Japanese consensus guidelines for pediatric nuclear medicine

Koizumi, Kiyoshi; Masaki, Hidekazu; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kono, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

doi:10.1007/s12149-014-0826-9

Cited by 42 publications

(29 citation statements)

References 9 publications

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“… For radiopharmaceuticals, we asked each facility to enter the median actual administered activity of radioisotope (RI) for each nuclear medicine examination conducted for standard-size patients. This survey was conducted for adults only; for children aged ≤ 15 years, the consensus guidelines for pediatric nuclear medicine in Japan were developed by the JSNM in 2014 [ 11 ]. For the radiation doses of hybrid CT of SPECT/CT or PET/CT, we asked each facility to enter the median CTDIvol and DLP values for each nuclear medicine examination conducted for standard-size adults.…”

Section: How the New Drls Were Determinedmentioning

confidence: 99%

The 2020 national diagnostic reference levels for nuclear medicine in Japan

et al. 2020

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The diagnostic reference levels (DRLs) are one of several effective tools for optimizing nuclear medicine examinations and reducing patient exposure. With the advances in imaging technology and alterations of examination protocols, the DRLs must be reviewed periodically. The first DRLs in Japan were established in 2015, and since 5 years have passed, it is time to review and revise the DRLs. We conducted a survey to investigate the administered activities of radiopharmaceuticals and the radiation doses of computed tomography (CT) in hybrid CT accompanied by single photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. We distributed a Web-based survey to 915 nuclear medicine facilities throughout Japan and survey responses were provided by 256 nuclear medicine facilities (response rate 28%). We asked for the facility's median actual administered activity and median radiation dose of hybrid CT when SPECT/CT or PET/CT was performed for patients with standard habitus in the standard protocol of the facility for each nuclear medicine examination. We determined the new DRLs based on the 75th percentile referring to the 2015 DRLs, drug package inserts, and updated guidelines. The 2020 DRLs are almost the same as the 2015 DRLs, but for the relatively long-lived radionuclides, the DRLs are set low due to the changes in the Japanese delivery system. There are no items set higher than the previous values. Although the DRLs determined this time are roughly equivalent to the DRLs used in the US, overall they tend to be higher than the European DRLs. The DRLs of the radiation dose of CT in hybrid CT vary widely depending on each imaging site and the purpose of the examination.

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Section: How the New Drls Were Determinedmentioning

confidence: 99%

The 2020 national diagnostic reference levels for nuclear medicine in Japan

et al. 2020

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“…Concerning pediatric nuclear medicine, the European Association of Nuclear Medicine (EANM) dosage card has been proposed and developed by the Pediatric Task Group EANM in Europe [ 18 – 21 ] and consensus guidelines have been proposed and developed by the Society of Nuclear Medicine and Molecular Imaging (SNMMI) in North America [ 22 – 26 ]. In 2014, the Japanese consensus guidelines for pediatric nuclear medicine were provided by JSNM in Japan [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Report of a nationwide survey on actual administered radioactivities of radiopharmaceuticals for diagnostic reference levels in Japan

et al. 2016

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ObjectiveThe optimization of medical exposure is one of the major issues regarding radiation protection in the world, and The International Committee of Radiological Protection and the International Atomic Energy Agency recommend establishing diagnostic reference levels (DRLs) as tools for dose optimization. Therefore, the development of DRLs based on the latest survey has been required for nuclear medicine-related societies and organizations. This prompted us to conduct a nationwide survey on the actual administered radioactivity to adults for the purpose of developing DRLs in nuclear medicine.MethodsA nationwide survey was conducted from November 25, 2014 to January 16, 2015. The questionnaire was sent to all of the 1249 nuclear medicine facilities in Japan, and the responses were collected on a website using an answered form.ResultsResponses were obtained from 516 facilities, for a response rate of 41 %. 75th percentile of 99mTc-MDP and 99mTc-HMDP: bone scintigraphy, 99mTc-HM-PAO, 99mTc-ECD and 123I-IMP: cerebral blood flow scintigraphy, 99mTc-Tetrofosmin, 99mTc-MIBI and 201Tl-Cl; myocardial perfusion scintigraphy and 18F-FDG: oncology PET (in-house-produced or delivery) in representative diagnostic nuclear medicine scans were 932, 937, 763, 775, 200, 831, 818, 180, 235 and 252, respectively. More than 90 % of the facilities were within the range of 50 % from the median of these survey results in representative diagnostic nuclear medicine facilities in Japan. Responses of the administered radioactivities recommended by the package insert, texts and guidelines such as 740 MBq (99mTc-MDP and 99mTc-HMDP: bone scintigraphy), 740 MBq (99mTc-ECD and 99mTc-HM-PAO: cerebral blood flow scintigraphy) and 740 MBq (99mTc-Tetrofosmin and 99mTc-MIBI: myocardial perfusion scintigraphy), etc. were numerous. The administered activity of many radiopharmaceuticals of bone scintigraphy (99mTc-MDP and 99mTc-HMDP), cerebral blood flow scintigraphy (99mTc-HM-PAO) and myocardial perfusion scintigraphy (99mTc-Tetrofosmin and 99mTc-MIBI), etc. were within the range of the EU DRLs and almost none of the administered radioactivity in Japan exceeded the upper limit of SNMMI standard administered radioactivity.ConclusionsThis survey indicated that the administered radioactivity in diagnostic nuclear medicine in Japan had been in the convergence zone and nuclear medicine facilities in Japan show a strong tendency to adhere to the texts and guidelines. Furthermore, the administered radioactivities in Japan were within the range of variation of the EU and the SNMMI administered radioactivities.

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“…Injected doses of 123 I-IMP ranged from 58.3 to 187.9 MBq PLOS ONE [13]. As per the Japanese consensus guidelines for pediatric nuclear medicine, potassium iodide was administered for 4 days to avoid thyroid uptake 2 days before 123 I-IMP CBF SPECT [14].…”

Section: Patient Characteristicsmentioning

confidence: 99%

Investigation of the new non-invasive semi-quantitative method of 123I-IMP pediatric cerebral perfusion SPECT

et al. 2020

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In pediatric cases requiring quantification of cerebral blood flow (CBF) using 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) single-photon emission computed tomography (SPECT), arterial blood sampling is sometimes impossible due to issues such as movement, crying, or body motion. If arterial blood sampling fails, quantitative diagnostic assessment becomes impossible despite radiation exposure. We devised a new easy non-invasive microsphere (e-NIMS) method using whole-body scan data. This method can be used in conjunction with autoradiography (ARG) and can provide supportive data for invasive CBF quantification. In this study, we examined the usefulness of e-NIMS for pediatric cerebral perfusion semi-quantitative SPECT and compared it with the invasive ARG. The e-NIMS estimates cardiac output (CO) using whole-body acquisition data after 123I-IMP injection and the body surface area from calculation formula. A whole-body scan was performed 5 minutes after the 123I-IMP injection and CO was estimated by region of interest (ROI) counts measured for the whole body, lungs, and brain using the whole-body anterior image. The mean CBF (mCBF) was compared with that acquired via ARG in 115 pediatric patients with suspected cerebrovascular disorders (age 0–15 years). Although the mCBF estimated by the e-NIMS indicated a slight deviation in the extremely low- or high-mCBF cases when compared with the values acquired using the invasive ARG, there was a good correlation between the two methods (r = 0.799; p < 0.001). There were no significant differences in the mCBF values based on physical features, such as patients’ height, weight, and age. Our findings suggest that 123I-IMP brain perfusion SPECT with e-NIMS is the simplest semi-quantitative method that can provide supportive data for invasive CBF quantification. This method may be useful, especially in pediatric brain perfusion SPECT, when blood sampling or identifying pulmonary arteries for CO estimation using the graph plot method is difficult.

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Japanese consensus guidelines for pediatric nuclear medicine

Cited by 42 publications

References 9 publications

The 2020 national diagnostic reference levels for nuclear medicine in Japan

The 2020 national diagnostic reference levels for nuclear medicine in Japan

Report of a nationwide survey on actual administered radioactivities of radiopharmaceuticals for diagnostic reference levels in Japan

Investigation of the new non-invasive semi-quantitative method of 123I-IMP pediatric cerebral perfusion SPECT

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