stereotactic radiosurgery/radiotherapy applications could be compromised in case of very small targets lying distant from the scanner's isocenter (eg, the periphery of the brain).