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Procedure Standards

The procedure standards help to identify those elements of the procedure that are most important in obtaining a high-quality examination, while simultaneously controlling costs. Use of procedure standards will increase the applicability of clinical research among multiple institutions, in turn, increasing the value of research studies, particularly in the field of technology assessment. In the interest of creating strong, comprehensive documents, some standards were formally adopted by SNMMI in collaboration with other professional organizations.

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) Practice Guidelines were renamed Procedure Standards in February 2014. This change was initiated in an effort to better reflect the terminology being used by external organizations. Any previous Practice Guideline or Procedure Guideline that describes how to perform a procedure is now considered an SNMMI Procedure Standard.

To view a section of SNMMI's Procedure Standards, please click the link(s) below:

Currently Available for Public Comment
Recently Approved Procedure Standards
Cardiovascular System
Endocrine System
Gastrointestinal System
Genitourinary System
General

Infection and Inflammation
Skeletal System
Central Nervous System
Oncology
Pediatric
Pulmonary System
Therapy
Retired Procedure Standards

Comments or Questions?
The SNMMI Committee on Procedure Standards is continually developing new standards and reviewing and updating existing procedure standards. If you have specific comments or questions on the content of any of the standards, or if you have suggestions for new standards that you feel should be written, please contact the SNMMI Committee on Procedure Standards here. All comments will be considered in the procedure standards development process.

Procedure Standards Available for Public Comment
Comments Due By	Document Title




As part of the revision or development process, the SNMMI Committee on Procedure Standards will seek public comment on draft documents in order to ensure we are creating the most accurate guidelines. Please submit comments to quality@snmmi.org. Below are guidelines currently for which we are seeking public input:

Recently Approved Procedure Standards
Date Approved	Document Title
October 8, 2022	Joint EANM/SNMMI/ANZSNM Practice Guidelines/Procedure Standards on Recommended Use of [18F]FDG PET/CT Imaging During Immunomodulatory Treatments in Patients with Solid Tumors Ver. 1.0
April 30, 2022	Joint EANM/SNMMI Guideline on Radiomics in Nuclear Medicine Supplemental Radiomics in Nuclear Medicine Material
April 30, 2022	SNMMI Procedure Standard/EANM Practice Guideline for SSTR Receptor PET: Imaging Neuroendocrine Tumors
February 8, 2022	Joint EANM/SNMMI/ANZSNM Practice Guidelines/Procedure Standards on Recommended Use of [18F]FDG PET/CT Imaging During Immunomodulatory Treatments in Patients with Solid Tumors Ver. 1.0
January 28, 2022	SNMMI Procedure Standard / EANM Practice Guideline for Molecular Breast Imaging with Dedicated Gamma-Cameras
January 28, 2022	SNMMI Procedure Standard/EANM Practice Guideline for Nuclear Medicine Evaluation and Therapy of Differentiated Thyroid Cancer
January 28, 2022	Joint EANM/SIOPE/RAPNO Practice Guidelines/SNMMI Procedure Standards for Imaging of Paediatric Gliomas Using PET with Radiolabelled Amino Acids and [18F]-FDG: Version 1.0.


Click Here to View Consensus Guidelines and Position Statements

Procedure Standards Under Development
EANM Practice Guideline/SNMMI Procedure Standard for PET/MR
EANM Practice Guideline/SNMMI Procedure Standard for Benign Thyroid Disease
EANM Practice Guideline/SNMMI Procedure Standard for 177Lu-PSMA-RLT
SNMMI Procedure Standard for Breast Scintigraphy with Breast-Specific Gamma Cameras 1.0
SNMMI Procedure Standard for In-111 Leucocyte Scintigraphy for Suspected Infection/Inflammation
SNMMI Procedure Standard for Tc-99m HMPAO-Labeled Leucocyte Scintigraphy for Suspected Infection/Inflammation
SNMMI Procedure Standard for Palliative Treatment of Painful Bone Metastases
SNMMI Procedure Standard/EANM Practice Guideline for Fluoroestradiol F18
Cardiovascular System
Date Approved	Document Title
March 29, 2020	SNMMI Procedure Standard for Gated Equilibrium Radionuclide Ventriculography
November 15, 2012	ASNC-SCCT-SNMMI Guideline for Cardiac SPECT/CT and PET/CT 1.0
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Cardiac Scintigraphy
June 14, 2008	SNMMI Procedure Standard for Myocardial Perfusion Imaging 3.3
	Click Here to View Consensus Guidelines and Position Statements on Cardiovascular System
Endocrine System
Date Approved	Document Title
January 25, 2020	SNMMI Procedure Standard for Scintigraphy for Differentiated Thyroid Cancer, V4.0
June 22, 2019	EANM Practice Guideline/SNMMI Procedure Standard for Radio Iodine Uptake (RAIU) and Scintigraphy, V 3.0
March 30, 2019	EANM Practice Guideline/SNMMI Procedure Standard for Radionuclide Imaging of Pheochromocytoma and Paraganglioma
September 17, 2011	SNMMI Procedure Standard for Parathyroid Scintigraphy 4.0
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Parathyroid Scintigraphy
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Thyroid Scintigraphy and Uptake Measurements
September 5, 2006	SNMMI Procedure Standard for Thyroid Uptake Measurement 3.0
Gastrointestinal System
Date Approved	Document Title
November 17, 2014	SNMMI Procedure Standard-EANM Practice Guideline Gastrointestinal Bleeding Scintigraphy 2.0
June 5, 2014	SNMMI Procedure Standard-EANM Practice Guideline for Meckel Diverticulum Scintigraphy 2.0 - Original Article - Article Erratum
September 29, 2013	The SNMMI and EANM Practice Guideline for Small-Bowel and Colon Transit 1.0*
October 1, 2010	ACR-SNMMI-SPR Practice Guideline for Performance of Gastrointestinal Scintigraphy
October 1, 2010	ACR-SNMMI-SPR Practice Guideline for the Performance of Liver and Spleen Scintigraphy
June 4, 2010	SNMMI Procedure Standard for Hepatobiliary Scintigraphy 4.0
February 8, 2009	SNMMI Procedure Standard for Gastric Emptying 3.0
	Click Here to View Consensus Guidelines and Position Statements on Gastrointestinal System
Genitourinary System
Date Approved	Document Title
May 6, 2020	EANM Practice Guideline/SNMMI Procedure Standard for FDG-PET/CT External Beam Radiotherapy Treatment Planning in Uterine Cervical Cancer
September 28, 2019	EANM Guideline/SNMMI Procedure Standard on [18F]Fluciclovine PET/CT for Prostate Cancer Imaging; Version 1.0
June 21, 2018	The SNMMI and EANM Practice Guideline for Renal Scintigraphy in Adults
June 22, 2018	The SNMMI and EANM Procedural Guidelines for Diuresis Renography in Infants and Children
January 27, 2018	SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0
October 1, 2010	ACR-SNMMI-SPR Practice Guideline for the Performance of Adult and Pediatric Radionuclide Cystography
June 20, 2003	SNMMI Procedure Standard for Renovascular Hypertension 3.0
General
Date Approved	Document Title
November 25, 2013	EANM Practice Guideline-SNMMI Procedure Standard for Tele-Nuclear Medicine 2.0
June 8, 2012	SNM/EANM Guideline for Guideline Development 6.0
October 1, 2011	ACR-SNMMI Technical Standard for Diagnostic Procedures Using Radiopharmaceuticals
September 12, 2010	SNMMI Procedure Standard for General Imaging 6.0
June 1, 2007	SNMMI Procedure Standard for Use of Radiopharmaceuticals 4.0
April 30, 2006	SNMMI Procedure Standard for SPECT/CT Imaging 1.0
	Click Here to View Consensus Guidelines and Position Statements
Infection and Inflammation
Date Approved	Document Title
January 27, 2018	FDG-PET/CT(A) Imaging in Large Vessel Vasculitis and Polymyalgia Rheumatica: Joint Procedural Recommendation of the EANM, SNMMI, PET Interest Group, and endorsed by ASNC
November 15, 2012	EANM Practice Guideline-SNMMI Procedure Standard for ¹⁸F-FDG Use in Inflammation and Infection
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Scintigraphy for Inflammation or Infection
June 2, 2004	SNMMI Procedure Standard for Gallium Scintigraphy in Inflammation 3.0
June 2, 2004	SNMMI Procedure Standard for ^99mTc Exametazime (HMPAO)-Labeled Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0
June 2, 2004	SNMMI Procedure Standard for ¹¹¹In-Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0
Skeletal System
Date Approved	Document Title
June 21, 2018	SNMMI Procedure Standard for Bone Scintigraphy 4.0
June 4, 2010	SNMMI Procedure Standard for Sodium ¹⁸F-Fluoride with PET/CT Bone Scans 1.1 – EANM Endorsement
Central Nervous System
Date Approved	Document Title
January 25, 2020	EANM Practice Guideline/SNMMI Procedure Standard for Dopaminergic Imaging in Parkinsonian Syndromes
January 30, 2016	SNMMI Procedure Standard-EANM Practice Guideline for Amyloid PET Imaging of the Brain
June 8, 2012	SNMMI Procedure Standard for Brain Death Scintigraphy 2.0
October 26, 2011	SNMMI Procedure Standard for Dopamine Transporter Imaging with ¹²³I-Ioflupane SPECT 1.0
February 8, 2009	SNMMI Procedure Standard for FDG-PET Brain Imaging 1.0
February 8, 2009	SNMMI Procedure Standard for Brain Perfusion Single Photon Emission Computed Tomography (SPECT) Using ^99mTc Radiopharmaceuticals 3.0
Oncology
Date Approved	Document Title
September 14, 2021	Joint EANM / SNMMI / ESTRO Practice Recommendations for the Use of 2-[18F]FDG PET/CT External Beam Radiation Treatment Planning in Lung Cancer V1.0
September 22, 2018	Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [18F]FDG: version 1.0
June 22, 2018	FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0 with the exception that the SUV max is used in the United States as the quantitative measurement
March 10, 2017	⁶⁸Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0
July 7, 2015	EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma – SNMMI Endorsement
February 7, 2014	Lymphoscintigraphy and Sentinel Node Localization in Gynecological Cancers – SNMMI Endorsement
September 29, 2013	EANM Practice Guideline-SNMMI Procedure Standard for Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer
September 22, 2012	131I/123I- Metaiodobenzylguanidine (MIBG) scintigraphy: procedure guidelines for tumour imaging – SNMMI Endorsement**
July 19, 2011	SNMMI Procedure Standard for Somatostatin Receptor Scintigraphy 2.0
June 4, 2010	SNMMI Procedure Standard for Breast Scintigraphy with Breast-Specific Gamma Cameras 1.0 – EANM Endorsement
February 11, 2006	SNMMI Procedure Standard for Tumor Imaging with ¹⁸F-FDG PET/CT 1.0
June 2, 2004	SNMMI Procedure Standard for Breast Scintigraphy 2.0
	Click Here to View Consensus Guidelines and Position Statements on Oncology
Pediatric
Date Approved	Document Title
May 24, 2021	SNMMI Procedure Standard/EANM Practice Guideline on Pediatric [99mTc]Tc-DMSA Renal Cortical Scintigraphy: An Update
March 29, 2020	SNMMI Procedure Standard/EANM Practice Guideline on Pediatric [¹⁸F]FDG PET-CT for Oncology 1.0 (New)
October 28, 2013	Pediatric Radiopharmaceutical Administration: Harmonization
October 26, 2010	SNMMI Procedure Standard for Pediatric Dose Consensus Guidelines
	*Based on the findings of a survey conducted at 13 premier pediatric hospitals in North America indicating administered radiopharmaceutical activities in children varied greatly, a workgroup was established representing the Society of Nuclear Medicine and Molecular Imaging (SNMMI) through the Pediatric Council, the Society for Pediatric Radiology and the Amercian College of Radiology (ACR). The Workgroup achieved concensus on pediatric administered radiopharmaceutical doses for 11 commonly used radiopharmaceuticals.
October 1, 2010	ACR-SNMMI-SPR Practice Guideline for the Performance of Adult and Pediatric Radionuclide Cystography
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Pulmonary Scintigraphy in Adults and Children
January 25, 2003	SNMMI Procedure Standard for Pediatric Sedation in Nuclear Medicine 3.0
January 25, 2003	SNMMI Procedure Standard for Radionuclide Cystography in Children 3.0
Pulmonary System
Date Approved	Document Title
July 19, 2011	SNMMI Procedure Standard for Lung Scintigraphy 4.0
October 1, 2009	ACR-SNMMI-SPR Practice Guideline for the Performance of Pulmonary Scintigraphy in Adults and Children
Therapy
Date Approved	Document Title
August 4, 2019	ACR-ACNM-ASTRO-SNMMI Practice Parameter for the Performance of Therapy with Radium-223
January 18, 2019	NANETS/SNMMI Procedure Standard for Somatostatin Receptor–Based Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE
January 25, 2013	The Joint IAEA, EANM, and SNMMI Practical Guidance on Peptide Receptor Radionuclide Therapy (PRRNT) in Neuroendocrine Tumors
June 8, 2012	SNMMI Procedure Standard for Therapy of Thyroid Disease with ¹³¹I (Sodium Iodide) 3.0
March 20, 2012	Radioimmunotherapy for B-cell lymphoma with ⁹⁰Y-radiolabelled itribumomab tiuxetan (Zevalin) – SNMMI Endorsement**
	* Pretherapeutic imaging with ¹¹¹In-ibritumomab tiuxetan is no longer mandatory in the United States.
January 25, 2003	SNMMI Procedure Standard for Palliative Treatment for Painful Bone Metastases 3.0
Regulatory Issues for EANM Guidelines Applicable to all countries: Clinicians involved in unsealed source therapy must be knowledgeable about and compliant with all applicable national and local legislation and regulations. Applicable in the United States:** The radiopharmaceutical(s) used for the diagnostic and therapeutic procedure(s) addressed in this guideline/guidance document is/are not approved by the Food and Drug Administration (FDA)in the United States. Therefore in the United States, these procedures should be performed only by physicians holding an FDA-approved Investigational New Drug (IND) application for the radiopharmaceutical.

Retired Procedure Standards
Please note the below procedure standards have been retired and thus not updated since their last approval. Therefore, these standards may not reflect current knowledge and practice in the field of nuclear medicine. SNMMI is providing these procedures on an 'as is' basis for general information purposes only and does not accept any responsibility for accuracy, completeness, currency, relevance, reliability or suitability of the information contained therein.
Date Approved	Document Title
June 20, 2003	SNMMI Procedure Standard for Hepatic and Splenic Imaging 3.0
June 23, 2001	SNMMI Procedure Standard for Gallium Scintigraphy in the Evaluation of Malignant Disease 3.0
February 7, 1999	SNMMI Procedure Standard for Tumor Imaging Using F-18 FDG 2.0
February 7, 1999	SNMMI Procedure Standard for Gastrointestinal Bleeding/Meckel's Diverticulum Scintigraphy 1.0

Feedback

Please let us know if you have any suggestions for future topics for AUC development, or any feedback on the existing publications by contacting us at quality@snmmi.org.

In This Section

Procedure Standards

Procedure Standards Available for Public Comment

Comments Due By

Document Title

Recently Approved Procedure Standards

Date Approved

Document Title

Click Here to View Consensus Guidelines and Position Statements

Procedure Standards Under Development

Cardiovascular System

Date Approved

Document Title

Click Here to View Consensus Guidelines and Position Statements on Cardiovascular System

﻿Endocrine System

Date Approved

Document Title

﻿Gastrointestinal System

Date Approved

Document Title

Click Here to View Consensus Guidelines and Position Statements on Gastrointestinal System

﻿Genitourinary System

Date Approved

Document Title

﻿General

Date Approved

Document Title

Click Here to View Consensus Guidelines and Position Statements

﻿Infection and Inflammation

Date Approved

Document Title

﻿Skeletal System

Date Approved

Document Title

﻿Central Nervous System

Date Approved

Document Title

﻿Oncology

Date Approved

Document Title

Click Here to View Consensus Guidelines and Position Statements on Oncology

﻿Pediatric

Date Approved

Document Title

﻿Pulmonary System

Date Approved

Document Title

﻿Therapy

Date Approved

Document Title

**Regulatory Issues for EANM Guidelines

﻿Retired Procedure Standards

Date Approved

Document Title

Feedback

RELATED CONTENT

Endocrine System

Gastrointestinal System

Genitourinary System

General

Infection and Inflammation

Skeletal System

Central Nervous System

Oncology

Pediatric

Pulmonary System

Therapy

Retired Procedure Standards