International Guidelines for Pediatric Radiopharmaceutical Administered Activities

Treves, S. Ted; Laßmann, Michael

doi:10.2967/jnumed.114.139980

Cited by 29 publications

(15 citation statements)

References 17 publications

(16 reference statements)

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“…For children and adolescents, administered FDG activity should adhere to the EANM or SNMMI recommendations on paediatric radiopharmaceutical administration [ 51 , 52 ] or national activity limits, if national limits are lower. Furthermore, there are specific guidelines for FDG PET/CT in paediatric oncology [ 22 ].…”

Section: Procedure/specification Of the Examinationmentioning

confidence: 99%

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

Boellaard

Delgado-Bolton

Oyen

et al. 2014

Eur J Nucl Med Mol Imaging

2,395

2,185

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The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings.

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Section: Procedure/specification Of the Examinationmentioning

confidence: 99%

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

Boellaard

Delgado-Bolton

Oyen

et al. 2014

Eur J Nucl Med Mol Imaging

2,395

2,185

View full text Add to dashboard Cite

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“…Reference geometries for newborn, 1 year old, 5 year old, 10 year old and 15 year old children are also described by the C−E phantom series and used to compute pediatric S values (Wayson et al 2012, Xie et al 2013, Xie and Zaidi 2014). Furthermore, all pediatric absorbed dose estimates reported by the International Commission on Radiological Protection (ICRP) use adult pharmacokinetic data coupled with pediatric reference phantom S values (Fahey et al 2011, 2016, Lassmann and Treves 2014, Treves et al 2014, 2016, Grant et al 2015, Mattsson et al 2015, Lassmann et al 2016). The reference geometry and corresponding S values for both adults and children were recently updated in ICRP Publication 128 (Mattsson et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Re-evaluation of pediatric ¹⁸F-FDG dosimetry: Cristy–Eckerman versus UF/NCI hybrid computational phantoms

et al. 2018

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Because of the concerns associated with radiation exposure at a young age, there is an increased interest in pediatric absorbed dose estimates for imaging agents. Almost all reported pediatric absorbed dose estimates, however, have been determined using adult pharmacokinetic data with radionuclide S values that take into account the anatomical differences between adults and children based upon the older Cristy-Eckerman (C-E) stylized phantoms. In this work, we use pediatric model-derived pharmacokinetics to compare absorbed dose and effective dose estimates for F-FDG in pediatric patients using S values generated from two different geometries of computational phantoms. Time-integrated activity coefficients ofF-FDG in brain, lungs, heart wall, kidneys and liver, retrospectively, calculated from 35 pediatric patients at the Boston's Children Hospital were used. The absorbed dose calculation was performed in accordance with the Medical Internal Radiation Dose method using S values generated from the University of Florida/National Cancer Institute (UF/NCI) hybrid phantoms, as well as those from C-E stylized computational phantoms. The effective dose was computed using tissue-weighting factors from ICRP Publication 60 and ICRP Publication 103 for the C-E and UF/NCI, respectively. Substantial differences in the absorbed dose estimates between UF/NCI hybrid pediatric phantoms and the C-E stylized phantoms were found for the lungs, ovaries, red bone marrow and urinary bladder wall. Large discrepancies in the calculated dose values were observed in the bone marrow; ranging between -26% to +199%. The effective doses computed by the UF/NCI hybrid phantom S values were slightly different than those seen using the C-E stylized phantoms with percent differences of -0.7%, 2.9% and 2.5% for a newborn, 1 year old and 5 year old, respectively. Differences in anatomical modeling features among computational phantoms used to perform Monte Carlo-based photon and electron transport simulations for F, and very likely for other radionuclides, impact internal organ dosimetry computations for pediatric nuclear medicine studies.

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“…NM radiation dosimetry is challenging due to diversities in the uptake, retention, and clearance of variable radiopharmaceuticals. Furthermore, individual administered doses in children also differ depending on the patient's body mass, type of examination, available SPECT model, examination time, and patient cooperation (22,23). Nevertheless, updated nuclear medicine drug decay half-lives are now available in ICRP Publication 107 (24).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Nuclear Medicine Examinations and Subsequent Risk of Neoplasm: A Nationwide Population-Based Cohort Study

et al. 2021

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Objective: To evaluate the association between radiation exposure from repeated nuclear medicine (NM) examinations and the subsequent risk of neoplasm in pediatric patients.Methods: From 2000 to 2017, participants under 18 years of age who underwent NM scanning were identified using the Health and Welfare Data Science Center (HWDC) dataset, which was extracted from the Taiwan National Health Insurance Research Database (NHIRD). Both the exposed cohort and unexposed subjects were followed up with until the presence of any malignancy arose, including malignant brain, lymphoid and hematopoietic tumors and benign brain or other central nervous tumors.Results: There were 35,292 patients in the exposed cohort and 141,152 matched subjects in the non-exposed group. The exposed cohort had an overall higher IR (IR: incidence rate, per 100,000 person-years) of any malignancy and benign central nervous tumor than the non-exposed group [IR, 16.9 vs. 1.54; adjusted hazard ratio (HR), 10.9; 95% CI, 6.53–18.2]. Further stratifying the number of NM examinations into 1-2, 3-4, and 5 or more times revealed that the IR of pediatric neoplasms increased gradually with the increased frequency of NM examinations (IR, 11.5; adjusted HR, 7.5; 95% CI, 4.29–13.1; IR, 25.8; adjusted HR, 15.9; 95% CI, 7.00–36.1; IR, 93.8; adjusted HR, 56.4; 95% CI, 28.8–110.3).Conclusion: NM examination is significantly associated with a higher risk of pediatric neoplasms, according to our population-based data. Thorough radiation protection and dose reduction in pediatric NM procedures should be an issue of concern.

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International Guidelines for Pediatric Radiopharmaceutical Administered Activities

Cited by 29 publications

References 17 publications

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

Re-evaluation of pediatric ¹⁸F-FDG dosimetry: Cristy–Eckerman versus UF/NCI hybrid computational phantoms

Pediatric Nuclear Medicine Examinations and Subsequent Risk of Neoplasm: A Nationwide Population-Based Cohort Study

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International Guidelines for Pediatric Radiopharmaceutical Administered Activities

Cited by 29 publications

References 17 publications

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

Re-evaluation of pediatric 18F-FDG dosimetry: Cristy–Eckerman versus UF/NCI hybrid computational phantoms

Pediatric Nuclear Medicine Examinations and Subsequent Risk of Neoplasm: A Nationwide Population-Based Cohort Study

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Re-evaluation of pediatric ¹⁸F-FDG dosimetry: Cristy–Eckerman versus UF/NCI hybrid computational phantoms