Department of Medical Physics , School of Medicine Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa.
Curr Radiopharm. 2021;14(2):107-111. doi: 10.2174/1874471013666200814141713.
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.
To determine appropriate pediatric dosing guideline for a South African Tertiary Hospital (SATH).
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.
The most commonly performed nuclear medicine studies at a SATH were bone scans, Tc-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), Tc-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.
NAC guidelines are recommended for dosing pediatric patients at SATH. These guidelines will certainly reduce pediatric doses, which are currently high.
诊断核医学揭示了体内的生理过程，有助于在解剖结构发生变化之前及早发现疾病。然而，在儿科研究中，选择合适的剂量指南具有挑战性。放射性物质咨询委员会（ARSAC）和北美共识（NAC）指南被广泛使用。
为南非一家三级医院（SATH）确定合适的儿科剂量指南。
采用回顾性和经验性研究相结合的方法。从 2012 年至 2015 年在 SATH 就诊的儿科患者档案中提取年龄、体重、核医学研究名称和给予的活动量。为了在基于 ARSAC 和 NAC 指南计算给予的活动量时增加样本量，使用了来自常见核医学研究的 60 名儿科患者（经验数据）的体重。
SATH 最常进行的核医学研究是骨扫描、Tc-HIDA 扫描、肾扫描、甲状腺扫描、MIBG 扫描和胃食管反流扫描。基于 SATH、ARSAC 和 NAC 指南的儿科平均放射性药物给予剂量分别为：骨扫描（57.7、15.2 和 10.0MBq/kg）、Tc-HIDA 扫描（13.7、5.0 和 3.6MBq/kg）、肾扫描（13.9、3.4 和 7.8MBq/kg）、甲状腺扫描（7.0、2.6 和 1.5MBq/kg）、MIBG 扫描（15.5、15.1 和 7.7MBq/kg）和胃食管反流扫描（2.1、1.9 和 1.7MBq/kg）。与 ARSAC 和 NAC 指南相比，SATH 指南的给予放射性药物活性（ARA）的变异性较大。
建议在 SATH 为儿科患者使用 NAC 指南进行剂量给药。这些指南肯定会降低目前较高的儿科剂量。
