Operational and Dosimetric Aspects of Pediatric PET/CT

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after January 30, 2024:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.75
Safety: 0.75
Radiation Safety and Dose: 0.75

Nuclear Medicine Technology: 2.00
Image Production: 2.00
Instrumentation: 2.00

Outline

1. Introduction
2. Basics of CT Dosimetry
3. Acquisition of PET/CT
4. Practice of Pediatric PET/CT
   1. Survey of North American Pediatric PET/CT Clinics
   2. Boston Childrenís Hospital Approach
   3. Case Study
5. Discussion
6. Conclusion

Objectives

Upon completion of this course, students will:

1. know the pediatric conditions for which PET/CT provides crucial diagnostic and management information
2. be familiar with pediatric malignancies which have had their staging and tumor response assessments transformed by PET/CT imaging
3. understand the reasoning behind why children are particularly sensitive to potential carcinogenic effects of ionizing radiation
4. know the considerations for best practices in pediatric PET/CT imaging
5. know the components on which the 3D tissue density map provided by the CT depend
6. know the unit of measurement for the x-ray tube current that characterizes the number of electrons striking the anode per second
7. understand the principles of x-ray tube voltage in relation to x-ray production and patient dose
8. understand CT pitch, the factors that control it, and the effects of changing it
9. understand the CT Hounsfield unit and how it is derived
10. know the objectives of CT automatic exposure control (AEC)
11. be familiar with the various dosimetric parameters used in CT imaging
12. know the three uses of the CT portion of a PET/CT examination
13. understand the part CT plays in the correction of PET data during image reconstruction
14. know the potential advantages of acquiring both diagnostic CT and PET in a single imaging session
15. understand the reasoning behind the adjustments to CT data prior to being used for PET attenuation correction
16. be familiar with the information which was asked from the surveyed institutions
17. be familiar with the breakdown of how the various 19 sites acquired the CT portion of their pediatric PET/CT examinations
18. know the primary reason for using automatic kV selection for kV modification in CT
19. know the advantages of the Boston Children’s Hospital approach to the CT portion of the PET/CT
20. understand the Boston Children’s Hospital approach to the CT portion of the PET/CT
21. know the phantom(s) used in the Boston Children’s Hospital phantom experiment
22. be familiar with the imaging scenarios considered in the Boston Children’s Hospital phantom experiment
23. understand how the various imaging scenarios in the Boston Children’s Hospital phantom experiment provided the 10-year-old phantom patient with reduced radiation dose
24. be familiar with the diagnosis and staging of the 13-year-old patient in the article’s case study
25. understand the value of having the diagnostic abdomen/pelvis CT as part of the PET/CT
26. understand the difference in patient radiation dose between the diagnostic CT and non-diagnostic CT acquisitions of the Boston Children’s Hospital PET/CT protocol
27. know the example provided in the article where the acquisition of a separate limited diagnostic CT would be more appropriate than using the Boston Children’s Hospital CT acquisition protocol
28. know the best practice approach in pediatric PET/CT imaging
29. know a good alternative protocol when using the Boston Children’s Hospital protocol is not an option due to the constraints of a facility’s PET/CT hardware or software
30. know the potential reason stated in the article for many sites not utilizing iodinated contrast material with PET/CT and the argument against this reasoning