## 4 Discussion and Summary
Evidence-based approaches indicate that while conservative algorithms like [PERSON] et al. may be useful in high-risk settings, there is also a need for algorithm validation through real-world exposure data to avoid both overestimation and underestimation of doses. During all stages of \({}^{99}\)Tc-MDP bone scintigraphy, validation of the algorithms using single and double dosimetry, the [PERSON] et al. algorithm (double dosimetry) has the closest fit to the actual measured effective dose. Our findings indicate a clear need for critically evaluating dosimetry models used in clinical settings. Healthcare institutions shouldconsider adopting validated, evidence-based algorithms to optimize radiation safety, potentially supplemented by real-time dosimetry data. It is crucial to remember that the dynamic nature of occupational exposure during medical procedures adds a layer of complexity, making it even more important to focus future research on validating these algorithms. Notably, the actual measured effective dose study highlights the distribution of time and occupational effective dose among healthcare professionals involved in \({}^{99\text{m}}\)Tc-MDP bone scintigraphy procedures:  
* Pharmacists: spent 48.30% of the total time on preparation but received only 0.04% of the total occupational effective dose. Focus should be on improving workflow efficiency rather than radiation safety. * Nurses: spent 7.70% of the time but received 26.01% of the total occupational effective dose due to proximity during administration. Strict adherence to radiation safety protocols and enhanced radiation protection is crucial to reduce exposure. * Radiological technologists and radiological technologist assistants: spent 39.36% of the time and received 73.05% of the total radiation dose, indicating the highest exposure. Enhanced protective measures, avoiding exposure, ALARA, and optimized imaging techniques are needed. This study indicates that radiation exposure patterns across different staff members suggest distinct occupational risks. For radiopharmacists (RP), the high levels of equivalent dose to the hands, particularly the R-thumb and R-index finger, suggest that the direct handling of radioactive materials is a major source of exposure. This suggests the need for focused protective measures, particularly enhanced hand protection, to mitigate the risks associated with frequent manipulation of radioactive substances. The relatively low exposure to the whole body and eye lenses points to the effectiveness of current protective protocols. However, the moderate uncertainty in hand exposure values emphasizes the need for consistent monitoring and adherence to safety protocols. For registered nurses (RN), the exposure data during intravenous \({}^{99\text{m}}\)Tc-MDP injection indicates that hand protection is particularly important, especially for the L-thumb, which showed the highest exposure. The fact that the left-hand exposure exceeded that of the right hand may reflect procedural factors, such as the method of intravenous injection. The low exposure to the eye lenses and whole body suggests that current protective measures in these areas are adequate but should be continually monitored. In the case of radiological technologists (RT), the elevated exposure to the R-eye lens is a notable finding [55]. This suggests that eye protection is a critical concern for this group, as their tasks may involve extended proximity to radiation sources, potentially increasing the risk of eye damage. The much lower exposure in the hands and whole body implies that their role in operating machines or guiding procedures limits direct contact with radioactive substances, reducing overall exposure. The eye lens exposure suggests precise effective dose monitoring is adhered to and underscores the importance of reinforcing the use of leaded glasses or other eye protection devices. For the radiological technologist assistants (RTA), the data indicate a more generalized exposure pattern, with the whole body receiving the highest exposure.