Abstract
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Objectives: This retrospective audit is done to describe the changing profile of Nuclear Medicine (NM) studies at the WITS university hospitals from 2004 to 2019.
Methods: Annual statistic and patient reports of the NM departments at both Charlotte Maxeke Johannesburg and Chris Hani Baragwanath Academic Hospitals from January 2004 - December 2019 were analyzed.
Results: A total of 120 033 procedures were performed. Subsequent to the PET/CT camera installation in August 2008, PET/CT study numbers showed a steady increase, comprising 10.11% of all procedures over the past 11 years. The majority of PET/CT investigations are 18F-FDG oncology (76.84%), with lymphoma the most common clinically indication (38.4% of 18F-FDG oncology PET/CT). 68Ga-DOTATATE became available in 2010 and 68Ga-PSMA in 2015. Both of these showed initial excellent growth, with a drop in 2019. The most common general NM procedures were as follows: bone scan (23.48%), myocardial perfusion imaging (17.11%), VQ scans (10.76%), Pertechnetate thyroid scans (7.90%), MUGA (7.14%) and Mag3 renogram (5.03%). A very worrisome drop is seen in the number of MPI studies over the last 2 years. The biggest drop was seen in DMSA scan, Ga67 citrate and venoscintigraphy, all of which are now hardly ever performed. In contrast to these, there has been a marked increase in the number of Mag3 renogram, labelled white cell and bone marrow studies. The most common therapeutic procedure was I-131 ablation for hyperthyroidism (3 307 patients). A total of 611 I-131 doses were administered for thyroid cancer management. Our local producer of Technetium generators had significant production issues in 2017 and throughout 2018. This impact is seen in a significant negative growth of -6,49% in 2018 and -6,84% in 2019. Conclusion: The landscape of NM is dynamic and ever changing, but notably delicate. Factors such as breakdown of equipment or lack of isotope supply have a profound effect on actual number of studies, with a “knock on” effect extending over several months and even years. This is possibly due to a transient change in imaging modality chosen by referring clinicians. Ongoing education of referring physicians and stabilization of isotope supply is imperative to ensure sustained growth of our field.