Pediatric Injected Activity Tool

NOTE: All values listed are consistent with the 2024 North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical (see references below).

DISCLAIMER: Information on this site is for educational purposes only. This site has not been extensively tested on all platforms, under all conditions. As such, users of this tool must verify all results prior to clinical decision making. Use of this tool assumes that users free from any and all liability the SNMMI and associated parties.

ABOUT: This tool provides recommended injected activity for pediatric patients based on the North American concensus guidelines and the European Association of Nuclear Medicine guidelines. This information is intended as a guideline only. Local practice may vary depending on patient population and equipment considerations, including choice of collimator, software, and the specific requirements of clinical protocols. For example, those PET scanners with digital PET detectors or extended fields of view, embedded with artificial intelligence or advanced iterative reconstruction to enable high-resolution scans could consider dosing at the lower portion of the range. Administered activity may be adjusted when appropriate by the nuclear medicine practitioner’s order.

For patients who weigh more than 70 kg, it is recommended that the maximum administered activity not exceed the product of the patient’s weight (kg) and the recommended weight-based administered activity. If not specified in the table, some practitioners may choose to set a fixed maximum administered activity according to the package insert for adults or equal to 70 times the recommended weight-based administered activity, for example, approximately 17.5 mCi (648 MBq) for 99mTc- MDP. The administered activities assume the use of a low energy high-resolution collimator for 99mTc- radiopharmaceuticals or a medium energy collimator for 123I-MIBG.

Individual practitioners may use lower administered activities if their equipment or software permits them. Higher administered activities may also be required in selected patients. No recommended dose is given for 67Ga-citrate. Intravenous 67Ga-citrate should be used very infrequently and only in low doses.

REFERENCES

1. 2024 Update of the North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities, link
2. 2016 Update of the North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities, S. Ted Treves, Michael J. Gelfand, Frederic H. Fahey, Marguerite T. Parisi Journal of Nuclear Medicine Dec 2016, 57 (12) 15N-18N. link
3. Harmonization: Lassmann and Treves, Paediatric radiopharmaceutical administration: harmonization of the 2007 EANM paediatric dosage card (version 1.5.2008) and the 2010 North American consensus guidelines, Eur J Nucl Med Mol Imaging March 2014. link 
4. NA Concensus Guidelines: Gelfand, Parisi, and Treves, Pediatric Radiopharmaceutical Administered Doses: 2010 North American Consensus Guidelines, J Nucl Med 2011 52:318-322. link
5. EANM Ped Dose Card: Lassmann, Biassoni, Monsieurs,Franzius, and Jacobs, The New EANM Paediatric Dosage Card, Eur J Nucl Med Mol Imaging 2007 34:796-798.link 

Site made possible by the SNMMI Dose Optimization Task Force.
Site developed by Adam Alessio, Michigan State University, July 2013; Revised July 2024.

Copyright © 2013, Adam M Alessio, All rights reserved.