Paediatric and Nephrourology: Guidelines
In 2008 the EANM published their paediatric dosage card. In 2011 the North American consensus guidelines recommended a set of administered activities for paediatric nuclear medicine. The purpose of this work was to identify differences between these guidelines and suggest changes in both guidelines to achieve a level of harmonization. In addition, the new version of the EANM paediatric dosage card (version 01.02.2014) is provided. The document has been endorsed by the SNMMI Board.
The present consensus report was written by the INRG Imaging Committee to optimize imaging and staging and reduce interobserver variability. The rationales for using imaging methods (ultrasonography, magnetic resonance imaging, computed tomography, and scintigraphy), as well as technical guidelines, are described. The new INRG Staging System includes two stages of localized disease, which are dependent on whether image-defined risk factors (IDRFs) are or are not present. IDRFs are features detected with imaging at the time of diagnosis.
Guidelines for standard and diuretic renogram in children (2011)
This guideline contains information related to the acquisition, processing, interpretation and indications for standard renography in children. Part of this guideline has been strongly influenced by the consensus report on quality control of quantitative measurements of renal function published by the International Scientific Committee of Radionuclides in Nephrourology, following the meeting in Copenhagen, May 1998, which also reflects the European practice.
The guidelines include information related to the indications, acquisition, processing and interpretation of bone scans in children, focusing primarily on 99mTc-labelled diphosphonate scintigraphy, and also recommendations with regard to the emerging use of PET with 18F-fluoride.
Pediatric Radiopharmaceutical Administered Doses: 2010 North American Consensus Guidelines (2010)
Consensus on pediatric administered radiopharmaceutical doses for 9 commonly used radiopharmaceuticals, in terms of administered activity per kilogram and minimum administered radiopharmaceutical dose for the smallest patients.
ACR-SNMMI-SPR Practice Guideline for Performance of Gastrointestinal Scintigraphy (2010)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians performing gastrointestinal scintigraphy in adult and pediatric patients. Properly performed imaging with radiopharmaceuticals that localize in or are introduced into the gastrointestinal tract or peritoneum is a sensitive means for detecting, evaluating, and quantifying numerous conditions affecting the alimentary tract and peritoneum. As with all scintigraphic studies, correlation of findings with the results of other imaging and nonimaging procedures, as well as clinical information, is necessary to achieve maximum diagnostic yield.
ACR-SNMMI-SPR Practice Guideline for the Performance of Liver and Spleen Scintigraphy (2010)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to assist interpreting physicians performing liver and spleen scintigraphy. Properly performed imaging with radiopharmaceuticals that localize in the reticuloendothelial system or in the blood pool of the liver and spleen can be used to assess certain disorders of the liver and spleen. Imaging of the hepatobiliary system is discussed in the ACR–SPR Practice Guideline for the Performance of Hepatobiliary Scintigraphy. Correlation of findings with clinical information and the results of other imaging modalities is frequently necessary to maximize the diagnostic yield.
ACR-SNMMI-SPR Practice Guideline for the Performance of Scintigraphy for Inflammation or Infection (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians in performing scintigraphy for inflammation and infection. Properly performed imaging with radiopharmaceuticals that localize in inflamed or infected tissue is an effective means of detecting and evaluating many overt or occult infections. Correlation with clinical findings and other imaging modalities is imperative for maximum diagnostic yield. For this guideline, discussion is limited solely to agents that are not organ specific. The reader is referred to the guidelines covering scintigraphy of specific organs (e.g., the ACR Practice Guideline for the Performance of Adult and Pediatric Skeletal Scintigraphy for osteomyelitis and the ACR–SPR Practice Guideline for the Performance of Adult and Pediatric Hepatobiliary Scintigraphy for acute cholecystitis) for a discussion of those organs.
ACR-SNMMI-SPR Practice Guideline for the Performance of Adult and Pediatric Radionuclide Cystography (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians in performing radionuclide cystography (RNC) in adult and pediatric patients. Properly performed imaging of the bladder with radiopharmaceuticals provides a sensitive means of detecting, following, and evaluating certain conditions of the bladder and ureters. As with all scintigraphic studies, correlation of findings with the results of other imaging and nonimaging procedures, as well as clinical information, is necessary for maximum diagnostic yield.
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide physicians performing pulmonary scintigraphy in adult and pediatric patients. Properly performed ventilation imaging with radioaerosol or gaseous radiopharmaceuticals and perfusion imaging with technetium-99m-labeled perfusion agents that localize by temporary capillary blockade are sensitive tools for detecting certain kinds of pulmonary abnormalities. Correlation with clinical data and current chest radiographs is imperative to optimize the interpretation of images.
ACR-SNMMI-SPR Practice Guideline for the Performance of Parathyroid Scintigraphy (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians performing parathyroid scintigraphy in adult and pediatric patients. Additionally, correlation with other radiographic modalities such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest radiography, or with other radionuclide imaging studies may also be helpful.
ACR-SNMMI-SPR Practice Guideline for the Performance of Thyroid Scintigraphy and Uptake Measurements (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians performing thyroid scintigraphy and in-vivo radioiodine thyroid uptake measurements in adult and pediatric patients. Additionally, correlation with other radiographic modalities such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest radiography, or with other radionuclide imaging studies may also be helpful.
SNM Procedure Guideline for Diuretic Renography in Children (2008)
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of diuretic renography in children. Diuretic renography is a safe and valuable method for the evaluation of renal function and differentiation between obstructive and nonobstructive causes of renal or ureteral dilation. The preferred radiotracer, 99mTc-mercaptoacetyltriglycine (99mTc-MAG3), is cleared mainly by tubular secretion. But 99mTc-diethylene triamine pentaacetic acid ( 99mTc-DTPA), a glomerular agent, is also used.
EANM Procedure Guidelines for 99m Tc-DMSA Scintigraphy in Children (2009)
The purpose of this guideline is to offer to the nuclear medicine team a framework that could prove helpful in daily practice. This guideline contains information related to the acquisition, processing, interpretation and indications for 99mTc-DMSA scintigraphy in children. This guideline summarizes the views of the Paediatric Committee of the European Association of Nuclear Medicine.
EANM Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology (2008)
The purpose of these guidelines is to offer to the nuclear medicine team a framework that could prove helpful in daily practice. These guidelines contain information related to the indications, acquisition, processing and interpretation of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in paediatric oncology.
Imaging guidelines are provided for osteosarcoma and Ewing sarcoma (including soft tissue variants) which comprise 90% of pediatric malignant bone tumors. The guidelines are separated into anatomic and functional imaging techniques and presented according to the patient’s treatment status. The supporting narrative is also organized by the patient’s treatment status and provides the rationale supporting these recommendations with specific references to the differences between the Ewing sarcoma and osteosarcoma guidelines, when applicable.
EANM Guidelines for lung scintigraphy in children (2007)
The purpose of this guideline is to offer the nuclear medicine team a helpful framework in daily practice. This guideline deals with the indications, acquisition, processing and interpretation of lung scintigraphy in children.
SNM Procedure Guideline for Renal Cortical Scintigraphy in Children (2003)
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of renal cortical scintigraphy in children. Renal cortical scintigraphy is used for the detection of the cortical defects of acute pyelonephritis and scarring related to chronic pyelonephritis. 99mTc-DMSA and 99mTc-glucoheptonate (GH) are used for this application.
SNM Procedure Guideline for Pediatric Sedation in Nuclear Medicine (2003)
There are several uses of sedation in nuclear medicine. Firstly, some procedures, such as SPECT or high-resolution pinhole imaging, require that the child remain absolutely still for extended periods of time. The second use of sedation is to allow performance of a procedure that requires the cooperation of an older child who refuses to cooperate. Thirdly, patient sedation can enhance patient care by minimizing discomfort. These recommendations provide suggestions on how to use sedation to maximize the quality of imaging procedures while minimizing the risks.
SNM Procedure Guideline for Radionuclide Cystography in Children (2003)
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of radionuclide cystography (RNC) in children. RNC is a method to evaluate for vesicoureteral reflux, which results in significantly less gonadal radiation when compared with conventional radiographic technique (VCUG). 99mTc-pertechnetate is usually used as the instillate.
EANM Procedure Guidelines for Radioiodinated MIBG Scintigraphy in Children (2002)
The purpose of this guideline is to offer to the Nuclear Medicine team a useful framework in daily practice. The present document is influenced by the conclusions of the reunion on "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncologic Committee of the French Society of Nuclear Medicine. This guideline summarises the views of the Paediatric Committee of the European Association of Nuclear Medicine.
EANM Procedure Guidelines for Direct Radionuclide Cystography in Children (2002)
The purpose of this guideline is to offer to the nuclear medicine team a framework, which could prove helpful in daily practice. This guideline contains information related to the indications, acquisition, processing and interpretation of direct radioisotope cystography (DRC) in children.
EANM Procedure Guidelines for Glomerular Filtration Rate Determination in Children (2000)
The purpose of this guideline is to offer to the nuclear medicine team a framework, which could prove helpful in daily practice. This guideline contains information related to the procedure and indications of measurement of glomerular filtration rate using blood samples in children.
EANM Procedure Guidelines for Indirect Cystography (2000)
The purpose of this guideline is to offer to the nuclear medicine team a framework, which could prove helpful in daily practice. This guideline contains information related to the indications, acquisition, processing and interpretation of Indirect Radioisotope Cystography (IRC).
EANM Procedure Guidelines for Standard and Diuretic Renogram in Children (2000)