Treves S Ted, Fahey Frederic H
Harvard Medical School; Brigham and Women's Hospital.
Harvard Medical School; Boston Children's Hospital.
Semin Nucl Med. 2022 Mar;52(2):149-156. doi: 10.1053/j.semnuclmed.2021.11.007. Epub 2021 Dec 13.
Nuclear medicine provides methods and techniques in that has benefited pediatric patients and their referring physicians for over 40 years. Nuclear medicine provides qualitative and quantitative information about overall and regional function of organs, systems, and lesions in the body. This involves applications in many organ systems including the skeleton, the brain, the kidneys and the heart as well as in the diagnosis and treatment of cancer. The practice of nuclear medicine requires the administration of radiopharmaceuticals which expose the patient to very low levels of ionizing radiation. Advanced approaches in the estimation of radiation dose from the internal distribution of radiopharmaceuticals in patients of various sizes and shapes have been developed in the past 20 years. Although there is considerable uncertainty in the estimation of the risk of adverse health effects from radiation at the very low exposure levels typically associated with nuclear medicine, some considers it prudent to be more cautious when applied to children as they are generally considered to be at higher risk than adults. Standard guidelines for administered activities for nuclear medicine procedures in children have been established including the North American consensus guidelines and the Paediatric Dosage Card developed by the European Association of Nuclear Medicine. As we move into the future, these guidelines would likely be reviewed in response to changes in clinical practice, a better understanding of radiation dosimetry as applied to children as well as new clinical applications, new advancements in the field with respect to both instrumentation and image reconstruction and processing.
核医学提供的方法和技术已经使儿科患者及其转诊医生受益超过40年。核医学提供有关身体器官、系统和病变的整体及局部功能的定性和定量信息。这涉及到在包括骨骼、大脑、肾脏和心脏等许多器官系统中的应用,以及在癌症诊断和治疗中的应用。核医学实践需要给予放射性药物,这会使患者暴露于非常低水平的电离辐射。在过去20年里,已经开发出了先进的方法来估计不同大小和形状患者体内放射性药物内部分布所产生的辐射剂量。尽管在通常与核医学相关的极低暴露水平下,估计辐射对健康产生不良影响的风险存在相当大的不确定性,但一些人认为,应用于儿童时更加谨慎是审慎的做法,因为儿童通常被认为比成年人面临更高的风险。已经制定了儿童核医学程序给药活动的标准指南,包括北美共识指南和欧洲核医学协会制定的儿科剂量卡。随着我们迈向未来,这些指南可能会根据临床实践的变化、对应用于儿童的辐射剂量学的更好理解、新的临床应用、该领域在仪器设备以及图像重建与处理方面的新进展而进行审查。