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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]

The main contributions in the applications of nuclear sciences and technologies to the diagnosis and treatment of neoplasic diseases, obtained by medical physicists from various Havana institutions are summarized. Additionally, the main activities to guarantee the training and accreditation of medical physicists for radiodiagnosis, nuclear medicine, radiotherapy and radiation protection services in Havana hospital network is presented. [ABSTRACT FROM AUTHOR]