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:

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

May 24, 2024

Joint SNMMI/EANM Procedure Standard/Practice Guideline for Fibroblast Activation Protein (FAP) PET

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

August 25, 2023

International EANM‑SNMMI‑ISMRM Consensus Recommendation for PET/MRI in Oncology

July 4, 2023

Joint EANM/SNMMI/IHPBA Procedure Guideline for [99mTc]Tc-Mebrofenin Hepatobiliary Scintigraphy SPECT/CT in the Quantitative Assessment of the Future Liver Remnant Function

June 23, 2023

SNMMI Procedure Standard/EANM Practice Guideline for Estrogen Receptor Imaging of Patients with Breast Cancer Using 16α-[18F]Fluoro-17β-Estradiol PET

June 14, 2023

SNMMI Procedure Standard/EANM Practice Guideline for Palliative Nuclear Medicine Therapies of Bone Metastases

January 27, 2023

Joint EANM/SNMMI Procedure Guideline for the Use of 177Lu-Labeled PSMA-Targeted Radioligand-Therapy (177Lu-PSMA-RLT)

January 9, 2023

PSMA PET/CT: Joint EANM Procedure Guideline/SNMMI Procedure Standard for Prostate Cancer Imaging 2.0

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

April 30, 2022 SNMMI Procedure Standard/EANM Practice Guideline for SSTR Receptor PET: Imaging Neuroendocrine Tumors
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 

SNMMI Procedure Standard/EANM Practice Guideline for FDG PET/CT Brain Imaging v 2.0
SNMMI Procedure Standard/EANM Practice Guideline for Imaging for Renal Masses
SNMMI Procedure Standard/EANM Practice Guideline for PET Imaging with Fibroblast Activation Protein (FAP)
SNMMI Procedure Standard/EANM Practice Guideline for Brain Death Scintigraphy v 2.0
EANM Practice Guideline/SNMMI Procedure Standard for Imaging and Therapy of Meningiomas Using Radiolabelled Somatostatin Receptor Ligands
EANM Practice Guideline/SNMMI Procedure Standard for Practical Guideline on Somatostatin Receptor-Targeted Radionuclide Therapy of Neuroendocrine Tumors
EANM Practice Guideline/SNMMI Procedure Standard for FDG use in Inflammation and Infection 
EANM Practice Guideline/SNMMI Procedure Standard in the Role of FDG PET/CT in Diagnosis, Staging, Prognostic Value, Therapy Assessment, and Restaging of Breast Cancer
EANM Practice Guideline/SNMMI Procedure Standard on Tau PET Imaging in Alzheimer’s Disease 
EANM Practice Guideline/SNMMI Procedure Standard Bone Hybrid Imaging in Paediatrics
EANM/SNMMI Position Paper on the Use of FDG in Pediatric Infection & Inflammation 
ANM/EANO/RANO Practice Guidelines/SNMMI Procedure Standard for Imaging and Therapy of Meningiomas Using Radiolabelled Somatostatin Receptor Ligands

Cardiovascular System

Date Approved

Document Title

March 29, 2020

Gated Equilibrium Radionuclide Ventriculography

October 1, 2009

Cardiac Scintigraphy



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

Endocrine System

Date Approved

Document Title

January 25, 2020

Scintigraphy for Differentiated Thyroid Cancer, V4.0

June 22, 2019

Radio Iodine Uptake (RAIU) and Scintigraphy, V 3.0 

March 30, 2019

Radionuclide Imaging of Pheochromocytoma and Paraganglioma

September 17, 2011

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

Gastrointestinal System

Date Approved

Document Title

November 17, 2014 Gastrointestinal Bleeding Scintigraphy 2.0 
June 5, 2014


Meckel Diverticulum Scintigraphy 2.0
  - Original Article
  - Article Erratum
September 29, 2013 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

Hepatobiliary Scintigraphy 4.0

February 8, 2009

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

FDG-PET/CT External Beam Radiotherapy Treatment Planning in Uterine Cervical Cancer 

September 28, 2019

[18F]Fluciclovine PET/CT for Prostate Cancer Imaging; Version 1.0 

June 21, 2018

Last reviewed on: October 15, 2022

Renal Scintigraphy in Adults

June 22, 2018

Diuresis Renography in Infants and Children

January 27, 2018

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

Last reviewed on: October 15, 2022

Renovascular Hypertension 3.0

General

Date Approved

Document Title

November 25, 2013

Tele-Nuclear Medicine 2.0

June 8, 2012

Guideline Development 6.0

October 1, 2011

ACR-SNMMI Technical Standard for Diagnostic Procedures Using Radiopharmaceuticals

September 12, 2010

General Imaging 6.0

June 1, 2007

Use of Radiopharmaceuticals 4.0

April 30, 2006

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
November 15, 2012 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

Gallium Scintigraphy in Inflammation 3.0

June 2, 2004

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

June 2, 2004

111In-Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0

Skeletal System

Date Approved

Document Title

June 21, 2018 Last Reviewed: 12/8/2023

Bone Scintigraphy 4.0

June 4, 2010

Sodium 18F-Fluoride with PET/CT Bone Scans 1.1

January 26, 2023

Palliative Nuclear Medicine Therapies of Bone Metastases

Central Nervous System

Date Approved

Document Title

January 25, 2020

Dopaminergic Imaging in Parkinsonian Syndromes

January 30, 2016

Amyloid PET Imaging of the Brain

June 8, 2012

Brain Death Scintigraphy 2.0

February 8, 2009

FDG-PET Brain Imaging 1.0

February 8, 2009

Brain Perfusion Single Photon Emission Computed Tomography (SPECT) Using 99mTc Radiopharmaceuticals 3.0

Oncology

Date Approved

Document Title

September 14, 2021

2-[18F]FDG PET/CT External Beam Radiation Treatment Planning in Lung Cancer V1.0

September 22, 2018

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: Prostate Cancer Imaging: version 1.0

July 7, 2015

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

Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer

September 22, 2012

131I/123I- Metaiodobenzylguanidine (MIBG) scintigraphy: procedure guidelines for tumour imaging – SNMMI Endorsement**

June 4, 2010

Breast Scintigraphy with Breast-Specific Gamma Cameras 1.0

June 2, 2004

Breast Scintigraphy 2.0

Click Here to View Consensus Guidelines and Position Statements on Oncology

Pediatric

Date Approved

Document Title

May 24, 2021 Pediatric [99mTc]Tc-DMSA Renal Cortical Scintigraphy: An Update
March 29, 2020 Pediatric [18F]FDG PET-CT for Oncology 1.0
October 28, 2013 Pediatric Radiopharmaceutical Administration: Harmonization
October 26, 2010 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

Pediatric Sedation in Nuclear Medicine 3.0

January 25, 2003

Radionuclide Cystography in Children 3.0

Pulmonary System

Date Approved

Document Title

July 19, 2011

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

Somatostatin Receptor–Based Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE

June 8, 2012

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.

**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

January 25, 2013

Peptide Receptor Radionuclide Therapy (PRRNT) in Neuroendocrine Tumors

November 15, 2012

Cardiac SPECT/CT and PET/CT 1.0

July 19, 2011

Somatostatin Receptor Scintigraphy 2.0

October 26, 2011

Dopamine Transporter Imaging with 123I-Ioflupane SPECT 1.0

June 14, 2008

Myocardial Perfusion Imaging 3.3

February 11, 2006

Tumor Imaging with 18F-FDG PET/CT 1.0

September 5, 2006

Thyroid Uptake Measurement 3.0

January 25, 2003

Palliative Treatment for Painful Bone Metastases 3.0

June 20, 2003

Hepatic and Splenic Imaging 3.0

June 23, 2001

Gallium Scintigraphy in the Evaluation of Malignant Disease 3.0

February 7, 1999

Tumor Imaging Using F-18 FDG 2.0

February 7, 1999

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.