Radiation Dosimetry in 18F-FDG PET/CT



The number of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and PET/computed tomography (CT) examinations that are performed is rapidly increasing. A total of 308,663 FDG PET and PET/CT examinations were performed in Korea in 2009 compared with 66 examinations conducted in 1994, when the first PET was installed (The Korean Society of Nuclear Medicine, Nuclear medicine procedures statistics over 48 years: year 2009, 2009). In the US, probably more than 1.5 million PET and PET/CT patient studies were performed per year in recent years.


Positron Emission Tomography Total Radiation Exposure Positron Emission Tomography Image Quality Excess Lifetime Risk Cancer Screening Tool 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    The Korean Society of Nuclear Medicine. Nuclear medicine procedures statistics over 48 years: year 2009; 2009.Google Scholar
  2. 2.
    Choi J, Kim B. Whole body positron emission tomography/computed tomography. J Korean Med Assoc. 2006;49:1027–34.CrossRefGoogle Scholar
  3. 3.
    Czernin J, Phelps ME. Positron emission tomography scanning: current and future applications. Annu Rev Med. 2002;53:89–112.PubMedCrossRefGoogle Scholar
  4. 4.
    Cameron J. Radiation dosimetry. Environ Health Perspect. 1991;91:45–8.PubMedCrossRefGoogle Scholar
  5. 5.
    ICRP. Recommendations of the international commission on radiological protection. ICRP Publication 60. Ann ICRP. 1991;21(1–3).Google Scholar
  6. 6.
    Mejia AA, Nakamura T, Itoh M, et al. Absorbed dose estimates in positron emission tomography ­studies based on the administration of 18F-labeled radio­pharmaceuticals. J Radiat Res (Tokyo). 1991; 32(3):243–61.CrossRefGoogle Scholar
  7. 7.
    Deloar HM, Fujiwara T, Shidahara M, et al. Estimation of absorbed dose for 2-[F-18]fluoro-2-deoxy-d-glucose using whole-body positron emission tomography and magnetic resonance imaging. Eur J Nucl Med. 1998;25(6):565–74.PubMedCrossRefGoogle Scholar
  8. 8.
    Gelfand MJ. Dosimetry of FDG PET/CT and other molecular imaging applications in pediatric patients. Pediatr Radiol. 2009;39(Suppl 1):S46–56.PubMedCrossRefGoogle Scholar
  9. 9.
    Brix G, Lechel U, Glatting G, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005;46(4):608–13.PubMedGoogle Scholar
  10. 10.
    Brix G, Nekolla EA, Nosske D, Griebel J. Risks and safety aspects related to PET/MR examinations. Eur J Nucl Med Mol Imaging. 2009;36(Suppl 1):S131–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Committee to assess health risks from exposure to low levels of ionizing radiation, National Research Council. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2. Washington, DC: The National Academy Press; 2006.Google Scholar
  12. 12.
    Huang B, Law MW, Khong PL. Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Radiology. 2009;251(1):166–74.PubMedCrossRefGoogle Scholar
  13. 13.
    Mossman KL. The linear no-threshold debate: where do we go from here? Med Phys. 1998;25(3):279–84. discussion 300.PubMedCrossRefGoogle Scholar
  14. 14.
    Fahey FH. Dosimetry of pediatric PET/CT. J Nucl Med. 2009;50(9):1483–91.PubMedCrossRefGoogle Scholar
  15. 15.
    Wu TH, Chu TC, Huang YH, et al. A positron emission tomography/computed tomography (PET/CT) acquisition protocol for CT radiation dose optimization. Nucl Med Commun. 2005;26(4):323–30.PubMedCrossRefGoogle Scholar
  16. 16.
    Beyer T, Townsend DW, Brun T, et al. A combined PET/CT scanner for clinical oncology. J Nucl Med. 2000;41(8):1369–79.PubMedGoogle Scholar
  17. 17.
    Brix G, Beyer T. PET/CT: dose-escalated image fusion? Nuklearmedizin. 2005;44(Suppl 1):S51–7.PubMedGoogle Scholar
  18. 18.
    Fahey FH, Palmer MR, Strauss KJ, Zimmerman RE, Badawi RD, Treves ST. Dosimetry and adequacy of CT-based attenuation correction for pediatric PET: phantom study. Radiology. 2007;243(1):96–104.PubMedCrossRefGoogle Scholar
  19. 19.
    Groves AM, Owen KE, Courtney HM, et al. 16-detector multislice CT: dosimetry estimation by TLD measurement compared with Monte Carlo simulation. Br J Radiol. 2004;77(920):662–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Huda W, Vance A. Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol. 2007; 188(2):540–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Zanzonico P, Dauer L, St Germain J. Operational radiation safety for PET-CT, SPECT-CT, and cyclotron facilities. Health Phys. 2008;95(5):554–70.PubMedCrossRefGoogle Scholar
  22. 22.
    Hany TF, Steinert HC, Goerres GW, Buck A, von Schulthess GK. PET diagnostic accuracy: improvement with in-line PET-CT system: initial results. Radiology. 2002;225(2):575–81.PubMedCrossRefGoogle Scholar
  23. 23.
    Kamel E, Hany TF, Burger C, et al. CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current. Eur J Nucl Med Mol Imaging. 2002;29(3):346–50.PubMedCrossRefGoogle Scholar
  24. 24.
    Gelfand MJ, Lemen LC. PET/CT and SPECT/CT dosimetry in children: the challenge to the pediatric imager. Semin Nucl Med. 2007;37(5):391–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology. 2004;231(2):305–32.PubMedCrossRefGoogle Scholar
  26. 26.
    Wechalekar K, Sharma B, Cook G. PET/CT in ­oncology–a major advance. Clin Radiol. 2005;60(11):1143–55.PubMedCrossRefGoogle Scholar
  27. 27.
    Lee JW, Kang KW, Paeng JC, et al. Cancer screening using 18F-FDG PET/CT in Korean asymptomatic volunteers: a preliminary report. Ann Nucl Med. 2009;23(7):685–91.PubMedCrossRefGoogle Scholar
  28. 28.
    American Cancer Society. Cancer facts and figures 2009. Atlanta: American Cancer Society; 2009.Google Scholar
  29. 29.
    Korea National Statistical Office. Causes of death statistics in 2008. In: Statistics Korea, editor. Annual report on the cause of death statistics, 14 Sept 2009.Google Scholar
  30. 30.
    Yasunaga H. Who wants cancer screening with PET? A contingent valuation surgery in Japan. Eur J Radiol. 2007;70:190–4.CrossRefGoogle Scholar
  31. 31.
    Kojima S, Zhou B, Teramukai S, et al. Cancer screening of healthy volunteers using whole-body 18F-FDG-PET scans: the Nishidai clinic study. Eur J Cancer. 2007;43(12):1842–8.PubMedCrossRefGoogle Scholar
  32. 32.
    Chen YK, Ding HJ, Su CT, et al. Application of PET and PET/CT imaging for cancer screening. Anticancer Res. 2004;24(6):4103–8.PubMedGoogle Scholar
  33. 33.
    Chung J, Cho H, Shim J, et al. Detection of cancer with PET and PET/CT in asymptomatic volunteers. Nucl Med Mol Imaging. 2009;43(6):526–34.Google Scholar
  34. 34.
    Weckesser M, Schober O. Is whole-body FDG-PET valuable for health screening? Against. Eur J Nucl Med Mol Imaging. 2005;32(3):342–3.PubMedCrossRefGoogle Scholar
  35. 35.
    Yasuda S, Ide M, Fujii H, et al. Application of positron emission tomography imaging to cancer screening. Br J Cancer. 2000;83(12):1607–11.PubMedCrossRefGoogle Scholar
  36. 36.
    Minamimoto R, Senda M, Terauchi T, et al. Analysis of various malignant neoplasms detected by FDG-PET cancer screening program: based on a Japanese nationwide survey. Ann Nucl Med. 2011;25(1):45–54.Google Scholar
  37. 37.
    Yasuda S, Shohtsu A. Cancer screening with whole-body 18F-fluorodeoxyglucose positron-emission tomography. Lancet. 1997;350(9094):1819.PubMedCrossRefGoogle Scholar
  38. 38.
    Robbins E. Radiation risks from imaging studies in children with cancer. Pediatr Blood Cancer. 2008;51(4):453–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Ide M, Suzuki Y. Is whole-body FDG-PET valuable for health screening? For. Eur J Nucl Med Mol Imaging. 2005;32(3):339–41.PubMedCrossRefGoogle Scholar
  40. 40.
    Schoder H, Gonen M. Screening for cancer with PET and PET/CT: potential and limitations. J Nucl Med. 2007;48(Suppl 1):4S–18.PubMedGoogle Scholar
  41. 41.
    Nishizawa S, Kojima S, Teramukai S, et al. Prospective evaluation of whole-body cancer screening with multiple modalities including [18F]fluorodeoxyglucose positron emission tomography in a healthy population: a preliminary report. J Clin Oncol. 2009;27(11):1767–73.PubMedCrossRefGoogle Scholar
  42. 42.
    Zhu X. Dosage of radiopharmaceuticals and internal dosimetry. In: Charron M, editor. Practical pediatric PET imaging. New York: Springer; 2006. p. 37–46.CrossRefGoogle Scholar
  43. 43.
    Cristy M, Eckerman KF. Specific absorbed fractions of energy at various ages from internal photon sources. I. Methods. Oak Ridge National Laboratory Rep. ORNL/TM-8381/V1; 1987.Google Scholar
  44. 44.
    ICRP. Radiation dose to patients from radiopharmaceuticals (Addendum to ICRP Publication 53). ICRP Publication 80. Ann ICRP. 1998;28(3).Google Scholar
  45. 45.
    Treves ST, Davis RT, Fahey FH. Administered radiopharmaceutical doses in children: a survey of 13 pediatric hospitals in North America. J Nucl Med. 2008;49(6):1024–7.PubMedCrossRefGoogle Scholar
  46. 46.
    Lassmann M, Biassoni L, Monsieurs M, Franzius C. The new EANM paediatric dosage card: additional notes with respect to F-18. Eur J Nucl Med Mol Imaging. 2008;35(9):1666–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Pediatric Nuclear Medicine Workgroup. North American consensus guidelines for administered radiopharmaceutical activities in children and adolescents 2010.Google Scholar
  48. 48.
    Ernst M, Freed ME, Zametkin AJ. Health hazards of radiation exposure in the context of brain imaging research: special consideration for children. J Nucl Med. 1998;39(4):689–98.PubMedGoogle Scholar
  49. 49.
    Charron M. The biologic effects of low-level radiation. In: Charron M, editor. Practical pediatric PET imaging. New York: Springer; 2006. p. 30–6.CrossRefGoogle Scholar
  50. 50.
    Zanotti-Fregonara P, Champion C, Trebossen R, Maroy R, Devaux JY, Hindie E. Estimation of the beta  +  dose to the embryo resulting from 18F-FDG administration during early pregnancy. J Nucl Med. 2008;49(4):679–82.PubMedCrossRefGoogle Scholar
  51. 51.
    ICRP. Pregnancy and medical radiation. ICRP Publication 84. Ann ICRP. 2000;30(1).Google Scholar
  52. 52.
    Leide-Svegborn S. Radiation exposure of patients and personnel from a PET/CT procedure with 18F-FDG. Radiat Prot Dosimetry. 2010;139(1–3):208–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Yale PET Center, Department of Diagnostic RadiologyYale University School of MedicineNew HavenUSA

Personalised recommendations