TABLE 2

Recommended Imaging Techniques for Radionuclide Studies to Support Brain Death

		Recommendation
Imaging type	Parameter	SNMMI (20,48)	American College of Radiology (21,47)
General	Scalp tourniquet	Optional	NS
	Collimator	LEHR or UHR; prefer focused collimators	LEAP or LEHR
	Radiopharmaceutical	Lipophilic preferred by some institutions; no clear evidence of greater accuracy	Lipophilic; alternatively, nonlipophilic may be used
Nonlipophilic	Radiopharmaceutical	^99mTc-DTPA	BBB agents such as ^99mTc-DTPA
	Dose (adult)	≤1,110 MBq	NS
	Dose (children)	11.1 MBq/kg; minimum, 185 MBq	NS
	Flow (view, rate)	Essential (ant, 1 s/frame × 1 min)	Mandatory (NS)
	Static delay	None	None
	Static views	Ant, lat, post^*	Ant, lat^, post^
	Static duration	500–1,000 kilocounts	500–1,000 kilocounts
Lipophilic	Radiopharmaceutical	^99mTc-HMPAO or ^99mTc-ECD	^99mTc-ECD or ^99mTc-HMPAO
	Dose (adult)	≤1,110 MBq	≤1,110 MBq
	Dose (children)	11.1 MBq/kg; minimum, 185 MBq	11.1 MBq/kg; minimum, 148 MBq
	Flow	Should be obtained	Recommended, optional
	Static delay	20 min	None
	Static views	Ant, both lats, post^† if SPECT not feasible	Ant, lat^, post^
	Static duration	NS	500–1,000 kilocounts
	SPECT	Optional	SPECT or SPECT/CT may be performed

↵* As needed.
↵† If possible.
LEHR = low-energy high-resolution; UHR = ultrahigh resolution; LEAP = low-energy all-purpose; BBB = blood–brain barrier; NS = not specified; ant = anterior; lat = lateral; post = posterior.