TABLE 1

North American Consensus Guidelines for Administered Radiopharmaceutical Activities in Children and Adolescents *

RadiopharmaceuticalRecommended administered activity (based on weight only)Minimum administered activityMaximum administered activityComments
123I-MIBG5.2 MBq/kg  (0.14 mCi/kg)37 MBq (1.0 mCi)370 MBq (10.0 mCi)EANM Paediatric Dose Card (2007 version ( 13))  may also be used in patients weighing  more than 10 kg.
99mTc-MDP9.3 MBq/kg  (0.25 mCi/kg)37 MBq (1.0 mCi)EANM Paediatric Dose Card (2007 version ( 13))  may also be used.
18F-FDGBody,  3.7–5.2 MBq/kg  (0.10–0.14 mCi/kg) Brain,  3.7 MBq/kg (0.10 mCi/kg)37 MBq (1.0 mCi)Low end of dose range should be considered for  smaller patients. Administered activity may  take into account patient mass and time  available on PET scanner. EANM Paediatric  Dose Card (2007 version ( 13)) may also  be used.
99mTc-dimercaptosuccinic acid1.85 MBq/kg  (0.05 mCi/kg)18.5 MBq (0.5 mCi)
99mTc-MAG3Without flow study,  3.7 MBq/kg  (0.10 mCi/kg) With flow study,  5.55 MBq/kg  (0.15 mCi/kg)37 MBq (1.0 mCi)148 MBq (4 mCi)Administered activities at left assume that image  data are reframed at 1 min/image.  Administered activity may be reduced if image  data are reframed at longer time per image.  EANM Paediatric Dose Card (2007 version  ( 13)) may also be used.
EANM Paediatric Dose Card (2007 version ( 13))  may also be used.
99mTc-iminodiacetic acid1.85 MBq/kg  (0.05 mCi/kg)18.5 MBq (0.5 mCi)Higher administered activity of 37 MBq (1 mCi) may  be considered for neonatal jaundice. EANM Paediatric Dose Card (2007 version ( 13)) may also  be used.
99mTc-macroaggregated albuminIf 99mTc used for  ventilation, 2.59  mBq/kg (0.07 mCi/kg)14.8 MBq (0.4 mCi)EANM Paediatric Dose Card (2007 version ( 13))  may also be used.
No 99mTc ventilation study,  1.11 MBq/kg (0.03 mCi/kg)EANM Paediatric Dose Card (2007 version ( 13))  may also be used.
99mTc-pertechnetate (Meckel diverticulum imaging)1.85 MBq/kg  (0.05 mCi/kg)9.25 MBq (0.25 mCi)EANM Paediatric Dose Card (2007 version ( 13))  may also be used.
18F-sodium fluoride2.22 MBq/kg  (0.06 mCi/kg)18.5 MBq (0.5 mCi)
99mTc (for cystography)No weight-based doseNo more than 37 MBq (1.0 mCi) for each bladder-filling cycle99mTc-sulfur colloid, 99mTc-pertechnetate,  99mTc-diethylene triamine pentaacetic acid, or  possibly other 99mTc radiopharmaceuticals  may be used. There is wide variety of  acceptable administration techniques for  99mTc, many of which will work well with lower  administered activities.
99mTc-sulfur colloid
 For oral liquid gastric emptyingNo weight-based dose9.25 MBq (0.25 mCi)37 MBq (1.0 mCi)Administered activity will depend on age of child,  volume to be fed to child, and time per frame  used for imaging.
 For solid gastric emptyingNo weight-based dose9.25 MBq (0.25 mCi)18.5 MBq (0.5 mCi)99mTc-sulfur colloid is usually used to label egg.
  • * This information is intended as a guideline only. Local practice may vary depending on patient population, choice of collimator, and specific requirements of clinical protocols.

  • Administered activity may be adjusted when appropriate by order of the nuclear medicine practitioner. For patients who weigh more than 70 kg, it is recommended that maximum administered activity not exceed product of patient's weight (kg) and recommended weight-based administered activity. Some practitioners may choose to set fixed maximum administered activity equal to 70 times recommended weight-based administered activity, for example, approximately 10 mCi (370 mBq), for 18F body imaging. The administered activities assume use of a low energy high resolution collimator for Tc-99m radiopharmaceuticals and a medium energy collimator for I-123-MIBG. Individual practitioners may use lower administered activities if their equipment or software permits them to do so. Higher administered activities may be required in certain patients. No recommended dose is given for 67Ga-citrate. Intravenous 67Ga-citrate should be used infrequently and only in low doses.