Children and Radiation Protection in Nuclear Medicine

In nuclear medicine, radiation is used to diagnose and treat various medical conditions. However, children are more sensitive to radiation than adults due to their developing bodies and higher cell division rates. As a result, special care must be taken when using radioactive materials in pediatric patients. Radiation protection for children in nuclear medicine involves minimizing exposure while ensuring accurate diagnosis and effective treatment. This can be achieved by using the lowest possible radiation dose, employing advanced imaging techniques, and adjusting protocols specifically for pediatric needs. Additionally, clear communication with families and strict adherence to safety guidelines are crucial in safeguarding young patients. Overall, balancing the benefits of nuclear medicine with the need for radiation protection is essential to ensure children's health and safety during medical procedures.

Optimization of Protection

For nuclear medicine examinations involving children, the optimization of protection focuses primarily on minimizing the administered activity while still obtaining a diagnostic result. The principle is the same as for adults: the administered activity should be the minimum required for an effective examination.

Scaling of Activity for Children

When determining the administered activity for children, body weight should always be measured and adjusted accordingly. The activity should be scaled down from the normal adult dose, which is based on an average body weight of 70 kg. However, the method of scaling may vary:

• One approach is to reduce the activity in proportion to the child's body weight. However, this method may sometimes result in inadequate image quality.
• Another method scales the activity in proportion to the child's body surface area, ensuring that the image quality remains consistent with that of an adult, although the effective dose may be slightly higher.

As a general guide, activity levels should not exceed 10% of the normal adult dose for children.

Hybrid Imaging Considerations

For hybrid imaging (e.g., PET/CT or SPECT/CT), the CT protocol should be carefully optimized. This includes reducing the tube current-time product (mAs) and tube potential (kV) to lower radiation exposure, while ensuring diagnostic image quality is not compromised. Additional optimizations include:

• Careful selection of slice width and pitch.
• Minimizing the scanning area to focus only on the region of interest.

Individualized protocols based on the child's size should be created, with the principles outlined by medical physicists and specialists.

Managing Motion During Examinations

One of the challenges in pediatric nuclear medicine examinations is ensuring that the child remains still during the procedure. Even minor movements can severely affect image quality and render the examination useless. To address this, several methods can be employed:

• Using mechanical supports to safely fasten the child in place.
• Engaging the child’s attention with distractions, such as a television program, which can be effective for older children.
• In some cases, sedation or general anesthesia may be necessary to ensure the child remains still.

Summary

In summary, the protection of children during nuclear medicine examinations involves minimizing radiation exposure through careful scaling of administered activity, optimizing imaging protocols, and using strategies to reduce motion. These efforts help ensure that children receive the highest quality of care while minimizing potential radiation risks.

Note: The protocols for pediatric nuclear medicine examinations should always be tailored to the individual child's size and medical needs.

Important: It is crucial that the nuclear medicine team, including medical physicists, collaborate to create child-specific protocols for optimal safety.