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A summary of the fundamental lines of medical equipment for Cuban public health developed by the Center for Technological Applications and Nuclear Development (CEADEN) is made. These lines are grouped in two fundamental directions: optical instrumentation and nuclear instrumentation for medical diagnosis, quality control and dosimetry. The main developments and impacts achieved in these two directions in the National Health System are exposed, as well as their perspectives for present and future developments. [ABSTRACT FROM AUTHOR]

Nuclear medicine (NM) diagnostic procedures use ionizing radiation and it is necessary to ensure that the amount of prescribed activity is as low as reasonably achievable. Optimizing these procedures, one of the greatest challenges facing Nuclear Medicine today, is based on achieving a balance between image quality and radiation dose. The objective of this article is to establish and validate a method for optimization studies of medical exposure in NM simulating different levels of activity that can be applied in patients without violating the ethical and radiological protection principles. The method is based on the recombination of data obtained in gated acquisitions to simulate activity levels. For this, measurements were made using different phantoms and a signal generator. A python code was developed that allows the different activity levels to be simulated automatically from a single gated acquisition and returns the studies in the same dicom format to be reconstructed in the registered processing program provided by the manufacturer. To validate our method, the linear dependence of the number of total counts with the simulated activity levels was demonstrated and the quality of the reconstructed images vs the simulated activity levels was qualitatively evaluated. This method constitutes a valid and applicable proposal in the majority of nuclear medicine services in the country to implement optimization procedures for SPECT studies, contributing to a reduction in population exposure to radiation, due to high-tech diagnostic tests. [ABSTRACT FROM AUTHOR]

The diagnostic image must be carried out with the minimum necessary exposure of the patient that allows the objective of the diagnosis to be satisfactorily achieved. For this reason, diagnostic reference levels emerge and are established as dynamic tools to help optimize radiation protection, contribute to the standardization of practices and strengthen culture of safety, without compromising the clinical purpose of each examination or process. The objective of this work is to provide an updated overview of the establishment and use of these levels for nuclear medicine and hybrid imaging. It is identified that to establish and use them properly, trained personnel and coordination and collaboration activities are required among multiple actors, including medical services, health authorities, professional organizations and regulatory bodies. The accelerated development of technology generally exceeds the change in regulations, so these levels must be updated periodically, in order to fulfil their role as a guide and spur for optimization. The worldwide expansion of hybrid technologies and their growing use are a phenomenon of the last decade, so the establishment of these levels for such technologies has not been consolidated, although countries such as the United Kingdom and Australia show solid steps in this address. Research has been carried out with phantoms and directly with patients, the latter with a more useful contribution of information. The installation of hybrid equipment in Cuba demands this study, hence its importance. [ABSTRACT FROM AUTHOR]

The introduction in Cuba of imaging hybrid systems in nuclear medicine has become a challenge for medical physicist in order to guaranty the patient´s radiation safety and proper dose estimation. The aim of this study was to retrospectively evaluate the CT radiation doses for studies performed with a SPECT/CT hybrid system (SPECT/CT). A MATLAB “in house” made tool was tested and validated for this purpose. 62 patients with CT studies were manually and automatically reviewed; the tool could visualize and properly recover the patient personal information, CT protocol and dose related data from the DICOM header in the SPECT/CT study file. The CT volume dose index (CTDIvol) parameter was used for calculating the CT dose-length product (DPL) and the effective doses (E). The CT radiation dose preliminary results were on the range of those reported by others authors for the typical studies, demonstrating the efficacy of the tool developed and the CT dose assessment method. [ABSTRACT FROM AUTHOR]