A third of the radiotracer dose: two decades of progress in pediatric [

Pediatrics Positron emission tomography Radiation dose Radioactive tracers [18F]fluorodeoxyglucose

Journal

European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774

Informations de publication

Date de publication:
19 Oct 2023
Historique:
received: 14 04 2023
accepted: 18 08 2023
revised: 11 08 2023
pubmed: 19 10 2023
medline: 19 10 2023
entrez: 19 10 2023
Statut: aheadofprint

Résumé

To assess the evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between years 2000 and 2021. Pediatric patients (≤ 16 years) referred for 18F-FDG PET/CT or PET/MR imaging of the body during 2000 and 2021 were retrospectively included. The amount of administered radiotracer activity in megabecquerel (MBq) was recorded, and signal-to-noise ratio (SNR) was measured in the right liver lobe with a 4 cm Two hundred forty-three children and adolescents underwent a total of 466 examinations. The median injected 18F-FDG activity in MBq decreased significantly from 296 MBq in 2000-2005 to 100 MBq in 2016-2021 (p < 0.001), equaling approximately one-third of the initial amount. The median SNR ratio was stable during all years with 11.7 (interquartile range [IQR] 10.7-12.9, p = 0.133). Children have benefited from a massive reduction in the administered 18F-FDG dose over the past 20 years without compromising objective image quality. Radiotracer dose was reduced considerably over the past two decades of pediatric F-18-fluorodeoxyglucose PET/CT and PET/MR imaging highlighting the success of technical innovations in pediatric PET imaging. • The evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between 2000 and 2021 was assessed. • The injected tracer activity decreased by 66% during the study period from 296 megabecquerel (MBq) to 100 MBq (p < 0.001). • The continuous implementation of technical innovations in pediatric hybrid 18F-FDG PET has led to a steady decrease in the amount of applied radiotracer, which is particularly beneficial for children who are more sensitive to radiation.

Identifiants

pubmed: 37855853
doi: 10.1007/s00330-023-10319-6
pii: 10.1007/s00330-023-10319-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2023. The Author(s).

Références

Freebody J, Wegner EA, Rossleigh MA (2014) 2-Deoxy-2-((18)F)fluoro-D-glucose positron emission tomography/computed tomography imaging in paediatric oncology. World J Radiol 6:741–755
doi: 10.4329/wjr.v6.i10.741
Harrison DJ, Parisi MT, Shulkin BL (2017) The role of (18)F-FDG-PET/CT in pediatric sarcoma. Semin Nucl Med 47:229–241
doi: 10.1053/j.semnuclmed.2016.12.004
Kluge R, Kurch L, Georgi T, Metzger M (2017) Current role of FDG-PET in pediatric Hodgkin’s lymphoma. Semin Nucl Med 47:242–257
doi: 10.1053/j.semnuclmed.2017.01.001
Uslu L, Donig J, Link M, Rosenberg J, Quon A, Daldrup-Link HE (2015) Value of 18F-FDG PET and PET/CT for evaluation of pediatric malignancies. J Nucl Med 56:274–286
doi: 10.2967/jnumed.114.146290
Gungor T, Engel-Bicik I, Eich G et al (2001) Diagnostic and therapeutic impact of whole body positron emission tomography using fluorine-18-fluoro-2-deoxy-D-glucose in children with chronic granulomatous disease. Arch Dis Child 85:341–345
doi: 10.1136/adc.85.4.341
Garg G, DaSilva R, Bhalakia A, Milstein DM (2016) Utility of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in a child with chronic granulomatous disease. Indian J Nucl Med 31:62–64
doi: 10.4103/0972-3919.172366
Theobald I, Fischbach R, Hulskamp G et al (2002) Pulmonary aspergillosis as initial manifestation of septic granulomatosis (chronic granulomatous disease, CGD) in a premature monozygotic female twin and FDG-PET diagnosis of spread of the disease. Radiologe 42:42–45
doi: 10.1007/s117-002-8116-0
Meller J, Sahlmann CO, Scheel AK (2007) 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med 48:35–45
Baum SH, Fruhwald M, Rahbar K, Wessling J, Schober O, Weckesser M (2011) Contribution of PET/CT to prediction of outcome in children and young adults with rhabdomyosarcoma. J Nucl Med 52:1535–1540
doi: 10.2967/jnumed.110.082511
Ricard F, Cimarelli S, Deshayes E, Mognetti T, Thiesse P, Giammarile F (2011) Additional benefit of F-18 FDG PET/CT in the staging and follow-up of pediatric rhabdomyosarcoma. Clin Nucl Med 36:672–677
doi: 10.1097/RLU.0b013e318217ae2e
London K, Stege C, Cross S et al (2012) 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors. Pediatr Radiol 42:418–430
doi: 10.1007/s00247-011-2278-x
Boktor RR, Omar WS, Mousa E et al (2012) A preliminary report on the impact of (1)(8)F-FDG PET/CT in the management of paediatric head and neck cancer. Nucl Med Commun 33:21–28
doi: 10.1097/MNM.0b013e32834c3ebe
Halalsheh H, Kaste SC, Navid F et al (2018) The role of routine imaging in pediatric cutaneous melanoma. Pediatr Blood Cancer 65:e27412
doi: 10.1002/pbc.27412
Daldrup-Link HE, Theruvath AJ, Baratto L, Hawk KE (2021) One-stop local and whole-body staging of children with cancer. Pediatr Radiol. https://doi.org/10.1007/s00247-021-05076-x
doi: 10.1007/s00247-021-05076-x
Biassoni L, Easty M (2017) Paediatric nuclear medicine imaging. Br Med Bull 123:127–148
doi: 10.1093/bmb/ldx025
Cheng G, Servaes S, Zhuang H (2013) Value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scan versus diagnostic contrast computed tomography in initial staging of pediatric patients with lymphoma. Leuk Lymphoma 54:737–742
doi: 10.3109/10428194.2012.727416
Jadvar H, Connolly LP, Fahey FH, Shulkin BL (2007) PET and PET/CT in pediatric oncology. Semin Nucl Med 37:316–331
doi: 10.1053/j.semnuclmed.2007.04.001
London K, Cross S, Onikul E, Dalla-Pozza L, Howman-Giles R (2011) 18F-FDG PET/CT in paediatric lymphoma: comparison with conventional imaging. Eur J Nucl Med Mol Imaging 38:274–284
doi: 10.1007/s00259-010-1619-6
Colleran GC, Kwatra N, Oberg L et al (2017) How we read pediatric PET/CT: indications and strategies for image acquisition, interpretation and reporting. Cancer Imaging 17:28
doi: 10.1186/s40644-017-0130-8
Foucault A, Ancelet S, Dreuil S et al (2022) Childhood cancer risks estimates following CT scans: an update of the French CT cohort study. Eur Radiol 32:5491–5498
doi: 10.1007/s00330-022-08602-z
Kutanzi KR, Lumen A, Koturbash I, Miousse IR (2016) Pediatric exposures to ionizing radiation: carcinogenic considerations. Int J Environ Res Public Health 13(11):1057. https://doi.org/10.3390/ijerph13111057
Mathews JD, Forsythe AV, Brady Z et al (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:f2360
doi: 10.1136/bmj.f2360
Nikkila A, Raitanen J, Lohi O, Auvinen A (2018) Radiation exposure from computerized tomography and risk of childhood leukemia: Finnish register-based case-control study of childhood leukemia (FRECCLE). Haematologica 103:1873–1880
doi: 10.3324/haematol.2018.187716
Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505
doi: 10.1016/S0140-6736(12)60815-0
Chawla SC, Federman N, Zhang D et al (2010) Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review. Pediatr Radiol 40:681–686
doi: 10.1007/s00247-009-1434-z
Nievelstein RA, Quarles van Ufford HM, Kwee TC et al (2012) Radiation exposure and mortality risk from CT and PET imaging of patients with malignant lymphoma. Eur Radiol 22:1946–1954
doi: 10.1007/s00330-012-2447-9
Schafer JF, Gatidis S, Schmidt H et al (2014) Simultaneous whole-body PET/MR imaging in comparison to PET/CT in pediatric oncology: initial results. Radiology 273:220–231
doi: 10.1148/radiol.14131732
Gatidis S, Schmidt H, Gucke B et al (2016) Comprehensive oncologic imaging in infants and preschool children with substantially reduced radiation exposure using combined simultaneous (1)(8)F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging: a direct comparison to (1)(8)F-fluorodeoxyglucose positron emission tomography/computed tomography. Invest Radiol 51:7–14
doi: 10.1097/RLI.0000000000000200
Gatidis S, Bender B, Reimold M, Schafer JF (2017) PET/MRI in children. Eur J Radiol 94:A64–A70
doi: 10.1016/j.ejrad.2017.01.018
Treves ST, Gelfand MJ, Fahey FH, Parisi MT (2016) 2016 Update of the North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities. J Nucl Med 57:15N-18N
Lassmann M, Treves ST (2014) Pediatric Radiopharmaceutical Administration: harmonization of the 2007 EANM Paediatric Dosage Card (Version 1.5.2008) and the 2010 North American Consensus guideline. Eur J Nucl Med Mol Imaging 41:1636
doi: 10.1007/s00259-014-2817-4
Sah BR, Stolzmann P, Delso G et al (2017) Clinical evaluation of a block sequential regularized expectation maximization reconstruction algorithm in 18F-FDG PET/CT studies. Nucl Med Commun 38:57–66
doi: 10.1097/MNM.0000000000000604
Vandenberghe S, D’Asseler Y, Van de Walle R et al (2001) Iterative reconstruction algorithms in nuclear medicine. Comput Med Imaging Graph 25:105–111
doi: 10.1016/S0895-6111(00)00060-4
Riddell C, Carson RE, Carrasquillo JA et al (2001) Noise reduction in oncology FDG PET images by iterative reconstruction: a quantitative assessment. J Nucl Med 42:1316–1323
Gong K, Kim K, Cui J, Wu D, Li Q (2021) The evolution of image reconstruction in PET: from filtered back-projection to artificial intelligence. PET Clin 16:533–542
doi: 10.1016/j.cpet.2021.06.004
(2021) R: A language and environment for statistical computing. Vienna, Austria. Version 4.1.1, https://www.rproject.org
Brenner DJ, Doll R, Goodhead DT et al (2003) Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A 100:13761–13766
doi: 10.1073/pnas.2235592100
Lassmann M, Biassoni L, Monsieurs M et al (2007) The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 34:796–798
doi: 10.1007/s00259-007-0370-0
Lassmann M, Biassoni L, Monsieurs M et al (2008) The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 35:1748
doi: 10.1007/s00259-007-0572-5
Marcassa C, Zoccarato O, Calza P, Campini R (2013) Temporal evolution of administered activity in cardiac gated SPECT and patients’ effective dose: analysis of an historical series. Eur J Nucl Med Mol Imaging 40:325–330
doi: 10.1007/s00259-012-2287-5
Cox CPW, van Assema DME, Verburg FA, Brabander T, Konijnenberg M, Segbers M (2021) A dedicated paediatric [(18)F]FDG PET/CT dosage regimen. EJNMMI Res 11:65
doi: 10.1186/s13550-021-00812-8
Jones T, Townsend D (2017) History and future technical innovation in positron emission tomography. J Med Imaging (Bellingham) 4:011013
doi: 10.1117/1.JMI.4.1.011013
Nardo L, Schmall JP, Werner TJ, Malogolowkin M, Badawi RD, Alavi A (2020) Potential roles of total-body PET/computed tomography in pediatric imaging. PET Clin 15:271–279
doi: 10.1016/j.cpet.2020.03.009

Auteurs

Stephan Waelti (S)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland.

Stephan Skawran (S)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Thomas Sartoretti (T)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Moritz Schwyzer (M)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Antonio G Gennari (AG)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Cäcilia Mader (C)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Valerie Treyer (V)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Christian J Kellenberger (CJ)

University of Zurich, Zurich, Switzerland.
Department of Diagnostic Imaging, University Children's Hospital Zurich, Zurich, Switzerland.

Irene A Burger (IA)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland.

Thomas Hany (T)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
MRI Bahnhofplatz, Zurich, Switzerland.

Alexander Maurer (A)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Martin W Huellner (MW)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Michael Messerli (M)

Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland. michael.messerli@usz.ch.
University of Zurich, Zurich, Switzerland. michael.messerli@usz.ch.

Classifications MeSH