Abstract
BackgroundAbsorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific. Such age-specific pharmacokinetic data are lacking for many of the diagnostic agents typically used in pediatric imaging. We have developed a pharmacokinetic model of [18F]fluorodeoxyglucose (FDG) applicable to premature infants and to 0- (newborns) to 5-year-old patients, which may be used to generate model-derived time-integrated activity coefficients and absorbed dose calculations for these patients.MethodsThe FDG compartmental model developed by Hays and Segall for adults was fitted to published data from infants and also to a retrospective data set collected at the Boston Children’s Hospital (BCH). The BCH data set was also used to examine the relationship between uptake of FDG in different organs and patient weight or age.ResultsSubstantial changes in the structure of the FDG model were required to fit the pediatric data. Fitted rate constants and fractional blood volumes were reduced relative to the adult values.ConclusionsThe pharmacokinetic models developed differ substantially from adult pharmacokinetic (PK) models which can have considerable impact on the dosimetric models for pediatric patients. This approach may be used as a model for estimating dosimetry in children from other radiopharmaceuticals.Electronic supplementary materialThe online version of this article (doi:10.1186/s13550-016-0179-6) contains supplementary material, which is available to authorized users.
Highlights
Absorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific
Overall approach To arrive at a pharmacokinetic FDG model applicable to pediatric patients, we started with a published FDG PK model applicable to adults [20]
Using data from the literature and from retrospective measurements in different patients obtained from Boston Children’s Hospital (BCH), we have developed pharmacokinetic models for dosimetry and activity concentration as a function of body weight to be used for image simulation
Summary
Absorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific. We derive an [18F]-FDG model for early-age pediatric patients (newborns to 5-year-olds) based on an established [18F]FDG model applicable to adults [20], which is made applicable to pediatric patients by adjusting the model and fitting it to a combination of published data and retrospective data collected at Boston Children’s Hospital (BCH). The latter data set was used to examine the relationship between FDG uptake in different organs and patient weight or age. Such relationships will be useful as input into image simulation and diagnostic image quality evaluation tasks as described previously [10]
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