Procedure Standards

**PLEASE NOTE: As of February 2014, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) Guidelines will now be referred to as Procedure Standards. 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.** 

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.

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 at hpra@snmmi.org. All comments will be considered in the procedure standards development process.

Cardiovascular System

Date Approved

Document title

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

June 15, 2002

SNMMI Procedure Standard for Gated Equilibrium Radionuclide Ventriculography 3.0

Endocrine System

Date Approved

Document title

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 25, 2006

SNMMI Procedure Standard Scintigraphy for Differentiated Papillary and Follicular Thyroid Cancer

September 10, 2006

SNMMI Procedure Standard for Thyroid Scintigraphy 3.0

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
September 29, 2013 EANM Practice Guideline-SNMMI Procedure Standard 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

 

 

Genitourinary System

 Date Approved

Document title

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

SNMMI Procedure Standard 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

Infection and Inflammation

Date Approved

Document title

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 Tc-99m Exametazime (HMPAO)-Labeled Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0

June 2, 2004

SNMMI Procedure Standard for In-111 Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0

Skeletal System

Date Approved

Document title

June 4, 2010

SNMMI Procedure Standard for Sodium 18-F Fluoride with PET/CT Bone Scans 1.1 – EANM Endorsement

June 20, 2003

SNMMI Procedure Standard for Bone Scintigraphy 3.0

Central Nervous System

Date Approved

Document title

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 Proton Emission Computed Tomography (SPECT) Using Tc-99m Radiopharmaceuticals 3.0

Oncology

Date Approved

Document title

September 29, 2013

EANM Practice Guideline-SNMMI Procedure Standard for Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer

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

June 15, 2002

SNMMI Procedure Standard for Lymphoscintigraphy and the Use of Intraoperative Gamma Probe for Sentinel Lymph Node Localization in Melanoma of Intermediate Thickness 1.0

Pediatric

Date Approved

Document title

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

September 1, 2008

SNMMI Procedure Standard for Diuretic Renography in Children 3.0

June 20, 2003

SNMMI Procedure Standard for Renal Cortical Scintigraphy in Children 3.0

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

June 8, 2012

SNMMI Procedure Standard for Therapy of Thyroid Disease with Iodine-131 (Sodium Iodide) 3.0

January 25, 2003 SNMMI Procedure Standard for Palliative Treatment for Painful Bone Metastases 3.0

 

 

EANM Guidelines

SNMMI endorses these guidelines. Dosage recommendations should be taken in the context of “good practice” of nuclear medicine and do not substitute for national and international legal or regulatory provisions.

SNMMI Approval Date

Document title

February 7, 2014

Lymphoscintigraphy and Sentinel Node Localization in Gynecological Cancers

October 28, 2013

Pediatric Radiopharmaceutical Administration: Harmonization

September 22, 2012

131I-meta-iodobenzylguanidine (131I-mIBG) therapy (2008)

March 20, 2012

131I/123I- Metaiodobenzylguanidine (MIBG) scintigraphy (2010)

March 20, 2012

Radioimmunotherapy for B-cell lymphoma with 90Y-radiolabelled itribumomab tiuxetan (Zevalin) (2006) 

 

* Pretherapeutic imaging with 111In-ibritumomab tiuxetan is no longer mandatory in the United States.

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

 

 

Procedure Standards Available for Public Comment

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. To submit comments on a standard, please download the response form and submit to Kendall Horvath via email, khorvath@snmmi.org. Below are guidelines currently for which we are seeking public input:

Comments Due By

Document title