Paediatric nuclear medicine

Abstract

Until the 1980s no serious attempts were made to develop paediatric nuclear medicine, as for various reasons many centres were reluctant to perform radionuclide examinations on children. Then two books were published on paediatric nuclear medicine in 1984 and 1985, respectively. In 1987, a group of physicians formed an informal club of paediatricians and nuclear medicine specialists in an effort to improve the relationship and cooperation between these specialties. Carrying out nuclear medicine examinations on children requires a completely different approach than on adults. Suggestions are made and tips given, and the specific problems involved are discussed in detail.

Radiation protection for the parent and child in diagnostic nuclear medicine

“…The use of scaling factors to derive the activity to be administered to a child from the usual adult value has been summarised, with the aim of producing a count rate density approximately equal to that from the same investigation of an adult (Piepsz et al 1991). The need to apply a minimum activity to each procedure in order to guarantee a diagnostic result has also been emphasized (Piepsz et al 1991).…”

“…The need to apply a minimum activity to each procedure in order to guarantee a diagnostic result has also been emphasized (Piepsz et al 1991). If tables of scaling factors are not used, then the two most simple methods for calculating the paediatric activity are to reduce the usual adult activity by the ratio of either the child's body weight or the child's body surface area to that of an adult.…”

“…These hazards have been cited as a reason for the reluctance of some referring clinicians and, indeed, nuclear medicine practitioners to exploit paediatric radiopharmaceutical investigations (Piepsz et al 1991). Ignorance of these hazards has the following consequences.…”

Where are we with nuclear medicine in pediatrics?

“…A search of the literature from 1992 to 1995 retrieves 1378 references, with 75 review articles containing some information pertaining to radionuclide imaging in children. In addition to the twovolume pediatric nuclear medicine series in Seminars in Nuclear Medicine in 1993 [1], Piepsz et al [2] have reviewed pediatric nuclear medicine in Europe in 1991 [3] and recent advances in European pediatric nuclear medicine in 1995. In the last 2 years two pediatric nuclear medicine textbooks, by Miller and Gelfand [4] and Treves (2nd edition) [5] have been published.…”

A new principle to normalize plasma concentrations allowing single-sample clearance determinations in both children and adults

“…This so-called "singlesample method" is a simple and sufficiently accurate procedure for routine clinical use which has, until now, only been applicable to adults and not to children and infants (Russell and Dubovsky 1989;Mulligan etal. 1990;Blaufox 1991;Piepsz et al 1991;Shore 1991). In particular, after the introduction of technetium-99m mercaptoacetyltriglycine (99mTc-MAG3), demand has clearly increased with respect to a simple clearance determination method applicable to children Piepsz et al 1991), considering that this radiopharmaceutical, because of its availability and the favourable physical properties of 99mTC, is especially suited for paediatric investigations.…”