A national survey of computed tomography doses in hybrid PET-CT and SPECT-CT examinations in the UK

Gareth R. Iball*, Natalie A. Bebbington, Maria Burniston, Sue Edyvean, Louise Fraser, Peter Julyan, Nasreen Parkar, Tim Wood

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

34 Citations (Scopus)


Objectives The aim of this study was to conduct a nationwide survey of computed tomography (CT) doses for a wide range of PET-CT and single photon emission computed tomography-computed tomography (SPECT-CT) imaging procedures, with the aim of generating proposed UK national diagnostic reference levels (NDRLs). Methods CT protocol and dosimetry data for three PET-CT and seven SPECT-CT examinations were gathered from centres across the UK. Data were divided according to CT purpose (attenuation correction, localization or diagnostic) and third quartile values of scanner average dose metrics were used to generate suggested NDRLs for a range of examination and CT purpose combinations. Achievable doses were also established from the median of the dose distributions. Results Data were obtained from 47 centres, allowing suggested NDRLs to be produced for fluorine-18-fluorodeoxyglucose half-body PET-CT, and parathyroid, post-thyroid ablation, meta-iodobenzylguanidine/octreotide, cardiac and bone SPECT-CT examinations. Variations in dose of up to a factor of 35 were observed for a given examination/CT purpose combination. For fluorine-18-fluorodeoxyglucose half-body PET-CT examination dose levels for the three CT purposes overlapped, which highlights the variability in the way in which CT purposes are interpreted across the UK. This lack of standardization is believed to be the largest contributor to the dose variations that were observed. The survey highlighted the need for targeted optimization work in many centres. Conclusion Suggested UK NDRLs and achievable doses for six common PET-CT and SPECT-CT examinations have been established as a result of this study.

Original languageEnglish
Pages (from-to)459-470
Number of pages12
JournalNuclear Medicine Communications
Issue number6
Publication statusPublished - 1 May 2017

Bibliographical note

Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc.


  • computed tomography
  • diagnostic reference levels
  • dosimetry
  • positron emission tomography
  • single photon emission computed tomography


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