Skip to main content
SpringerLink
Log in

Standardization of pediatric nuclear medicine administered radiopharmaceutical activities: the SNMMI/EANM Joint Working Group

  • Review Article
  • Published:
Clinical and Translational Imaging Aims and scope Submit manuscript

Abstract

Nuclear medicine is a unique and valuable method that contributes to the diagnosis and assessment of many diseases in children. It is generally accepted that radiation exposures to children undergoing diagnostic nuclear medicine studies and the resulting risks are low. However, due to the lack of pediatric guidelines there has been a rather wide variation of pediatric radiopharmaceutical administered activities. As a result, pediatric radiation exposures have also varied over a broad range. Some practices have been able to obtain useful results with administered activities in the lowest ranges while other centers and practices have used considerably larger administered activities. This was dramatically highlighted by surveys of nuclear medicine departments in North America and beyond. Efforts in Europe and North America have resulted in the development and publication of pediatric guidelines. These were initially developed separately utilizing different models, but more recently were joined through harmonization activities; the two sets of guidelines are now further aligned. Dissemination of these guidelines is an ongoing activity. We believe that adhering to these standards can help assure that the most appropriate administered activity is employed. Along with this goal, it is essential that the image quality and their diagnostic value be assured. Beyond the application of the recent guidelines, radiation exposures in children can be reduced further by optimizing use, updating protocols, applying advanced image processing and potentially developing and introducing advanced imaging systems. Further improvements will likely result from increased communication and cooperation by several nuclear medicine organizations in addition to the dissemination of updated information to the clinic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Treves ST (2014) Pediatric nuclear medicine/PET, 4th edn. Springer, New York

    Google Scholar 

  2. Treves ST, Baker A, Fahey FH, Cao X, Davis RT, Drubach LA, Grant FD, Zukotynski K (2011) Nuclear medicine in the first year of life. J Nucl Med 52(6):905–925

    Article  PubMed  Google Scholar 

  3. Brenner DJ (2010) Medical imaging in the 21st century—getting the best bang for the rad. N Engl J Med 362(10):943–945

    Article  CAS  PubMed  Google Scholar 

  4. Piepsz A, Hahn K, Roca I, Ciofetta G, Toth G, Gordon I, Kolinska J, Gwidlet J (1990) A radiopharmaceuticals schedule for imaging in paediatrics. Eur J Nucl Med 17(3–4):127–129

    CAS  PubMed  Google Scholar 

  5. Jacobs F, Thierens H, Piepsz A, Bacher K, Van De Wiele C, Ham H, Dierckx R (2005) Optimised tracer-dependent dosage cards to obtain weight-independent effective doses. Eur J Nucl Med Mol Imaging 32(5):581–588

    Article  CAS  PubMed  Google Scholar 

  6. Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F (2007) The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 34(5):796–798

    Article  CAS  PubMed  Google Scholar 

  7. Lassmann M, Biassoni L, Monsieurs M, Franzius C, Dosimetry E (2008) The new EANM paediatric dosage card: additional notes with respect to F-18. Eur J Nucl Med Mol Imaging 35(9):1666–1668

    Article  CAS  PubMed  Google Scholar 

  8. Machado JS, Beykan S, Herrmann K, Lassmann M (2016) Recommended administered activities for 68 Ga-labelled peptides in paediatric nuclear medicine. Eur J Nucl Med Mol Imaging:1–4

  9. Treves ST, Davis RT, Fahey FH (2008) Administered radiopharmaceutical doses in children: a survey of 13 pediatric hospitals in North America. J Nucl Med 49(6):1024–1027

    Article  PubMed  Google Scholar 

  10. Gelfand MJ, Parisi MT, Treves ST (2011) Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J Nucl Med 52(2):318–322

    Article  PubMed  Google Scholar 

  11. Treves ST, Parisi MT, Gelfand MJ (2011) Pediatric radiopharmaceutical doses: new guidelines. Radiology 261(2):347–349

    Article  PubMed  Google Scholar 

  12. Grant FD, Gelfand MJ, Drubach LA, Treves ST, Fahey FH (2015) Radiation doses for pediatric nuclear medicine studies: comparing the North American consensus guidelines and the pediatric dosage card of the European Association of Nuclear Medicine. Pediatr Radiol 45(5):706–713

    Article  PubMed  Google Scholar 

  13. Lassmann M, Treves ST (2014) Pediatric radiopharmaceutical administration: harmonization of the 2007 EANM paediatric dosage card (Version 1.5. 2008) and the 2010 North American consensus guideline. Eur J Nucl Med Mol Imaging 41(8):1636

    Article  PubMed  Google Scholar 

  14. Treves ST, Lassmann M, Group ESPDHW (2014) International guidelines for pediatric radiopharmaceutical administered activities. J Nucl Med 55(6):869–870

    Article  PubMed  Google Scholar 

  15. Fahey FH, Bom HH-S, Chiti A, Choi YY, Huang G, Lassmann M, Laurin N, Mut F, Nunez-Miller R, O’Keeffe D (2015) Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 1—statement of the issue and a review of available resources. J Nucl Med 56(4):646–651

    Article  PubMed  Google Scholar 

  16. Koizumi K, Masaki H, Matsuda H, Uchiyama M, Okuno M, Oguma E, Onuma H, Kanegawa K, Kanaya S, Kamiyama H (2014) Japanese consensus guidelines for pediatric nuclear medicine. Ann Nucl Med 28(5):498–503

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sheehy N, Tetrault TA, Zurakowski D, Vija AH, Fahey FH, Treves ST (2009) Pediatric 99mTc-DMSA SPECT performed by using iterative reconstruction with isotropic resolution recovery: improved image quality and reduced radiopharmaceutical activity 1. Radiology 251(2):511–516

    Article  PubMed  Google Scholar 

  18. Stansfield EC, Sheehy N, Zurakowski D, Vija AH, Fahey FH, Treves ST (2010) Pediatric 99mTc-MDP bone SPECT with ordered subset expectation maximization iterative reconstruction with isotropic 3D resolution recovery 1. Radiology 257(3):793–801

    Article  PubMed  Google Scholar 

  19. Hsiao EM, Cao X, Zurakowski D, Zukotynski KA, Drubach LA, Grant FD, Yahil A, Vija AH, Davis RT, Fahey FH (2011) Reduction in radiation dose in mercaptoacetyltriglycerine renography with enhanced planar processing. Radiology 261(3):907–915

    Article  PubMed  Google Scholar 

  20. Fahey F, Zukotynski K, Zurakowski D, Markelewicz R, Falone A, Vitello M, Cao X, Grant F, Drubach L, Vija AH (2014) Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy. Eur J Nucl Med Mol Imaging 41(12):2346–2353

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    S. Ted Treves

  2. Section of Nuclear Medicine, Department of Radiology, Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Michael J. Gelfand

  3. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Alison Goodkind & Frederic H. Fahey

  4. Department of Nuclear Medicine, University Würzburg, 97080, Würzburg, Germany

    Michael Lassmann

Authors
  1. S. Ted Treves
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael J. Gelfand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alison Goodkind
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Frederic H. Fahey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Lassmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Ted Treves.

Ethics declarations

Conflict of interest

S. Ted Treves, Michael J. Gelfand, Alison Goodkind, Frederic H. Fahey and Michael Lassmann declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Treves, S.T., Gelfand, M.J., Goodkind, A. et al. Standardization of pediatric nuclear medicine administered radiopharmaceutical activities: the SNMMI/EANM Joint Working Group. Clin Transl Imaging 4, 203–209 (2016). https://doi.org/10.1007/s40336-016-0170-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40336-016-0170-2

Keywords

Search

Navigation