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Fahey FH, Goodkind A, MacDougall RD, Oberg L, Ziniel SI, Cappock R, Callahan MJ, Kwatra N, Treves ST, Voss SD. Operational and Dosimetric Aspects of Pediatric PET/CT. J Nucl Med 2017; 58:1360-1366. [PMID: 28687601 DOI: 10.2967/jnumed.116.182899] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/05/2017] [Indexed: 01/04/2023] Open
Abstract
No consistent guidelines exist for the acquisition of a CT scan as part of pediatric PET/CT. Given that children may be more vulnerable to the effects of ionizing radiation, it is necessary to develop methods that provide diagnostic-quality imaging when needed, in the shortest time and with the lowest patient radiation exposure. This article describes the basics of CT dosimetry and PET/CT acquisition in children. We describe the variability in pediatric PET/CT techniques, based on a survey of 19 PET/CT pediatric institutions in North America. The results of the survey demonstrated that, although most institutions used automatic tube current modulation, there remained a large variation of practice, on the order of a factor of 2-3, across sites, pointing to the need for guidelines. We introduce the approach developed at our institution for using a multiseries PET/CT acquisition technique that combines diagnostic-quality CT in the essential portion of the field of view and a low-dose technique to image the remainder of the body. This approach leads to a reduction in radiation dose to the patient while combining the PET and the diagnostic CT into a single acquisition. The standardization of pediatric PET/CT provides an opportunity for a reduction in the radiation dose to these patients while maintaining an appropriate level of diagnostic image quality.
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Affiliation(s)
- Frederic H Fahey
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts .,Department of Radiology, Harvard Medical School, Boston, Massachusetts
| | - Alison Goodkind
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Robert D MacDougall
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Leah Oberg
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Sonja I Ziniel
- Section of Pediatric Hospital Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; and
| | - Richard Cappock
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Michael J Callahan
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts.,Department of Radiology, Harvard Medical School, Boston, Massachusetts
| | - Neha Kwatra
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts.,Department of Radiology, Harvard Medical School, Boston, Massachusetts
| | - S Ted Treves
- Department of Radiology, Harvard Medical School, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Stephan D Voss
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts.,Department of Radiology, Harvard Medical School, Boston, Massachusetts
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Woolf AD, Saperstein A, Zawin J, Cappock R, Sue YJ. Radiopacity of household deodorizers, air fresheners, and moth repellents. J Toxicol Clin Toxicol 1993; 31:415-28. [PMID: 8355318 DOI: 10.3109/15563659309000410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Household deodorizers and moth repellents are common agents implicated in many childhood poisonings. Their ingredients usually include either paradichlorobenzene or naphthalene compressed into a solid ball or another shape, sometimes with added essential oils and fragrances. Because medically naphthalene is a more important toxin than paradichlorobenzene, with hematologic and nervous system effects, clinicians often seek to discern which product has been ingested. We discovered fortuitously that a mothball swallowed by a retarded adult was radiopaque, and so designed an in vitro experiment to study the radiopacity of a variety of household deodorizers and products. Of 10 products screened for radiopacity by two radiologists, those containing paradichlorobenzene were consistently strongly radiopaque; those containing naphthalene were radiolucent. A third alternative ingredient which is used in some toilet bowl deodorizers, cetrimonium bromide, was also radiopaque. Radiopacity of paradichlorobenzene or cetrimonium bromide-containing products did not dissipate with time. We speculate that the halogen within the chemical structure of these compounds accounts for their radiopacity. We conclude that paradichlorobenzene-containing commercial products can be distinguished clinically from those containing naphthalene by the performance of an abdominal radiograph.
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Affiliation(s)
- A D Woolf
- Children's Hospital, Boston, Massachusetts
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