Administered Pediatric Radiopharmaceutical Doses at a Tertiary Hospital in South Africa: A Comparison with Corresponding Activities Based on North American Consensus Guidelines and Administration of Radioactive Substances Advisory Committee Guidelines.

Abstract

Diagnostic nuclear medicine reveals physiological processes in vivo, facilitating early detection of disease prior to anatomical changes. However, in pediatric studies, the selection of appropriate dosing guidelines is challenging. Administration of Radioactive Substances Advisory Committee (ARSAC) and North American Consensus (NAC) guidelines are extensively used. To determine appropriate pediatric dosing guideline for a South African Tertiary Hospital (SATH). A combination of retrospective and empirical studies was conducted. Age, weight, name of the nuclear medicine study and administered activities were extracted from archived pediatric patients' files in a SATH who were attended from 2012-2015. To increase the sample size when calculating would be administered activities based on ARSAC and NAC guidelines, weights for sixty pediatric patients (empirical data) from the commonly conducted nuclear medicine studies were used. The most commonly performed nuclear medicine studies at a SATH were bone scans, 99mTc-HIDA scans, renal scans, thyroid scans, MIBG scans and gastroesophageal reflux scans. The mean pediatric administered radiopharmaceutical activities based on SATH, ARSAC and NAC guidelines were; bone scans (57.7, 15.2 and 10.0 MBq/kg), 99mTc-HIDA scans (13.7, 5.0 and 3.6 MBq/kg), renal scans (13.9, 3.4 and 7.8 MBq/kg), thyroid scans (7.0, 2.6 and 1.5 MBq/kg), MIBG scans (15.5, 15.1 and 7.7 MBq/kg) and gastroesophageal reflux scans (2.1, 1.9 and 1.7 MBq/kg). High variability of Administered Radiopharmaceutical Activities (ARAs) was observed for SATH guidelines compared to ARSAC and NAC guidelines. NAC guidelines are recommended for dosing pediatric patients at SATH. These guidelines will certainly reduce pediatric doses, which are currently high.