Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy

Fahey, Frederic H.; Zukotynski, Katherine; Zurakowski, David; Markelewicz, Robert J.; Falone, Anthony E.; Vitello, Marie; Cao, Xinhua; Grant, Frederick D.; Drubach, Laura A.; Vija, A. Hans; Bhattacharya, M.; Ding, Xinhong; Bar-Sever, Zvi; Gelfand, Michael J.; Treves, S. Ted

doi:10.1007/s00259-014-2860-1

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…They insisted on treatment strategy used for other functional disorder rather than surgical approach, but the use of hepatobiliary scintigraphy is particularly of concern as it involves administration of radiopharmaceuticals to very young patients, infants, and neonates, who are at high potential risk of detrimental effects from ionizing radiation [30]. In our hospital, hepatobiliary scintigraphy in pediatric patients is not utilized frequently.…”

Section: Discussionmentioning

confidence: 99%

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

Han

Youn

et al. 2016

J Korean Assoc Pediatr Surg

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Purpose: Number of pediatric cholecystectomy has been recently showing a gradually increasing trend. The purpose of this study was to investigate the clinical features of patients who underwent pediatric cholecystectomy, and the latest trend in cholecystectomy. Methods: In the present study, we conducted a retrospective chart review on 47 patients who had undergone cholecystectomy at a single center. The entire patient population was divided into two groups, according to the time of cholecystectomy (early group, January 1999 to December 2006; late group, January 2007 to August 2014). Results:The comparison between the early and late groups showed that the number of cholecystectomy increased from 13 to 34 cases representing a 2.6-fold increase. The mean patient age also increased from 5.94±4.08 years to 10.51±5.57 years (p=0.01). Meanwhile, laparoscopic surgery also increased from 15.4% to 79.4%, respectively (p＜0.001). However, sex, mean body mass index, comorbidities, indications of cholecystectomy, and previous total parenteral nutrition were not statistically significant. Conclusion:The results of this study showed that pediatric cholecystectomy cases are increasing, particularly in the 10 to 19 years age group and laparoscopic cholecystectomies are also being performed at an increasing rate. When the patients were compared according to the time of cholecystectomy, there were no differences in other risk factors or indications for cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

Han

Youn

et al. 2016

J Korean Assoc Pediatr Surg

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“…We have been involved in several investigations including dose optimization projects in children involving 99m Tc DMSA SPECT, 99m Tc MDP SPECT, 99m Tc MAG3 renal scans and 99m Tc IDA hepatobiliary scans. 30–33 In this regard, it may be helpful if this judgment is made by the observer in the context of rendering an interpretation that the referring physician will find useful. Alternatively, the image quality could be characterized by an observer performance study using either a model observer such as the Channelized Hotelling Observer model or a collection of trained human observers.…”

Section: Dose Optimizationmentioning

confidence: 99%

Dose Estimation in Pediatric Nuclear Medicine

Fahey

Goodkind

Plyku

et al. 2017

Seminars in Nuclear Medicine

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The practice of nuclear medicine in children is well established for imaging practically all physiologic systems but particularly in the fields of oncology, neurology, urology, and orthopedics. Pediatric nuclear medicine yields images of physiologic and molecular processes that can provide essential diagnostic information to the clinician. However, nuclear medicine involves the administration of radiopharmaceuticals that expose the patient to ionizing radiation and children are thought to be at a higher risk for adverse effects from radiation exposure than adults. Therefore it may be considered prudent to take extra care to optimize the radiation dose associated with pediatric nuclear medicine. This requires a solid understanding of the dosimetry associated with the administration of radiopharmaceuticals in children. Models for estimating the internal radiation dose from radiopharmaceuticals have been developed by the Medical Internal Radiation Dosimetry Committee of the Society of Nuclear Medicine and Molecular Imaging and other groups. But to use these models accurately in children, better pharmacokinetic data for the radiopharmaceuticals and anatomical models specifically for children need to be developed. The use of CT in the context of hybrid imaging has also increased significantly in the past 15 years, and thus CT dosimetry as it applies to children needs to be better understood. The concept of effective dose has been used to compare different practices involving radiation on a dosimetric level, but this approach may not be appropriate when applied to a population of children of different ages as the radiosensitivity weights utilized in the calculation of effective dose are not specific to children and may vary as a function of age on an organ-by-organ bias. As these gaps in knowledge of dosimetry and radiation risk as they apply to children are filled, more accurate models can be developed that allow for better approaches to dose optimization. In turn, this will lead to an overall improvement in the practice of pediatric nuclear medicine by providing excellent diagnostic image quality at the lowest radiation dose possible.

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A randomized, double-blind, crossover comparison of novel continuous bed motion versus traditional bed position whole-body PET/CT imaging

Schatka

Weiberg

Reichelt

et al. 2015

Eur J Nucl Med Mol Imaging

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Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy

Cited by 7 publications

References 13 publications

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy

Dose Estimation in Pediatric Nuclear Medicine

A randomized, double-blind, crossover comparison of novel continuous bed motion versus traditional bed position whole-body PET/CT imaging

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