Guidelines for the use of PET-CT in children

1. It is reasonable to scan children with conditions where there is good evidence for the use of PET in adults. 2. In other conditions the use of PET needs to be assessed on a case-by-case basis where it may be useful for individual management. 3. Liaison with parents/caregivers in advance of the scan s required. 4. Any examination requiring anaesthesia or sedation should be carried out in centres with personnel and equipment immediately available to manage paediatric emergency situations. 5. Neurology and cardiology examinations for children requiring monitoring need to be carried out in centres with paediatric services. 6. Examinations, where a CT scan is performed with i.v. contrast at the same scanning session as the PET-CT scan, should be carried out in centres with paediatric services. 7. Patients under the age of 13 years should ideally be scanned in specialist regional PET units with experience in scanning children and who have direct access to paediatric inpatient services. Children older than this with developmental problems and children with severe systemic illness will also need to be scanned in specialist units. 8. Children aged between 8 and 12 years could be scanned in sites without paediatric services, however, at the discretion of the referring paediatrician provided an individual trained in APLS is in the vicinity and the paediatric resuscitation kit is available within the scanning facility. 9. Studies should always be performed by staff who scan children on a regular basis with experience in paediatric cannulation. All staff should be criminal records bureau checked and have appropriate child protection training. 10. PET and CT protocols should be optimized in accordance with the ALARA principle. 11. Scans should be interpreted by nuclear physicians or radiologists who report regularly the type of paediatric study being performed. 12. Regular audit and review of scan procedure, quality and interpretation are mandatory. 13. Given the complexity of requirements for PET/CT scanning in children, and the need to develop and maintain expertise in the reporting of sometimes rare conditions in children, specialist regional centres should be established in the UK. 14. Scans could be performed at sites more local to the patient in circumstances outlined above but according to protocols developed at the regional centre with reporting carried out at the regional centre. © 2008 Lippincott Williams & Wilkins, Inc.