September 6, 2016 -- Reston, Va. - The Nuclear Medicine Global Initiative (NMGI), which was formed in 2012 and consists of 13 international organizations (Table 1), focused on pediatric nuclear medicine for its first project. Its final report, published in the July issue of The Journal of Nuclear Medicine (JNM), sets forth recommendations for achieving global standards for the administration of radiopharmaceuticals in children.

Frederic H. Fahey, DSc, was the SNMMI’s representative to NMGI and acted as chair of this inaugural project. According to Fahey, “The group recognized the importance of the standardization of administered activities particularly in the context of pediatric nuclear medicine.”

Part 1 of the project (report published in April 2015 JNM) was a review of pediatric nuclear medicine value and practice, the carcinogenic risk to children of radiation from radiopharmaceuticals, and dosimetric models. The indications for pediatric nuclear medicine are often quite different from those for adults. Dose optimization in pediatric nuclear medicine is of particular importance due to the higher radiosensitivity of children compared with adults. The biologic effects of radiation can appear long after exposure, with the probability of adverse effects proportional to expected life span. The goal is to maintain image quality with the lowest possible dose.

In part 2 of the study, an international survey of 313 nuclear medicine clinics and centers in 29 countries was use to evaluate current standards for children and adolescents. Much information is available about the appropriate use of nuclear medicine in children, as well as radiation dosimetry, and nuclear medicine professionals are responsible for staying current with the literature.

The study found that gaps remain in knowledge about the biokinetics and radiation dosimetry associated with the use of nuclear medicine in children, and there’s wide variability in the practice of pediatric nuclear medicine across the globe.

The report makes the following recommendations:

Regions without pediatric guidelines should either develop their own or officially adopt an existing set of guidelines.
Regions with guidelines should expand them to include all nuclear medicine procedures practiced on children.
The administered activity for pediatric patients should be incorporated into the auditing process for nuclear medicine sites.
Pediatric dose recommendations should be incorporated into formal training curricula and recertification programs.

Molecular Imaging Homepage