Operational and Dosimetric Aspects of Pediatric PET/CT

• Published in: Journal of Nuclear Medicine Vol. 58; no. 9; pp. 1360 - 1366
• Main Authors: Fahey, Frederic H., Goodkind, Alison, MacDougall, Robert D., Oberg, Leah, Ziniel, Sonja I., Cappock, Richard, Callahan, Michael J., Kwatra, Neha, Treves, S. Ted, Voss, Stephan D.
• Format: Journal Article
• Language: English
• Published: United States Society of Nuclear Medicine 01.09.2017
• Subjects: Child; Children; Computed tomography; Continuing Education; Current modulation; Diagnostic systems; Dosimeters; Dosimetry; Field of view; Guidelines; Hospitals; Humans; Image Processing, Computer-Assisted; Image quality; Ionizing radiation; Medical imaging; Pediatrics; Positron emission; Positron Emission Tomography Computed Tomography - methods; Radiation dosage; Radiation effects; Radiometry - methods; Reduction; Risk exposure; Standardization; Surveys and Questionnaires; Tomography; computed tomography; dosimetry; PET/CT; pediatric
• ISSN: 0161-5505; 1535-5667; 2159-662X; 1535-5667
• DOI: 10.2967/jnumed.116.182899

No consistent guidelines exist for the acquisition of a CT scan as part of pediatric PET/CT. Given that children may be more vulnerable to the effects of ionizing radiation, it is necessary to develop methods that provide diagnostic-quality imaging when needed, in the shortest time and with the lowest patient radiation exposure. This article describes the basics of CT dosimetry and PET/CT acquisition in children. We describe the variability in pediatric PET/CT techniques, based on a survey of 19 PET/CT pediatric institutions in North America. The results of the survey demonstrated that, although most institutions used automatic tube current modulation, there remained a large variation of practice, on the order of a factor of 2-3, across sites, pointing to the need for guidelines. We introduce the approach developed at our institution for using a multiseries PET/CT acquisition technique that combines diagnostic-quality CT in the essential portion of the field of view and a low-dose technique to image the remainder of the body. This approach leads to a reduction in radiation dose to the patient while combining the PET and the diagnostic CT into a single acquisition. The standardization of pediatric PET/CT provides an opportunity for a reduction in the radiation dose to these patients while maintaining an appropriate level of diagnostic image quality.