Radionuclide diagnostics in St. Petersburg: сurrent status and development challenges

This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.

This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.

Materials and methods. The radionuclide diagnostics temporal and structural changes’ analysis was based on Federal state statistical observation forms No.3-DOZ for St. Petersburg and on the results of radionuclide diagnostics subdivision surveys with radiology physicians’ questionnaires on the amount and composition of conducted examinations, dosages of introduced radioactivity of radiopharmaceticals and patients’ doses.

The results. Since the end of 1990s until 2012 the amount of radionuclide diagnostics procedures had been steadily reducing. 74000 procedures were conducted in 2005 and 35500 in 2012. The number of radionuclide diagnostics procedures per one thousand residents reduced from 16 to 7.2. Both indicators slightly grew in 2013. In 2014 the total number of radiodiagnostic proceduress amounted up to 42000 and 8.2 tests per 1000 residents. Since 2011 the diagnostic equipment was upgraded. Four medical institutions received SPECT (single photon emission computed tomography) or SPECT/CT, two new PET ( positron emission tomographs) – centers were set up, three medical institutions had acquired positron emission tomographs (PET) and are conducting PET – diagnostics receiving radiofarmaceuticals from external PET – center. At the same time one a third of radiodiagnostic units still has been operating obsolete and depreciated equipment dating back to 1980–1990 .

Inspection results indicated that St. Petersburg healthcare centers for in vivo diagnostics were using 24 radiofarmaceuticals, traced 99mTc, 123I, 131I, 67Ga, for PET – diagnostics – radiofarmaceuticals with cyclotron radionuclides 18F, 11C, 13N, 15O. 60–70% are traced 99mTc. Over 10 years the radiodiagnostics structure has changed towards increased number of scintigraphic studies and reduction of “functional” (radiometric) procedures which reflects the changes in the equipment of the radionuclide diagnostics units, the replacement of the old equipment by new SPECT.

         The mean effective dose per one radiodiagnostic test in St. Petersburg is 2.4 mSv. Scintigraphic tests’ mean exposure doses are between 0.9 mSv and 7 mSv. Patients are exposed to the highest doses during whole body diagnostics with administration of 67Ga- citrate and 123I – sodium iodide (about 20 mSv and above). During heart and brain diagnolstics patient’s exposure dose averages 4 mSv. Radiometric (functional) tests’ exposure doses are 0.1 – 0.3 mSv.

Conclusion. Since 2013 the amount of radionuclide diagnostic tests has increased.

The main objective is to modernize the radionuclide diagnostics equipment in the city. After replacement of the old equipment by the state-of-the art one in most probability high- dose diagnostics will increase in number which will result in increased radionuclide diagnostics contribution into population medical exposure dose. Statistical observation form of patients’ medical exposure doses 3 – DOZ requires modernization in the part of radionuclide diagnostics in compliance with advancement in this medical sphere.

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