When a nuclear medicine procedure is appropriately administered, the benefits to the patient far outweigh any potential risks associated with the radiation. The risk from exposure to small amounts of radiation is very small. The need to reach a consensus on pediatric-administered doses is therefore of utmost importance and forms the central impetus for this critical survey.

"This report provides the data and incentive needed to work toward establishing radiopharmaceutical administration guidelines for pediatric molecular imaging patients. We will be working with the study investigators, the SNM community and the FDA to help establish such guidelines," said George Sgouros, Ph.D., vice-chairman of SNM's Medical Internal Radiation Dose (MIRD) Committee.


In an effort to document pediatric radiopharmaceutical doses among a group of pediatric hospitals, Dr. Treves and his co-authors designed a survey consisting of 16 pediatric nuclear medicine examinations. Survey participants were asked to report the minimum and maximum administered activities for each exam as well as the administration schedule based on body weight. From these data, the authors computed minimum, maximum, median and mean values for each procedure, which confirmed what the authors long suspected: Among the institutions surveyed, the administered doses varied widely, with the greatest disparity noted in the smallest patients for levels of minimum total administered activity.

The study authors recommend establishing guidelines that balance the need for high-quality image resolution and low radiation exposure with each child's unique profile. "High doses that do not result in improved diagnostic accuracy, or conversely, low doses that do not permit adequate examination, should both be considered unnecessary radiation exposures," said Treves. "This is why it is critical that pediatric radiopharmaceutical doses be determined by the minimal amount necessary to ensure satisfactory examinations."

The authors say their findings suggest a clear need to achieve some level of standardization by reaching a broader consensus on pediatric radiopharmaceutical dosimetry. They hope to stimulate a dialogue within the pediatric nuclear medicine community that will ultimately lead to the establishment of guidelines for administered radiopharmaceutical doses in children that rely on the most current instrumentation, imaging processing techniques and computer technologies.

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