1. A Research of Standards of Radiopharmaceutical Doses in Pediatric Nuclear Medicine Yong Ho Do, Gye Hwan Kim, Hong Jae Lee, Jin Eui Kim, Hyun Joo Kim Department of Nuclear Medicine, Seoul National University Hospital A Research of Standards for Radiopharmaceutical Doses in Pediatric Nuclear Medicine Written by Yong Ho Do Dept. NM, SNUH, Seoul, Korea

2. Background & Purpose

3. Dosage Formula for Pediatric Nuclear Medicine  Body Mass Formula (mCi/kg) Dose injected = Adult dose x Child’s weight / 70kg  Body Surface Formula(mCi/m 2 ) Dose Injected = Adult dose X child’s body surface / 1.73  IAEA Formula (mCi/kg) Dose injected = Maximum dose x Child’s weight / 70kg  EANM Formula (mCi/kg) Dose injected = Baseline Activity x Multiplier

4. Problems  Universally applied pediatric dosage standard isn’t exited  Hard to estimate exact doses for children younger than 1year and heavier than 50kg Lower DoseMore Dose

5. Materials & Method

6. Survey paper for 4 Hospitals 1.How did you establish standard of radiopharmaceutical doses for pediatric studies? 1) -Flowing by body mass formula -Flowing by body surface formula 2) SNM, EANM, IAEA guideline or Vial kit manual 2. How amount of radiopharmaceutical doses are injected for Bone, DMSA, Lung, DTPA(Renal)? 3. Give us how to get doses for each study and write a formula.

7. Replying from 4 hospitals 1.Received Dosage from 4 Hospitals 2.Changed Dosage to Multiplier 3.Dose injected = Adult dose X Multiplier 4.Compare Multipliers to Korea, Europe, America

8. How to Change Dosage to Multiplier Select dosage for 70kg adultGet doses for children by Body Mass FormulaMultiplier = Dose for child / Dose for adultDose injected = Dose for adult X Multiplier

9. Results

10. Multiplier Comparison Chart America:0.12 Europe:0.09 Korea:0.05 America:0.95 Europe:0.95 Korea:0.91 America:0.58 Europe:0.51 Korea:0.45

11. Pediatric Dose Chart of IAEA Weight(kg)Body Mass MethodGilday’s Method 10kg0.140.30 20kg0.280.48 30kg0.420.60 40kg0.570.76 50kg0.710.88 60kg0.850.93 70kg1.00

12. Conclusion

13. Conclusion Better Image Reasonable Imaging time Reduce Radiation exposure Proper Dosage Establish universally applied dosage standard Develop better image reconstruction software The body mass formula has problem to yield exact doses for PNM studies Problem 2. Most hospitals are generally fallowing by Body mass formula Problem 1.

14. Written by Yong Ho Do with Gye Hwan Kim Hong Jae Lee Jin Eui Kim Hyun Joo Kim Special Thanks to.. Jin Wook Choi.. Written by Yong Ho Do with Gye Hwan Kim Hong Jae Lee Jin Eui Kim Hyun Joo Kim Special Thanks to.. Jin Wook Choi.. Thank you..