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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:

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
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
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.
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
May 24, 2021 SNMMI Procedure Standard/EANM Practice Guideline on Pediatric [99mTc]Tc-DMSA Renal Cortical Scintigraphy: An Update
May 6, 2020 EANM Practice Guideline/SNMMI Procedure Standard for FDG-PET/CT External Beam Radiotherapy Treatment Planning in Uterine Cervical Cancer (New)
March 29, 2020 SNMMI Procedure Standard for Gated Equilibrium Radionuclide Ventriculography
March 29, 2020 SNMMI Procedure Standard/EANM Practice Guideline on Pediatric [18F]FDG PET-CT for Oncology 1.0
January 25, 2020 SNMMI Procedure Standard for Scintigraphy for Differentiated Thyroid Cancer, V4.0
January 25, 2020 EANM Practice Guideline/SNMMI Procedure Standard for Dopaminergic Imaging in Parkinsonian Syndromes (New)

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 Radiomics
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 SSTR-PET (including 64Cu-DOTATATE and 111In)
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

Endocrine System

Date Approved

Document Title

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 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
  - 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

 

 

Genitourinary System

 Date Approved

Document Title
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

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 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 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

Pediatric

Date Approved

Document Title
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

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
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.

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