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FORM NUCLEAR MEDICINE PROCEDURES

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					                                                               FORM M3: NUCLEAR MEDICINE PROCEDURES

                               Estimated number                       Percentage of    Activity administered   Typical effective dose                       Age and sex distribution (%)
                                 of procedures       Most common      examinations             (MBq)            (mSv) (if available)       0-15 years              16-40 years                >40 years
    Examination or treatment
                                   performed            radio-       performed using
                                                                                       Mean       Variation    Mean         Variation   Male       Female       Male         Female        Male      Female
                                    annually        pharmaceutical     this material
                                                                                        DIAGNOSTIC EXAMINATIONS
Bone
Cardiac
Lung perfusion
Lung ventilation
Thyroid
Renal
Gastroenterology
Brain
PET
PET/CT combined
TOTAL of all examinations
                                                                                        THERAPEUTIC TREATMENTS
Thyroid malignancy
Hyperthyroidism
Polycythaemia vera
Bone metastases
Synovitis
Other: e.g. 90YCl
TOTAL of all treatments


POPULATION BASE (if data do not apply to the entire country)


Name of individual completing form

E-mail address
,




Page 1 of 1                                                                                                                                                                     UNSCEAR/QF/M3 (April 2006)

				
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