Call for the Standardization of Pediatric Nuclear Medicine

September 6, 2016

A Report of the First Nuclear Medicine Global Initiative Project

Reston, Va. - The Nuclear Medicine Global Initiative (NMGI), which was formed in 2012 and consists of 13 international organizations (Table 1), focused on pediatric nuclear medicine for its first project. Its final report, published in the July issue of The Journal of Nuclear Medicine (JNM), sets forth recommendations for achieving global standards for the administration of radiopharmaceuticals in children.

Frederic H. Fahey, DSc, was the SNMMI’s representative to NMGI and acted as chair of this inaugural project. According to Fahey, “The group recognized the importance of the standardization of administered activities particularly in the context of pediatric nuclear medicine.”

Part 1 of the project (report published in April 2015 JNM) was a review of pediatric nuclear medicine value and practice, the carcinogenic risk to children of radiation from radiopharmaceuticals, and dosimetric models. The indications for pediatric nuclear medicine are often quite different from those for adults. Dose optimization in pediatric nuclear medicine is of particular importance due to the higher radiosensitivity of children compared with adults. The biologic effects of radiation can appear long after exposure, with the probability of adverse effects proportional to expected life span. The goal is to maintain image quality with the lowest possible dose.

In part 2 of the study, an international survey of 313 nuclear medicine clinics and centers in 29 countries was use to evaluate current standards for children and adolescents. Much information is available about the appropriate use of nuclear medicine in children, as well as radiation dosimetry, and nuclear medicine professionals are responsible for staying current with the literature.

The study found that gaps remain in knowledge about the biokinetics and radiation dosimetry associated with the use of nuclear medicine in children, and there’s wide variability in the practice of pediatric nuclear medicine across the globe.

The report makes the following recommendations:

  • Regions without pediatric guidelines should either develop their own or officially adopt an existing set of guidelines.
  • Regions with guidelines should expand them to include all nuclear medicine procedures practiced on children.
  • The administered activity for pediatric patients should be incorporated into the auditing process for nuclear medicine sites.
  • Pediatric dose recommendations should be incorporated into formal training curricula and recertification programs.
  • All organizations involved in nuclear medicine should disseminate the NMGI findings and recommendations to members and constituents.

“This first project of the NMGI was very successful in providing some outstanding guidance regarding the practice of nuclear medicine in children,” said Fahey. “We hope it sets the stage for many future projects of the NMGI.”


Table 1. Participating Organizations

Asia Oceania Federation of Nuclear Medicine and Biology
Australian and New Zealand Society of Nuclear Medicine
Canadian Association of Nuclear Medicine
Chinese Society of Nuclear Medicine
European Association of Nuclear Medicine
International Atomic Energy Agency
Japanese society of Nuclear Medicine
Korean Society of Nuclear Medicine
Latin American Association of Societies of Nuclear Medicine and Biology
Society of Nuclear Medicine India
Society of Nuclear Medicine and Molecular Imaging
South African Society of Nuclear Medicine
World Federation on Nuclear Medicine and Biology


Please visit the SNMMI Media Center to view the PDF of the study, including images, and more information about molecular imaging and personalized medicine. To schedule an interview with the researchers, please contact Laurie Callahan at (703) 652-6773 or Current and past issues of The Journal of Nuclear Medicine can be found online at


About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to raising public awareness about nuclear medicine and molecular imaging, a vital element of today’s medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated and helping provide patients with the best health care possible.

SNMMI’s more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit

NMGI final report on pediatric NM