SNM and SPR approve new North American Guidelines for Radiopharmaceutical Doses for Children

The Society of Nuclear Medicine (SNM) and the Society for Pediatric Radiology's Board of Directors recently approved new North American Guidelines for Radiopharmaceutical Doses for Children. These societies have expanded their pediatric radiation protection initiative by standardizing doses (based on body weight) for 11 nuclear medicine procedures commonly performed in children. The Alliance for Radiation Safety in Pediatric Imaging has collaborated in this effort, and will support efforts to promote the new, lower radiopharmaceutical doses.

"Children may be more sensitive to radiation from medical imaging scans than adults. A radiopharmaceutical dose which is too low may risk poor diagnostic image quality. Doses too high may expose the child to unnecessary radiation exposure without benefit," said S. Ted Treves, MD, strategy leader of the Image Gently- Nuclear Medicine Initiative, Chief of Nuclear Medicine and Molecular Imaging at Children's Hospital Boston and Professor of Radiology at Harvard Medical School. Dr. Treves; Michael J. Gelfand, MD; and Marguerite T. Parisi, MD. MS, are co-chairs of the workgroup of 20 pediatric nuclear medicine professionals that worked together to reach these consensus guidelines.

"It is important that we standardize dose to help ensure that all pediatric nuclear medicine professionals consistently optimize medical images while only using the minimum amount of radiation necessary to obtain these images," said Treves. "These latest SNM and Image Gently efforts are a major step forward toward dose reduction in pediatric nuclear medicine."

The new guidelines are available on the SNM (www.snm.org), SPR (www.pedrad.org) and Image Gently (www.imagegently.org) websites.

A companion Image Gently- publication, "What You Should Know About Pediatric Nuclear Medicine and Radiation Safety," can help families gain a better understanding of the complex factors involved in providing safe, effective nuclear medicine exams to children. The Image Gently campaign encourages pediatric nuclear medicine specialists to download the new brochure from the Image Gently- website (www.imagegently.org) and make it available to parents in waiting rooms and offices. This brochure will be a part of a dedicated section of the website, now under construction, that will offer parents the latest information on pediatric imaging so they can better understand the benefits and concerns associated with nuclear medicine.

"We pediatric nuclear medicine practitioners are working together to standardize radiopharmaceutical doses so that physicians who do not work with children on a day-to-day basis will have an accessible resource that will aid them in dose reduction," said Michael J. Gelfand, MD, past-president of SNM and Chief of Nuclear Medicine at Cincinnati Children's Hospital. "This dose reduction effort reflects our commitment toward maximizing the benefits and minimizing possible risks to our patients."

"The Image Gently nuclear medicine brochure is a tremendous resource to parents about radiation risk and safety. A group of pediatric physicians in pediatric nuclear medicine from the Society for Pediatric Radiology and the SNM collaborated to ensure it emphasizes the importance of not only lowering dose, but lowering it effectively and tailoring it to each patient," said Marguerite T. Parisi, MD, MS, Chair of the Society for Pediatric Radiology Committee on Nuclear Medicine and Chief of PET/CT and Ultrasound at Seattle Children's Hospital.

Since its inception, the Image Gently- campaign has had one central message: As children may be more sensitive to radiation received from medical imaging than adults, the Alliance urges radiologists and nuclear medicine physicians who perform imaging exams on children to:

• "Child-size" the amount of radiopharmaceutical used by following the new guidelines
• Individualize doses and technique based on the specific clinical task
• Involve your physicist to review your adult and pediatric nuclear medicine protocols
• Work collaboratively with technologists to implement changes
• Familiarize yourself with recommended administered activities

"This is a great accomplishment. SNM Practice Guidelines are in the process of being updated and the new SNM guidelines will incorporate the doses recommended in the North American Guidelines for Radiopharmaceutical Dose for Children," said Dominique Delbeke, MD, PhD, SNM President and Director of Nuclear Medicine and Director of Positron Emission Tomography at Vanderbilt University Medical Center, in Nashville, TN.