Radiation dose optimization and dosimetry in pediatric nuclear medicine: Current concepts and future directions

IF 6.6 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine Pub Date : 2026-09-01 Epub Date: 2026-08-06 DOI:10.1053/j.semnuclmed.2026.07.005

Serin Moghrabi, Kamo Ramonaheng, Raghad Mohammad Al-houwari, Ali Mohamedkhair, Nouraldeen Alzorgan, Abdullah Amro, Ahmed Abdlkadir, Mike Sathekge, Akram Al-Ibraheem

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Over the past decade, substantial advances in quantitative imaging, detector technology, hybrid imaging, computational dosimetry, and theranostics have transformed radiation management from standardized activity administration toward increasingly individualized approaches. This review summarizes the biological basis of radiation risk in children, fundamental principles of internal dosimetry, and the unique anatomical and physiological factors influencing radiation dose estimation in pediatric patients. Current international recommendations for pediatric administered activities are discussed alongside practical strategies for radiation dose optimization across common nuclear medicine procedures and hybrid PET/CT and SPECT/CT imaging. The review further examines the growing role of quantitative PET and SPECT, patient-specific dosimetry, voxel-based dose calculation, Monte Carlo simulation, and advanced computational phantoms in improving absorbed-dose estimation and supporting personalized imaging and radionuclide therapy. Emerging applications of artificial intelligence, including image reconstruction, automated organ segmentation, predictive dosimetry, and low-count imaging, are also highlighted. Finally, current challenges, radiation protection principles, and future directions are discussed, emphasizing the transition toward precision pediatric nuclear medicine. 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引用次数: 0

Abstract

•
Reviews current strategies for radiation dose optimization in pediatric nuclear medicine.
•
Summarizes international pediatric activity guidelines and ALARA-based imaging.
•
Explores patient-specific dosimetry using quantitative PET/SPECT and Monte Carlo methods.
•
Discusses AI, voxel-based dosimetry, and advanced computational imaging technologies.
•
Highlights future directions toward precision pediatric imaging and theranostics.

Pediatric nuclear medicine plays an essential role in the diagnosis and treatment of a wide range of oncologic and non-oncologic diseases while requiring particular attention to radiation safety because of children's greater radiosensitivity, ongoing growth, and longer life expectancy. Over the past decade, substantial advances in quantitative imaging, detector technology, hybrid imaging, computational dosimetry, and theranostics have transformed radiation management from standardized activity administration toward increasingly individualized approaches. This review summarizes the biological basis of radiation risk in children, fundamental principles of internal dosimetry, and the unique anatomical and physiological factors influencing radiation dose estimation in pediatric patients. Current international recommendations for pediatric administered activities are discussed alongside practical strategies for radiation dose optimization across common nuclear medicine procedures and hybrid PET/CT and SPECT/CT imaging. The review further examines the growing role of quantitative PET and SPECT, patient-specific dosimetry, voxel-based dose calculation, Monte Carlo simulation, and advanced computational phantoms in improving absorbed-dose estimation and supporting personalized imaging and radionuclide therapy. Emerging applications of artificial intelligence, including image reconstruction, automated organ segmentation, predictive dosimetry, and low-count imaging, are also highlighted. Finally, current challenges, radiation protection principles, and future directions are discussed, emphasizing the transition toward precision pediatric nuclear medicine. Continued technological innovation, standardized quantitative methodologies, and prospective pediatric validation studies will be essential to optimize radiation safety while maximizing the diagnostic and therapeutic benefits of molecular imaging and theranostics in children.

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儿童核医学中辐射剂量优化和剂量测定：当前概念和未来方向。

儿童核医学在广泛的肿瘤和非肿瘤疾病的诊断和治疗中起着至关重要的作用，同时由于儿童更大的放射敏感性、持续生长和更长的预期寿命，需要特别注意辐射安全。在过去的十年中，定量成像、探测器技术、混合成像、计算剂量学和治疗学方面的重大进步已经将辐射管理从标准化的活动管理转变为越来越个性化的方法。本文综述了儿童辐射风险的生物学基础，内剂量学的基本原理，以及影响儿童患者辐射剂量估算的独特解剖和生理因素。本文讨论了目前国际上关于儿科给药活动的建议，以及在普通核医学程序和混合PET/CT和SPECT/CT成像中优化辐射剂量的实用策略。这篇综述进一步探讨了定量PET和SPECT、患者特异性剂量测定、基于体素的剂量计算、蒙特卡罗模拟和先进的计算幻影在改善吸收剂量估计和支持个性化成像和放射性核素治疗方面日益增长的作用。人工智能的新兴应用，包括图像重建、自动器官分割、预测剂量学和低计数成像，也得到了强调。最后，讨论了当前面临的挑战、辐射防护原理和未来发展方向，强调了向精准儿科核医学的过渡。持续的技术创新、标准化的定量方法和前瞻性儿科验证研究将是优化辐射安全的必要条件，同时最大限度地提高儿童分子成像和治疗学的诊断和治疗效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in nuclear medicine 医学-核医学

CiteScore

9.80

自引率

6.10%

发文量

审稿时长

14 days

期刊介绍： Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.