IMPLEMENTASI INDONESIAN DIAGNOSTIC REFERENCE LEVEL (I-DRL) PADA PELAYANAN DIAGNOSTIK IN VIVO KEDOKTERAN NUKLIR DI RSUP DR. SARDJITO TAHUN 2022-2023

Abstract

The Indonesian Diagnostic Reference Level (I-DRL) value in nuclear medicine was only published in November 2022 by the Nuclear Energy Regulatory Agency (BAPETEN). Implementing I-DRL in in-vivo diagnostic services in nuclear medicine at Sardjito Hospital, which has been running so far, needs ongoing evaluation to help realize an increase in the ratio of benefits to risks of radiation to patients. This research aims to apply I-DRL nuclear medicine at Dr. Sardjito Hospital while still applying the principles of optimizing medical exposure. Optimization focuses on maintaining guaranteed image quality, namely images that are readable or not readable by nuclear medicine specialists, while still implementing radiation protection against medical exposure. The research is a retrospective descriptive method from bone scan patient data from 2022-2023. The selection of 299 bone scan data was based on the most frequently performed examinations. The bone scan imaging tool used was a GE brand single-photon emission computed tomography (SPECT-CT) gamma camera type NM/CT 870 DR. Image processing uses a comparison of region of interest (ROI) values from the target and background on the femur bone using Xeleris software. Based on the image analysis results, the target and background's lowest, average, and highest comparison values were respectively 1.15, 2.1, and 3.75. Spearman statistical testing was also carried out between the dose per Body Mass Index (BMI) and the target/background value ratio, obtaining an R-value of -0.046, which means the two variables have a weak relationship. This research provides information that I-DRL Bone scan can be implemented without affecting the image quality results. Implementing I-DRL is a form of optimizing radiation protection for patients, preventing unnecessary radiation exposure, and ensuring the quality of nuclear medicine services will improve in the future. Keywords: I-DRL, in vivo diagnostics, optimization, radiation protection, bone scan.