Review of the Clinical and Technical Aspects of Tc-Dimercaptosuccinic Acid Renal Imaging: The Comeback "Kit".

Tc-labeled dimercaptosuccinic acid (Tc-DMSA) imaging is a well-established and highly sensitive method for the diagnosis of several renal cortical disorders affecting children and adults. Beginning in 2014, Tc-DMSA availability was severely impaired when it was added to the Drug Shortages List of the U.S.

Development and autoregulation of kidney function in children: a retrospective study using Tc-MAG3 renography.

Background: Both the development of kidney function in healthy children and autoregulation ability of kidney function in patients with asymmetric kidneys are important in clinical diagnosis and treatment of kidney-related diseases, but there are however only limited studies. This study aimed to investigate development of kidney function in normal children with healthy symmetric kidneys and autoregulation of the healthy kidney compensating the functional loss of a diseased one in children with asymmetric kidneys.

Methods: Two hundred thirty-seven children (156 male, 81 female) from 0 to 20y (average 4.

Radiation Dose to Pediatric Patients From Radiopharmaceuticals.

Nuclear medicine provides methods and techniques in that has benefited pediatric patients and their referring physicians for over 40 years. Nuclear medicine provides qualitative and quantitative information about overall and regional function of organs, systems, and lesions in the body. This involves applications in many organ systems including the skeleton, the brain, the kidneys and the heart as well as in the diagnosis and treatment of cancer.

Renal Tc-DMSA pharmacokinetics in pediatric patients.

Unlabelled: Tc-DMSA is one of the most commonly used pediatric nuclear medicine imaging agents. Nevertheless, there are no pharmacokinetic (PK) models for Tc-DMSA in children, and currently available pediatric dose estimates for Tc-DMSA use pediatric S values with PK data derived from adults. Furthermore, the adult PK data were collected in the mid-70's using quantification techniques and instrumentation available at the time.

Detecting lumbar lesions in Tc-MDP SPECT by deep learning: Comparison with physicians.

Purpose: Tc-MDP single-photon emission computed tomography (SPECT) is an established tool for diagnosing lumbar stress, a common cause of low back pain (LBP) in pediatric patients. However, detection of small stress lesions is complicated by the low quality of SPECT, leading to significant interreader variability. The study objectives were to develop an approach based on a deep convolutional neural network (CNN) for detecting lumbar lesions in Tc-MDP scans and to compare its performance to that of physicians in a localization receiver operating characteristic (LROC) study.

DeepAMO: a multi-slice, multi-view anthropomorphic model observer for visual detection tasks performed on volume images.

We propose a deep learning-based anthropomorphic model observer (DeepAMO) for image quality evaluation of multi-orientation, multi-slice image sets with respect to a clinically realistic 3D defect detection task. The DeepAMO is developed based on a hypothetical model of the decision process of a human reader performing a detection task using a 3D volume. The DeepAMO is comprised of three sequential stages: defect segmentation, defect confirmation (DC), and rating value inference.

Body morphometry appropriate computational phantoms for dose and risk optimization in pediatric renal imaging with Tc-99m DMSA and Tc-99m MAG3.

Current guidelines for administered activity (AA) in pediatric nuclear medicine imaging studies are based on a 2016 harmonization of the 2010 North American Consensus guidelines and the 2007 European Association of Nuclear Medicine pediatric dosage card. These guidelines assign AA scaled to patient body mass, with further constraints on maximum and minimum values of radiopharmaceutical activity. These guidelines, however, are not formulated based upon a rigor-ous evaluation of diagnostic image quality.

Current pediatric administered activity guidelines for Tc-DMSA SPECT based on patient weight do not provide the same task-based image quality.

Purpose: In the current clinical practice, administered activity (AA) for pediatric molecular imaging is often based on the North American expert consensus guidelines or the European Association of Nuclear Medicine dosage card, both of which were developed based on the best clinical practice. These guidelines were not formulated using a rigorous evaluation of diagnostic image quality (IQ) relative to AA. In the guidelines, AA is determined by a weight-based scaling of the adult AA, along with minimum and maximum AA constraints.

Non-invasive Seizure Localization with Ictal Single-Photon Emission Computed Tomography is Impacted by Preictal/Early Ictal Network Dynamics.

Objective: More than one third of children with epilepsy have medically intractable seizures. Promising therapies, including targeted neurostimulation and surgery, depend on accurate localization of the epileptogenic zone. Ictal perfusion Single-Photon Emission Computed Tomography (SPECT) can localize the seizure focus noninvasively, with comparable accuracy to that of invasive EEG.

Chronic Acalculous Cholecystitis in Children With Biliary Symptoms: Usefulness of Hepatocholescintigraphy.

Objectives: Chronic acalculous cholecystitis (CAC) increasingly is being diagnosed as a cause of recurring biliary symptoms in children, but its clinical diagnosis remains challenging. The primary objective was to evaluate the utility of hepatocholescintigraphy in pediatric patients with suspected CAC. A secondary objective was to describe their clinical follow-up after diagnosis.

Re-evaluation of pediatric F-FDG dosimetry: Cristy-Eckerman versus UF/NCI hybrid computational phantoms.

Because of the concerns associated with radiation exposure at a young age, there is an increased interest in pediatric absorbed dose estimates for imaging agents. Almost all reported pediatric absorbed dose estimates, however, have been determined using adult pharmacokinetic data with radionuclide S values that take into account the anatomical differences between adults and children based upon the older Cristy-Eckerman (C-E) stylized phantoms. In this work, we use pediatric model-derived pharmacokinetics to compare absorbed dose and effective dose estimates for F-FDG in pediatric patients using S values generated from two different geometries of computational phantoms.

A projection image database to investigate factors affecting image quality in weight-based dosing: application to pediatric renal SPECT.

Balancing the tradeoff between radiation dose, acquisition duration and diagnostic image quality is essential for medical imaging modalities involving ionizing radiation. Lower administered activities to the patient can reduce absorbed dose, but can result in reduced diagnostic image quality or require longer acquisition durations. In pediatric nuclear medicine, it is desirable to use the lowest amount of administered radiopharmaceutical activity and the shortest acquisition duration that gives sufficient image quality for clinical diagnosis.

Operational and Dosimetric Aspects of Pediatric PET/CT.

No consistent guidelines exist for the acquisition of a CT scan as part of pediatric PET/CT. Given that children may be more vulnerable to the effects of ionizing radiation, it is necessary to develop methods that provide diagnostic-quality imaging when needed, in the shortest time and with the lowest patient radiation exposure. This article describes the basics of CT dosimetry and PET/CT acquisition in children.

Dose Estimation in Pediatric Nuclear Medicine.

The practice of nuclear medicine in children is well established for imaging practically all physiologic systems but particularly in the fields of oncology, neurology, urology, and orthopedics. Pediatric nuclear medicine yields images of physiologic and molecular processes that can provide essential diagnostic information to the clinician. However, nuclear medicine involves the administration of radiopharmaceuticals that expose the patient to ionizing radiation and children are thought to be at a higher risk for adverse effects from radiation exposure than adults.

The promise of subtraction ictal SPECT co-registered to MRI for improved seizure localization in pediatric epilepsies: Affecting factors and relationship to the surgical outcome.

Objective: Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery.

Estimation of Split Renal Function With Tc-DMSA SPECT: Comparison Between 3D Volumetric Assessment and 2D Coronal Projection Imaging.

Objective: Split renal function (SRF) can be estimated with Tc-labeled dimercaptosuccinic acid (DMSA) SPECT cortical renal scintigraphy on either 2D projected images or 3D images. The purpose of this study was to determine whether there is a significant difference between SRF values calculated with the 2D method and those calculated with the 3D method.

Materials And Methods: This retrospective study was performed with Tc-DMSA SPECT images of 316 patients (age range, 1-26 years).

Administered Activities in Pediatric Nuclear Medicine and the Impact of the 2010 North American Consensus Guidelines on General Hospitals in the United States.

Unlabelled: We sought to describe the practice of pediatric nuclear medicine at general hospitals in the United States and to assess the impact of dose awareness campaigns such as Image Gently.

Methods: A web-based survey was developed that requested information regarding hospital type, whether the hospital practices pediatric nuclear medicine, and the hospital's method for determining the administered activity for children. The survey invitation was emailed to a sample of general hospitals with more than 300 beds, excluding dedicated pediatric, veterans, psychiatric, and rehabilitation hospitals.

Pharmacokinetic modeling of [(18)F]fluorodeoxyglucose (FDG) for premature infants, and newborns through 5-year-olds.

Background: Absorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific. Such age-specific pharmacokinetic data are lacking for many of the diagnostic agents typically used in pediatric imaging. We have developed a pharmacokinetic model of [(18)F]fluorodeoxyglucose (FDG) applicable to premature infants and to 0- (newborns) to 5-year-old patients, which may be used to generate model-derived time-integrated activity coefficients and absorbed dose calculations for these patients.