Abstract
AimRecent advancements in PET technology have brought with it significant improvements in PET performance and image quality. In particular, the extension of the axial field of view of PET systems, and the introduction of semiconductor technology into the PET detector, initially for PET/MR, and more recently available long-field-of-view PET/CT systems (≥ 25 cm) have brought a step change improvement in the sensitivity of PET scanners. Given the requirement to limit paediatric doses, this increase in sensitivity is extremely welcome for the imaging of children and young people. This is even more relevant with PET/MR, where the lack of CT exposures brings further dose reduction benefits to this population. In this short article, we give some details around the benefits around new PET technology including PET/MR and its implications on the EANM paediatric dosage card.Material and methods Reflecting on EANM adult guidance on injected activities, and making reference to bed overlap and the concept of MBq.min bed−1 kg−1, we use published data on image quality from PET/MR systems to update the paediatric dosage card for PET/MR and extended axial field of view (≥ 25 cm) PET/CT systems. However, this communication does not cover the expansion of paediatric dosing for the half-body and total-body scanners that have recently come to market.ResultsIn analogy to the existing EANM dosage card, new parameters for the EANM paediatric dosage card were developed (class B, baseline value: 10.7 MBq, minimum recommended activity 10 MBq). The recommended administered activities for the systems considered in this communication range from 11 MBq [18F]FDG for a child with a weight of 3 kg to 149 MBq [18F]FDG for a paediatric patient weight of 68 kg, assuming a scan of 3 min per bed position. The mean effective dose over all ages (1 year and older) is 2.85 mSv.ConclusionWith this, recommendations for paediatric dosing are given for systems that have not been considered previously.
Highlights
Molecular imaging plays an important role in the diagnosis of many paediatric disorders including urology, orthopaedics, oncology, endocrinology or neurology
The European Association of Nuclear Medicine (EANM) has developed guidelines on paediatric activity dosing since the late 1990s leading to the publication of the first versions of the EANM paediatric dosage card in 2007 [4, 5]
In 2016, the EANM dosage card was amended for 68Ga-labelled compounds, based on a publication by Machado et al [8]
Summary
Molecular imaging plays an important role in the diagnosis of many paediatric disorders including urology, orthopaedics, oncology, endocrinology or neurology. These methods reveal physiological processes in vivo, allow early detection of disease, assist in patient management and therapeutic. The European Association of Nuclear Medicine (EANM) has developed guidelines on paediatric activity dosing since the late 1990s leading to the publication of the first versions of the EANM paediatric dosage card in 2007 [4, 5]. In 2014, an effort to harmonize the EANM dosage card and the NACG resulted in new published versions of each [7]. The NACG were amended around this same time [9]
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