PT  - JOURNAL ARTICLE
AU  - Alessio, Adam M.
AU  - Kinahan, Paul E.
AU  - Manchanda, Vivek
AU  - Ghioni, Victor
AU  - Aldape, Lisa
AU  - Parisi, Marguerite T.
TI  - Weight-Based, Low-Dose Pediatric Whole-Body PET/CT Protocols
AID  - 10.2967/jnumed.109.065912
DP  - 2009 Oct 01
TA  - Journal of Nuclear Medicine
PG  - 1570--1578
VI  - 50
IP  - 10
4099  - http://jnm.snmjournals.org/content/50/10/1570.short
4100  - http://jnm.snmjournals.org/content/50/10/1570.full
SO  - J Nucl Med2009 Oct 01; 50
AB  - Adult PET/CT acquisition protocols need to be modified for pediatric imaging to minimize the radiation dose while maintaining diagnostic utility. We developed pediatric PET/CT acquisition protocols customized to patient weight and estimated the dosimetry and cancer risk of these low-dose protocols to communicate basic imaging risks. Methods: Protocols were developed for whole-body 18F-FDG imaging of patients in PET mode with a weight-based injected activity (5.3 MBq/kg) and acquisition times (3–5 min/field of view) and for CT for attenuation correction and localization with a weight-based tube current ranging from 10 to 40 mAs. Patients were categorized on the basis of the Broselow–Luten color-coded weight scale. Dosimetry and radiation-induced cancer risk for the PET and CT acquisition in each category were derived from mean patient sizes and the interpolation of factors from accepted patient models. Results: Whole-body pediatric PET/CT protocols require the customization of PET-acquisition settings and task-specific selection of CT technique. The proposed weight-based protocols result in an approximate effective dose ranging from 8.0 mSv for a 9-kg patient up to 13.5 mSv for a 63-kg patient. The radiation dose from the proposed protocols is 20%−50% (depending on patient weight), the dose from PET/CT protocols that use a fixed CT technique of 120 mAs and 120 kVp. The approximate, conservative estimate of additional lifetime attributable risk (LAR) of cancer incidence for females using the proposed protocols was approximately 3 in 1,000, with a variation of 18% across patient categories. For males, the additional LAR of cancer incidence was approximately 2 in 1,000, with a variation of 16% across categories. Conclusion: Low-dose PET/CT protocols for 11 patient weight categories were developed. The proposed protocols offer an initial set of acquisition parameters for pediatric PET/CT. The use of multiple categories allows for the continued refinement of dose-reduction parameters to minimize dose while maintaining image quality across the range of pediatric patient sizes.