PANG Chun-lan,GUAN Shao-xiang,YANG Xiao-chun,et al.Clinical Study of Effective Dose for Pediatric Whole-body 18F-FDG PET/CT Examination[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):271-278.
PANG Chun-lan,GUAN Shao-xiang,YANG Xiao-chun,et al.Clinical Study of Effective Dose for Pediatric Whole-body 18F-FDG PET/CT Examination[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):271-278.DOI:
Clinical Study of Effective Dose for Pediatric Whole-body 18F-FDG PET/CT Examination
To evaluate the effective dose (ED) of radiation received by children undergoing whole-body
18
F-FDG PET/CT examination.
Methods
2
We retrospectively reviewed 50 pediatric patients undergoing
18
F-FDG PET/CT examination in the Nuclear Medicine Department of Sun Yat-sen University Cancer Center from July 2019 to April 2020. With automatic exposure control technique, ED of radiation from the whole-body CT scan was calculated by using dose length product (DLP) method as recommended by International Comission on Radiological Protection (ICRP) Publication 102 and ED from
18
F-FDG PET was estimated by means of the model proposed by ICRP Publication 128. The two doses mentioned above were added together to obtain the total ED (
ED
TOTAL
) for
18
F-FDG PET/CT examination. The children were divided into 3 groups based on age: 1~4 years old (
n
=10), 5~9 years old (
n
=25) and 10~13 years old (
n
=15). One way-ANOVA was used to analyze ED from PET (
ED
PET
), ED from whole-body CT (
ED
WBCT
) as well as the sum of
ED
PET
and
ED
WBCT
(
ED
PET+WBCT
) in different age groups. Kruskal-Wallis
H
test was used to compare the
DLP
values of different age groups. The children were then divided into 2 groups based on median height (127.5 cm): taller children (
n
=25) and shorter children (
n
=25); 2 groups based on median body surface area (
BSA
) (0.94 m
2
): larger
BSA
(
n
=27) and smaller
BSA
(
n
=23). Independent sample
t
test was used to analyze whether there were statistically significant differences between
ED
PET+WBCT
of different height groups and between
ED
PET+WBCT
of different
BSA
groups.
P
<0.05 means the difference was statistically significant.
Results
2
ED
TOTAL
for
18
F-FDG PET/CT of all three groups of children was (4.42~14.35) mSv, with an average ED of (9.37±2.21) mSv.
ED
PET
from
18
F-FDG PET was (2.76~6.79) mSv, with an average ED of (4.49±0.96) mSv; the total effective CT dose (
ED
CT
) was (1.66~8.19) mSv, with an average ED of (4.88±1.63) mSv; and
ED
WBCT
was 1.66~6.69 mSv, with an average ED of (3.26±1.05) mSv. The average
DLP
values at different age groups were 135 (115~179) mGy.cm, 224 (183~274) mGy.cm and 252 (199~319) mGy.cm, with statistically significant difference (
H
=17.191,
P
=0.000). The average
DLP
value in the group of 1~4 years old was significantly lower than that in the group of 5~9 years old (
P=
0.006 ) as well as than that in the group of 10~14years old (
P=
0.000). No difference was found in
ED
PET+WBCT
between different height groups (
t
=-0.545
, P
=0.588).
ED
PET+WBCT
for larger and smaller
BSA
groups were (7.25±1.84) mSv and (8.34±1.69) mSv respectively, with statistically significant difference (
t
=-2.191,
P
=0.033).
Conclusion
2
ED for whole body
18
F-FDG PET/CT in children with larger
BSA
was higher. The update of scanning equipment and technology could help reduce ED for whole body
18
F-FDG PET/CT in children.
关键词
Keywords
references
Padma S , Sundaram PS , Tewari A . PET/CT in paediatric malignancies-an update [J]. Indian J Med Paediatr Oncol , 2016 , 37 ( 3 ): 131 .
Sabri A , Wong J . Estimation of effective dose for whole body 18 F-FDG PET/CT examination [C]. J Phys : Conf Ser , 2019 , 1248 : 012006 .
Fahey FH , Goodkind A , Macdougall RD , et al . Operational and dosimetric aspects of pediatric PET/CT [J]. J Nucl Med , 2017 , 58 ( 9 ): 1360 - 1366 .
Li Y , Jiang L , Wang H , et al . Effective radiation dose of 18 F-FDG PET/CT: how much does diagnostic CT contribute? [J]. Radiat Prot Dosimetry , 2019 , 187 ( 2 ): 183 - 190 .
Yue BR , Niu YT . Managing patient dose in multi-detector computed tomography (MDCT) [M]. BeiJing : People's Military Med Press , 2011 .
Mattsson S , Johansson L , Svegborn SL , et al . Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances [J]. Ann ICRP , 2015 , 44 ( S2 ): 7 - 321 .
Niven E , Nahmias C . Absorbed dose to very low birth weight infants from 18 F-fluorodeoxyglucose [J]. Health Phys , 2003 , 84 ( 3 ): 307 - 316 .
Gelfand MJ , Parisi MT , Treves ST . Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines [J]. J Nucl Med , 2011 , 52 ( 2 ): 318 - 322 .
Lassmann M , Biassoni L , Monsieurs M , et al . The new EANM paediatric dosage card [J]. Eur J Nucl Med Mol Imaging , 2007 , 34 ( 5 ): 796 - 798 .
Dhalisa H , Mohamad A , Rafidah Z . Radiation assessment to paediatric with F- 18 -FDG undergo whole-body PET/CT examination [C]. AIP Conf Pro , 2016 , 1704 : 030004 .
Qi Z , Gates EL , O’brien MM , et al . Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma [J]. Pediatr radiol , 2018 , 48 ( 2 ): 196 - 203 .
Hussin D , Said M , Ali N , et al . The effective dose result of 18 F-FDG PET-CT paediatric patients [C]. J Phys : Conf Ser , 2017 , 851 : 012004 .
Wu ZY , Wang H . Evaluation of radiation dose in pediatric whole-body dual-modality 18 F-FDG PET/CT examinations [J]. J Radioimmunol , 2012 , 25 ( 5 ): 494 - 497 .
Quinn B , Dauer Z , Pandit-Taskar N , et al . Radiation dosimetry of 18 F-FDG PET/CT: incorporating exam-specific parameters in dose estimates [J]. BMC med imaging , 2016 , 16 ( 1 ): 41 .
Parisi MT , Bermo MS , Alessio AM , et al . Optimization of pediatric PET/CT [C]. Semin Nucl Med , 2017 , 47 : 258 - 274 .
Inoue Y , Nagahara K , Inoki Y , et al . Clinical evaluation of CT radiation dose in whole-body 18 F-FDG PET/CT in relation to scout imaging direction and arm position [J]. Ann Nucl Med , 2019 , 33 ( 3 ): 169 - 176 .
Wu YT , Geng JH , Du ZM , et al . Study on the effective dose of CT in PET/CT on automatic tube current modulation [J]. Chin J Radiol Health , 2018 , 27 ( 1 ): 39 - 43 .
Bertolini V , Palmieri A , Bassi M , et al . CT protocol optimisation in PET/CT: a systematic review [J]. EJNMMI phys , 2020 , 7 ( 1 ): 1 - 25 .
Chen Y , Yang JG , Zhao FQ , et al . Technical operation criteria and clinical application guidelines for pediatric nuclear medicine [J]. Chin J Med Imaging Technol , 2017 , 33 ( 10 ): 1591 - 1595 .
Lassmann M , Treves ST . Pediatric radiopharmaceutical administration: harmonization of the 2007 EANM paediatric dosage card (version 1.5. 2008) and the 2010 North American consensus guideline [J]. Eur J Nucl Med Mol Imaging , 2014 , 41 ( 8 ): 1636 - 1636 .
Treves ST , Gelfand MJ , Fahey FH , et al . 2016 update of the north American consensus guidelines for pediatric administered radiopharmaceutical activities [J]. J Nucl Med , 2016 , 57 ( 12 ): 15 N- 18N .
Milana MA , Marko E , Miroslav L , et al . Importance of PET/CT scan use in planning radiation therapy for lymphoma [J]. Asian Pac J Cancer Prev , 2015 , 16 : 2051 - 2054 .
Kwatra NS , Lim R , Gee MS , et al . PET/MR imaging:current updates on pediatric applications [J]. Magn Reson Imaging Clin N Am , 2019 , 27 ( 2 ): 387 - 407 .
Badawi RD , Shi H , Hu P , et al . First human imaging studies with the EXPLORER total-body PET scanner [J]. J Nucl Med , 2019 , 60 ( 3 ): 299 - 303 .
Cherry SR , Jones T , Karp JS , et al . Total-body PET: maximizing sensitivity to create new opportunities for clinical research and patient care [J]. J Nucl Med , 2018 , 59 ( 1 ): 3 - 12 .
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