Dose estimation in patients from different protocols of 18F-FDG PET/CT studies and analysis of optimization strategies

This study aimed to evaluate the dose in different protocols of 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) procedure. The retrospective study involves 207 patients with confirmed malignancies who underwent PET/CT. Effective dose (E) from PET was estimated based on injected activity and dose coefficient as per International Commission on Radiation Protection (ICRP) 128. Estimation of E from CT was done utilizing the dose length product (DLP) method and conversion factors as per ICRP 102. There was a significant statistical difference observed in E between different PET/CT protocols (P < .001). E of PET in the whole body (WB) was found to be 4.9 ± 0.9 mSv, whereas mean volume computed tomography dose indexvol, DLP, and E of CT in WB were 7.0 ± 0.2 mGy, 674.3 ± 80.7 mGy.cm, and 10.1 ± 1.2 mSv, respectively. No linear correlation was seen between the size-specific dose estimate and E of CT (r = -0.003; P = .978). The total mean E in WB PET/CT was 17.0 ± 1.7 mSv. CT dose was contributing more than PET dose in all protocols except brain PET/CT. Optimization strategies can be evaluated only if monitored periodically.