Generic placeholder image

Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Research Article

Administered Pediatric Radiopharmaceutical Doses at a Tertiary Hospital in South Africa: A Comparison with Corresponding Activities Based on North American Consensus Guidelines and Administration of Radioactive Substances Advisory Committee Guidelines

Author(s): Mpumelelo Nyathi*

Volume 14, Issue 2, 2021

Published on: 14 August, 2020

Page: [107 - 111] Pages: 5

DOI: 10.2174/1874471013666200814141713

open access plus

Abstract

Background: Diagnostic nuclear medicine reveals physiological processes in vivo, facilitating early detection of disease prior to anatomical changes. However, in pediatric studies, the selection of appropriate dosing guidelines is challenging. Administration of Radioactive Substances Advisory Committee (ARSAC) and North American Consensus (NAC) guidelines are extensively used.

Objective: To determine appropriate pediatric dosing guideline for a South African Tertiary Hospital (SATH).

Methods: A combination of retrospective and empirical studies was conducted. Age, weight, name of the nuclear medicine study and administered activities were extracted from archived pediatric patients’ files in a SATH who were attended from 2012-2015. To increase the sample size when calculating would be administered activities based on ARSAC and NAC guidelines, weights for sixty pediatric patients (empirical data) from the commonly conducted nuclear medicine studies were used.

Results: The most commonly performed nuclear medicine studies at a SATH were bone scans, 99mTc-HIDA scans, renal scans, thyroid scans, MIBG scans and gastroesophageal reflux scans. The mean pediatric administered radiopharmaceutical activities based on SATH, ARSAC and NAC guidelines were; bone scans (57.7, 15.2 and 10.0 MBq/kg), 99mTc-HIDA scans (13.7, 5.0 and 3.6 MBq/kg), renal scans (13.9, 3.4 and 7.8 MBq/kg), thyroid scans (7.0, 2.6 and 1.5 MBq/kg), MIBG scans (15.5, 15.1 and 7.7 MBq/kg) and gastroesophageal reflux scans (2.1, 1.9 and 1.7 MBq/kg). High variability of Administered Radiopharmaceutical Activities (ARAs) was observed for SATH guidelines compared to ARSAC and NAC guidelines.

Conclusion: NAC guidelines are recommended for dosing pediatric patients at SATH. These guidelines will certainly reduce pediatric doses, which are currently high.

Keywords: Nuclear medicine studies, pediatric patients, radiopharmaceutical activities, pediatric dosing guidelines, retrospective study.

Graphical Abstract
[1]
Koizumi, K.; Masaki, H.; Mastudi, H.; Uchiyama, K.M.; Okuno, M.; Oguma, E.; Onuma, H.; Kanegawa, K.; Kanaya, S.; Kamiyama, H.; Karasawa, K.; Kitamura, M.; Kida, T.; Kono, T.; Kondo, C.; Sasaki, M.; Terada, H.; Nakanishi, A.; Hashimoto, T.; Hataya, H.; Hamano, S.; Hirono, K.; Fujita, Y.; Hoshino, Y.K.; Masayuki Yano, M.; Watanabe, S. Japanese Consensus guidelines for paediatric nuclear medicine. Part 1. Paediatric radiopharmaceutical administered doses (JSNM paediatric dose card). Ann. Nucl. Med., 2014, 28, 498-503.
[http://dx.doi.org/10.1007/s12149-014-0826-9] [PMID: 24647992]
[2]
Fahey, F.H.; Goodkind, A.B.; Plyku, D.; Khamwan, K.; O’Reilly, S.E.; Cao, X.; Frey, E.C.; Li, Y.; Bolch, W.E.; Sgouros, G.; Treves, S.T. Dose Estimation in Pediatric Nuclear Medicine. Semin. Nucl. Med., 2017, 47(2), 118-125.
[http://dx.doi.org/10.1053/j.semnuclmed.2016.10.006] [PMID: 28237000]
[3]
National Research Council. Health Risks to low levels of ionizing radiation: BEIR VII Phase 2; The National Academies: Washington, DC, 2006.
[4]
Treves, S.T.; Davis, R.T.; Fahey, F.H. Administered radiopharmaceutical doses in children: a survey of 13 pediatric hospitals in North America. J. Nucl. Med., 2008, 49(6), 1024-1027.
[http://dx.doi.org/10.2967/jnumed.107.049908] [PMID: 18483096]
[5]
Support Unit, A.R.S.A.C. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources., 2018.https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/694951/ARSAC_notes_for_guidance.pdf.4
[6]
Gelfand, M.J.; Parisi, M.T.; Treves, S.T. Pediatric Nuclear Medicine Dose Reduction Workgroup. Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J. Nucl. Med., 2011, 52(2), 318-322.
[http://dx.doi.org/10.2967/jnumed.110.084327] [PMID: 21233182]
[7]
Treves, S.T.; Grant, F.D. General aspects of pediatric nuclear medicine. Pediatric Nuclear medicine /Pet, 4th ed; Springer: New York, NY, 2014.
[8]
Treves, S.T.; Gelfand, M.J.; Fahey, F.H.; Parisi, M.T. 2016 update of the North American Consensus guidelines for paediatric administered radiopharmaceuticals activities. J. Nucl. Med., 2016, 57(12), 15N-18N.
[PMID: 27909182]
[9]
Rzeszotarski, M.S. The AAPM/RSNA Physics tutorial for Residents. Radiographics, 1999, 19, 765-782.
[http://dx.doi.org/10.1148/radiographics.19.3.g99ma33765] [PMID: 10336202]
[10]
Fahey, F.H.; Goodkind, A.; Treves, S.T.; Frederick, D. Nuclear Medicine and Radiation Protection. J. Radiol. Nurs., 2016, 35, 5-11.
[http://dx.doi.org/10.1016/j.jradnu.2015.12.005]
[11]
Grant, F.D.; Gelfand, M.J.; Drubach, L.A.; Treves, S.T.; Fahey, F.H. Radiation doses for pediatric nuclear medicine studies: comparing the North American consensus guidelines and the pediatric dosage card of the European Association of Nuclear Medicine. Pediatr. Radiol., 2015, 45(5), 706-713.
[http://dx.doi.org/10.1007/s00247-014-3211-x] [PMID: 25367355]
[12]
Treves, S.T.; Falone, A.E.; Fahey, F.H. Pediatric nuclear medicine and radiation dose. Semin. Nucl. Med., 2014, 44(3), 202-209.
[http://dx.doi.org/10.1053/j.semnuclmed.2014.03.009] [PMID: 24832585]
[13]
Civelek, A.C. Patient safety and privacy in the electronic health information era: medical and beyond. Clin. Biochem., 2009, 42(4-5), 298-299.
[http://dx.doi.org/10.1016/j.clinbiochem.2008.09.018] [PMID: 19863928]

© 2024 Bentham Science Publishers | Privacy Policy