Nuclear Medicine in the First Year of Life

Nuclear medicine has an important role in the care of newborns and children less than 1 y old. Patients in this age group present with a spectrum of diseases different from those of older children or adults. These patients can benefit from the full range of nuclear medicine studies. In these young children, nuclear medicine studies are more likely to be used to evaluate a wide range of congenital conditions but also can be helpful for evaluating acquired conditions such as infection, cancer, and trauma. This review first will cover the general aspects of nuclear medicine practice with these patients, including the special considerations that can help achieve successful diagnostic imaging. These topics will include clinical indications, imaging technology, instrumentation, software, positioning and immobilization, sedation, local and general anesthesia, radiopharmaceutical doses, radiation risk, and dose reduction. The review then will discuss the specific nuclear medicine studies that typically are obtained in patients in this age group. With extra care and attention to the special needs of this population, nuclear medicine departments can successfully study patients less than 1 y old.

[1]  D. Crawford Introduction , 2008, CACM.

[2]  G. Rotondano,et al.  Gastrointestinal bleeding , 2007, Drug Therapy for Gastrointestinal and Liver Diseases.

[3]  S. Treves,et al.  An improved radionuclide method for the diagnosis of gastroesophageal reflux and aspiration in children (milk scan). , 1979, Radiology.

[4]  M. Osman,et al.  123I-MIBG Scintigraphy and 18F-FDG PET in Neuroblastoma , 2010, Journal of Nuclear Medicine.

[5]  Icrp Radiation dose to patients from radiopharmaceuticals , 1988 .

[6]  N Tonami,et al.  Age-related changes in the cerebral distribution of 99mTc-ECD from infancy to adulthood. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[7]  J. Clerc,et al.  Scintigraphic Imaging of Paediatric Thyroid Dysfunction , 2008, Hormone Research in Paediatrics.

[8]  A. Maclennan,et al.  Combined ultrasound and isotope scanning is more informative in the diagnosis of congenital hypothyroidism than single scanning , 2006, Archives of Disease in Childhood.

[9]  U. Berg,et al.  99mTechnetium-dimercaptosuccinic acid scan in the diagnosis of acute pyelonephritis in children: relation to clinical and radiological findings , 1992, Pediatric Nephrology.

[10]  L. V. dos Remedios,et al.  Renal cortical imaging in 35 patients: superior quality with 99mTc-DMSA. , 1974, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[11]  S. Mandelstam,et al.  Complementary use of radiological skeletal survey and bone scintigraphy in detection of bony injuries in suspected child abuse , 2003, Archives of disease in childhood.

[12]  T. Rudd,et al.  Differential renal function using technetium-99m dimercaptosuccinic acid (DMSA): in vitro correlation. , 1979, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[13]  S. Treves,et al.  Quantitative thallium-201 myocardial imaging in assessing right ventricular pressure in patients with congenital heart defects. , 1981, British heart journal.

[14]  S Ted Treves,et al.  Administered Radiopharmaceutical Doses in Children: A Survey of 13 Pediatric Hospitals in North America , 2008, Journal of Nuclear Medicine.

[15]  S. Lawless,et al.  The use of the salivagram in the evaluation of severe and chronic aspiration. , 1997, International journal of pediatric otorhinolaryngology.

[16]  I. Gordon,et al.  Antenatal diagnosis of renal pelvic dilatation — The natural history of conservative management , 2005, Pediatric Radiology.

[17]  M. Lassmann,et al.  The new EANM paediatric dosage card , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  S. Treves,et al.  The radionuclide salivagram in children with pulmonary disease and a high risk of aspiration , 1995, Pediatric Radiology.

[19]  M. Gelfand,et al.  123I-MIBG Scintigraphy and 18F-FDG PET in Neuroblastoma , 2009, Journal of Nuclear Medicine.

[20]  S Ted Treves,et al.  Skeletal PET with 18F-Fluoride: Applying New Technology to an Old Tracer* , 2007, Journal of Nuclear Medicine.

[21]  Chang Py,et al.  Conservative treatment of neonatal hydronephrosis. , 1992 .

[22]  J. D. Vijlder Primary congenital hypothyroidism: defects in iodine pathways. , 2003 .

[23]  Jeannette M. Perez-Rossello,et al.  Skeletal trauma in child abuse: detection with 18F-NaF PET. , 2010, Radiology.

[24]  H. Nadel Pediatric bone scintigraphy update. , 2010, Seminars in nuclear medicine.

[25]  Yuan Shi,et al.  Brain positron emission tomography in preterm and term newborn infants. , 2009, Early human development.

[26]  S. Treves,et al.  Right ventricular and left ventricular ejection fraction in pediatric patients with normal hearts: first-pass radionuclide angiocardiography. , 1984, American heart journal.

[27]  N. Simionescu,et al.  The Cardiovascular System , 1983 .

[28]  H. N. Noe,et al.  The long-term results of prospective sibling reflux screening. , 1992, The Journal of urology.

[29]  Royal T. Davis,et al.  Ictal Perfusion Brain SPECT in Pediatric Patients with Intractable Epilepsy: A Multidisciplinary Approach , 1996 .

[30]  J. Conway,et al.  Neonatal osteomyelitis examined by bone scintigraphy. , 1984, Radiology.

[31]  S. Heyman Toxicity and safety factors associated with lung perfusion studies with radiolabeled particles. , 1979, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[32]  S. Cohn,et al.  Clinical impact and prognostic value of metaiodobenzylguanidine imaging in children with metastatic neuroblastoma. , 1999, Journal of pediatric hematology/oncology.

[33]  Joachim Hornegger,et al.  Isotropic reconstruction of SPECT data using OSEM3D: correlation with CT. , 2006, Academic radiology.

[34]  Rosalind S. Brown,et al.  Update of Newborn Screening and Therapy for Congenital Hypothyroidism , 2006, Pediatrics.

[35]  A.H. Vija,et al.  Adaptive noise reduction and sharpening of OSEM-reconstructed data , 2005, IEEE Nuclear Science Symposium Conference Record, 2005.

[36]  M. Bandstra,et al.  Measurements of Fukushima fallout by the Berkeley Radiological Air and Water Monitoring project , 2011, 2011 IEEE Nuclear Science Symposium Conference Record.

[37]  K. Hjälmås,et al.  Renal function in idiopathic hydronephrosis in children. Follow-up after conservative and surgical treatment. , 1984, Scandinavian journal of urology and nephrology.

[38]  J. E. Allen,et al.  The visualization of Meckel's diverticulum with 99mTc-pertechnetate. , 1970, Surgery.

[39]  Michael G. Stabin,et al.  Radiation Dose to Patients from Radiopharmaceuticals , 2009 .

[40]  S. Treves,et al.  Effect of early emptying on quantitation and interpretation of liquid gastric emptying studies of infants and young children. , 2000, Journal of Nuclear Medicine.

[41]  C. J. Lin,et al.  Conservative treatment of neonatal hydronephrosis. , 1992, Journal of the Formosan Medical Association = Taiwan yi zhi.

[42]  S. Treves,et al.  Natural history of vesicoureteral reflux in siblings. , 1996, The Journal of urology.

[43]  Paul Kinahan,et al.  Weight-Based, Low-Dose Pediatric Whole-Body PET/CT Protocols , 2009, Journal of Nuclear Medicine.

[44]  P. Mannion The Liver and Spleen , 2007 .

[45]  S. Treves,et al.  Silent renal damage in symptom-free siblings of children with vesicoureteral reflux: assessment with technetium Tc 99m dimercaptosuccinic acid scintigraphy. , 1993, The Journal of pediatrics.

[46]  B. Shapiro,et al.  A multiobserver comparison of 99mTcO4 and 123I thyroid imaging , 1981, European Journal of Nuclear Medicine.

[47]  A. Madani,et al.  Screening for vesicoureteral reflux and renal scars in siblings of children with known reflux , 2004, Pediatric Nephrology.

[48]  I. Verber,et al.  Serial 99mTc dimercaptosuccinic acid (DMSA) scans after urinary infections presenting before the age of 5 years. , 1989, Archives of disease in childhood.

[49]  S. Treves,et al.  Radionuclide angiocardiography: an improved deconvolution technique for improvement after suboptimal bolus injection. , 1983, Radiology.

[50]  C. Kuni,et al.  Diagnosis of biliary atresia with radionuclide hepatobiliary imaging. , 1983, Radiology.

[51]  R. Hutchinson,et al.  Iodine-131-metaiodobenzylguanidine and bone scintigraphy for the detection of neuroblastoma. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[52]  J. Sibert,et al.  Which radiological investigations should be performed to identify fractures in suspected child abuse? , 2006, Clinical radiology.

[53]  Xinhua Cao,et al.  Automated motion correction based on target tracking and software implementation , 2008 .

[54]  J. Villanueva-Meyer,et al.  Pediatric gastric emptying: value of right lateral and upright positioning. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[55]  J. de Vijlder Primary congenital hypothyroidism: defects in iodine pathways. , 2003, European journal of endocrinology.

[56]  B. Engelstad,et al.  Localization of m-iodo(131I)benzylguanidine in neuroblastoma. , 1984, AJR. American journal of roentgenology.

[57]  P. Puri Antenatal diagnosis of renal pelvic dilatation—The natural history of conservative management : I. Gordon, H.K. Dhillon, and A.M. Peters. Pediatr Radiol 21:272–273, (May), 1991 , 1992 .

[58]  H. Harcke Bone imaging in infants and children: a review. , 1978, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[59]  H. G. Rushton,et al.  Renal cortical scintigraphy in the diagnosis of acute pyelonephritis. , 1992, Seminars in nuclear medicine.

[60]  K. McHugh Renal and adrenal tumours in children , 2007, Cancer imaging : the official publication of the International Cancer Imaging Society.

[61]  S T Treves,et al.  Registration and alignment of three-dimensional images: an interactive visual approach. , 1996, Radiology.

[62]  S. Ted Treves,et al.  Pediatric Radiopharmaceutical Administered Doses: 2010 North American Consensus Guidelines , 2011, The Journal of Nuclear Medicine.

[63]  S Ted Treves,et al.  Pediatric 99mTc-DMSA SPECT performed by using iterative reconstruction with isotropic resolution recovery: improved image quality and reduced radiopharmaceutical activity. , 2009, Radiology.

[64]  S. Heyman,et al.  Detection of pulmonary aspiration in children by radionuclide "salivagram". , 1989, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[65]  S Ted Treves,et al.  Pediatric 99mTc-MDP bone SPECT with ordered subset expectation maximization iterative reconstruction with isotropic 3D resolution recovery. , 2010, Radiology.

[66]  Medical versus surgical treatment of primary vesicoureteral reflux: report of the International Reflux Study Committee. , 1981, Pediatrics.

[67]  S. Lafranchi Congenital hypothyroidism: etiologies, diagnosis, and management. , 1999, Thyroid : official journal of the American Thyroid Association.

[68]  G. Sfakianakis,et al.  Detection of ectopic gastric mucosa in Meckel's diverticulum and in other aberrations by scintigraphy: ii. indications and methods--a 10-year experience. , 1981, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[69]  Nicola Fox,et al.  Cardiovascular system. , 2007, Nursing Standard.

[70]  S. Treves,et al.  Renal localization of 99mTc-stannous glucophetonate and 99mTc-stannous dimercaptosuccinate in the rat by frozen section autoradiography. The efficiency and resolution of technetium-99m. , 1977, Radiation research.

[71]  H. Nadel,et al.  Early experience with PET/CT scan in the evaluation of pediatric abdominal neoplasms. , 2008, Journal of pediatric surgery.

[72]  R. Reba,et al.  Effect of phenobarbital on 99mTc-IDA scintigraphy in the evaluation of neonatal jaundice. , 1981, Seminars in nuclear medicine.

[73]  R. Hutchinson,et al.  PET FDG studies of Wilms tumors. , 1997, Journal of pediatric hematology/oncology.

[74]  A. Belman,et al.  Direct and indirect radionuclide cystography. , 1974, The Journal of urology.

[75]  S. Treves,et al.  Functional bladder capacity measured during radionuclide cystography in children. , 1996, Radiology.

[76]  S. Treves,et al.  Congenital hypothyroidism: 123I thyroidal uptake and scintigraphy. , 1982, The Journal of pediatrics.

[77]  G. Lonergan,et al.  Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. , 2002, Radiographics : a review publication of the Radiological Society of North America, Inc.

[78]  J. Fettich,et al.  Vesicoureteric reflux and renal scars in asymptomatic siblings of children with reflux. , 1992, Archives of disease in childhood.

[79]  E. Eugster,et al.  Definitive diagnosis in children with congenital hypothyroidism. , 2004, The Journal of pediatrics.

[80]  G. Sfakianakis,et al.  The effect of gastrointestinal hormones on the pertechnetate imaging of ectopic gastric mucosa in experimental Meckel's diverticulum. , 1981, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[81]  I Gardin,et al.  Use of subtraction ictal SPECT co-registered to MRI for optimizing the localization of seizure foci in children. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[82]  C. Kondo Myocardial perfusion imaging in pediatric cardiology , 2004, Annals of nuclear medicine.

[83]  L J SCHEINMAN,et al.  Vesicoureteral Refl ux , 2014 .

[84]  H. Chugani,et al.  Functional brain imaging in pediatrics. , 1992, Pediatric clinics of North America.

[85]  S. Treves Pediatric Nuclear Medicine , 1984 .

[86]  A. D. Van den Abbeele,et al.  Vesicoureteral reflux in asymptomatic siblings of patients with known reflux: radionuclide cystography. , 1987, Pediatrics.

[87]  S. Treves,et al.  Quantitative Radionuclide Angiocardiography: Determination of Qp:Qs in Children , 1973, Circulation.

[88]  M. Harris,et al.  Undiagnosed fractures in severely injured children and young adults. Identification with technetium imaging. , 1994, The Journal of bone and joint surgery. American volume.

[89]  B. Fireman,et al.  The Key Role of Newborn Thyroid Scintigraphy With Isotopic Iodide (123I) in Defining and Managing Congenital Hypothyroidism , 2004, Pediatrics.

[90]  F. Saad,et al.  Transitional hydronephrosis of the newborn and infant. , 1990, The Journal of urology.