Dose Optimization

The right test with the right dose should be given to the right patient at the right time. SNMMI continually strives to ensure patients receive the best, safest and most appropriate care.

In nuclear medicine and molecular imaging, small amounts of radioactive agents are administered to the patient to allow the physician to examine molecular processes within the body. These procedures are highly effective, safe and painless diagnostic tools that present physicians with a detailed view of what’s going on inside an individual’s body at the cellular level. For more than 60 years, these studies have been used to evaluate practically all systems within the body, including the heart and brain, as well as to image many types of cancer. 

Radiation dose for all nuclear medicine and molecular imaging procedures should be optimized so that the patient receives the smallest possible amount of radiopharmaceutical that will provide the appropriate diagnostic information. However, if an appropriate procedure—one that can provide the physician with clinical information essential to the patient’s treatment—is not performed when necessary due to fear of radiation, it can be detrimental to the patient. The right test with the right dose should be given to the right patient at the right time. When nuclear medicine and molecular imaging procedures are performed correctly on appropriate patients, the benefits of the procedure very far outweigh the potential risks.

SNMMI has a large body of knowledge in dose optimization that is continually growing and developing. Listed below are SNMMI journal articles, educational offerings, and other resources as well as media-related information and links to useful websites.

SNMMI Position Statement on Dose Optimization for Nuclear Medicine and Molecular Imaging Procedures

Paediatric Radiopharmaceutical Administration: Harmonized Guideline (2014)

2014 Go With the Guidelines Poster

Many articles related to dose optimization are published in SNMMI's journals, The Journal of Nuclear Medicine and the Journal of Nuclear Medicine Technology.

Recent JNM Articles on Dose Optimization

Recent JNMT Articles on Dose Optimization

View dose optimization abstracts in the Meeting Planner

View dose optimization abstracts in the JNM Abstract supplement

  • Additional Radiopharmaceuticals For Inclusion in the North American Guidelines
  • CT Dose and Image Quality in PET/CT
  • CT Dose Reduction Strategies for Pediatric SPECT/CT and PET/CT
  • CT Technique in Clinical PET/CT: Dose and Contrast Considerations
  • Dose Optimization: A European Perspective
  • Dose Optimization: A United States Perspective
  • Dose Tracking Initiatives of the ACR
  • Dosimetric Approaches: Dose Optimization and New Perspectives
  • F-18 FDG Dose Optimization
  • Image Gently Activities
  • The Importance of Understanding and Applying Appropriate Dosing
  • Reducing Imaging Doses in Nuclear Cardiology
  • Reducing Radiation Exposure: What’s All the Hype?
  • Standardizing Discharge Criteria for MIBG and Thyroid I-131
  • Surveys
  • Ultra-Low Dose CT - Emerging Technologies
  • Attenuation correction optimization reduces patient dose while maintaining quantitative quality of PET/CT.
  • The benefits of using a low dose Thallium-201 protocol with D-SPECT Cardiac Imaging System for myocardial perfusion studies.
  • A combined radiation dose and acquisition time reduction in SPECT MPI.
  • Comparison of radiation doses for 18-F FDG PET/CT imaging and the effect of varying protocols on image interpretation.  
  • Comparison of radiation exposure dose, CT image quality and PET SUV according to pitch (Table speed) in PET/CT using AEC (Auto Exposure Control).
  • Controlled administration of penicillamine reduces radiation exposure to normal organs in 64Cu-ATSM internal radiotherapy.
  • The implementation of (ultra-low dose) CT protocols in PET/CT.
  • Incremental decrease to total effective dose delivered by subtracting residual activity in an 18F-FDG syringe.
  • A new administration dose index for optimization of acquisition time at PET imaging using count data using an ionization type survey meter.
  • PET-CT studies with low doses: Optimization of 18F-FDG doses and implementation of CT low-dose protocol.
  • Reducing dose in SPECT/CT using adaptive statistical iterative reconstruction technique.
  • Reducing radiation exposure using iterative statistical CT reconstruction in PET/CT and its impact on PET. SUV.
  • Usefulness of CT iterative reconstruction method for low-dose CT attenuation correction on the accuracy of PET image in obesity phantom study.
  • The value of low dose CT in spine SPECT.
  • The variability of CT techniques and radiopharmaceutical doses for SPECT/CT MPI studies.

 

Dose optimization sessions from previous SNMMI annual meetings

The following online lectures can be ordered at www.snmmi.org/moc

  • Radiation Protection and Dosimetry in PET and PET/CT
  • Risk Assessment and Predictive Value of Coronary Artery Disease Testing

Order an LLSAP Maintenance of Certification module

The following online lectures can be ordered at www.snmmi.org/onlinelectures

  • Basic Radiation Protection in Nuclear Medicine (physician)
  • Cellular Responses to Radiation
  • MIRD CME: Bystander and Low-Dose Rate Effects – Are These Relevant to Radionuclide Therapy (physician)
  • Radiation Risks in Clinical Research: Putting It in Perspective (physician)
  • Radiation Characterization and Quantities (physician)
  • Radiation Measurement Systems (physician)
  • Whole Body Effects of Ionizing Radiation (physician)
  • The Importance of Following the Protocol in Clinical Trials (technologist)
  • MR Safety and Clinical Procedures (technologist)

Order an Online Lecture

IMAGE GENTLY


SNMMI participates in image gently, a campaign to change practice by increasing awareness of the opportunities to promote radiation protection in the imaging of children.

More information

 

IMAGE WISELY

 

SNMMI participates in Image Wisely, a campaign to lower the amount of radiation used in medically necessary imaging studies and eliminate unnecessary procedures.

More information

 

Application Tools

The two calculators below show the recommended administered activity according to SNMMI practice guidelines for pediatric and adult patients and estimates of the effective and critical organ dose for these procedures.


Nuclear Medicine Radiation Dose Tool

With this tool, specify the nuclear medicine procedure, the injected activity, and the patient model (gender, age) to calculate the effective dose for this procedure.

Click here!


Pediatric Injected Activity Tool

With this tool, specify the nuclear medicine procedure and the pediatric patient’s weight to find the recommended administered activity for the patient.

Click here!