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Research ArticlePRACTICE GUIDELINES

SNM Practice Guideline for Brain Death Scintigraphy 2.0

Kevin J. Donohoe, Garima Agrawal, Kirk A. Frey, Victor H. Gerbaudo, Giuliano Mariani, James S. Nagel, Barry L. Shulkin, Michael G. Stabin and Margaret K. Stokes
Journal of Nuclear Medicine Technology September 2012, 40 (3) 198-203; DOI: https://doi.org/10.2967/jnmt.112.105130
Kevin J. Donohoe
1Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Garima Agrawal
2Mallinckrodt Institute of Radiology, St. Louis, Missouri
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Kirk A. Frey
3University of Michigan Medical Center, Ann Arbor, Michigan
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Victor H. Gerbaudo
4Brigham and Women’s Hospital, Boston, Massachusetts
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Giuliano Mariani
5University of Pisa Medical School, Pisa, Italy
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James S. Nagel
6VA Boston Healthcare System, West Roxbury, Massachusetts
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Barry L. Shulkin
7St. Jude Children’s Research Hospital, Memphis, Tennessee; and
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Michael G. Stabin
8Vanderbilt University, Nashville, Tennessee
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Margaret K. Stokes
1Beth Israel Deaconess Medical Center, Boston, Massachusetts
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  • Article
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    TABLE 1

    Radiation Dosimetry: Adults (24,25)

    Administered activity (intravenous)Largest radiation doseEffective dose
    RadiopharmaceuticalMBqmCiOrganmGy/MBqrad/mCimSv/MBqrem/mCi
    99mTc-DTPA (24)555–1,11015–30Bladder wall0.0650.240.00630.023
    99mTc-HMPAO (25)370–1,11010–30Kidneys0.0340.01260.00930.034
    99mTc-ECD370–1,11010–30Bladder wall0.050.180.00770.028
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    TABLE 2

    Radiation Dosimetry: Children (5 Years Old; Normal Renal Function) (24,25)

    Administered activity (intravenous)Minimum doseMaximum doseLargest radiation doseEffective dose
    RadiopharmaceuticalMBq/kgmCi/kgMBqmCiMBqmCiOrganmGy/MBqrad/mCimSv/MBqrem/mCi
    99mTc-DTPA (24)7.40.23701074020Bladder wall0.170.630.0170.063
    99mTc-HMPAO (25)11.10.3185574020Thyroid0.140.520.0270.099
    99mTc-ECD (26)11.10.3185574020Bladder wall0.110.410.0220.081
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    TABLE 3

    99mTc-DTPA in the Pregnant or Potentially Pregnant Patient (27)

    Fetal dose
    Stage of gestationmGy/MBqrad/mCimGyrad
    Early0.0120.0446.7–8.90.67–0.89
    3 mo0.00870.0324.8–6.40.48–0.64
    6 mo0.00410.0152.3–3.00.23–0.30
    9 mo0.00470.0172.6–3.50.26–0.35
    • Dose estimates to fetus were provided by Russell et al. (27). Information about possible placental crossover of this compound was included in the calculations.

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    TABLE 4

    99mTc-HMPAO in the Pregnant or Potentially Pregnant Patient (27)

    Fetal dose
    Stage of gestationmGy/MBqrad/mCimGyrad
    Early0.00870.0323.2–9.70.32–0.97
    3 mo0.00670.0252.5–7.40.25–0.74
    6 mo0.00480.0181.8–5.30.18–0.53
    9 mo0.00360.0131.3–4.00.13–0.40
    • Dose estimates to fetus were provided by Russell et al. (27). No information about possible placental crossover of this compound was available.

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Journal of Nuclear Medicine Technology: 40 (3)
Journal of Nuclear Medicine Technology
Vol. 40, Issue 3
September 1, 2012
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SNM Practice Guideline for Brain Death Scintigraphy 2.0
Kevin J. Donohoe, Garima Agrawal, Kirk A. Frey, Victor H. Gerbaudo, Giuliano Mariani, James S. Nagel, Barry L. Shulkin, Michael G. Stabin, Margaret K. Stokes
Journal of Nuclear Medicine Technology Sep 2012, 40 (3) 198-203; DOI: 10.2967/jnmt.112.105130

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SNM Practice Guideline for Brain Death Scintigraphy 2.0
Kevin J. Donohoe, Garima Agrawal, Kirk A. Frey, Victor H. Gerbaudo, Giuliano Mariani, James S. Nagel, Barry L. Shulkin, Michael G. Stabin, Margaret K. Stokes
Journal of Nuclear Medicine Technology Sep 2012, 40 (3) 198-203; DOI: 10.2967/jnmt.112.105130
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  • Article
    • PREAMBLE
    • I. INTRODUCTION
    • II. GOALS
    • III. DEFINITIONS
    • IV. COMMON CLINICAL INDICATIONS
    • V. QUALIFICATIONS AND RESPONSIBILITES OF PERSONNEL (IN THE UNITED STATES)
    • VI. PROCEDURE/SPECIFICATIONS OF THE EXAMINATION
    • VII. DOCUMENTATION/REPORTING
    • VIII. EQUIPMENT SPECIFICATION
    • IX. QUALITY CONTROL AND IMPROVEMENT
    • X. RADIATION SAFETY IN IMAGING
    • Acknowledgments
    • XIII. APPROVAL
    • Footnotes
    • XII. REFERENCES
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  • Brain Death Scintigraphy: Do Not Blow the Flow
  • Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline: Report of the AAN Guidelines Subcommittee, AAP, CNS, and SCCM
  • Radionuclide Evaluation of Brain Death in the Post-McMath Era: Epilogue and Enigmata
  • Radionuclide Evaluation of Brain Death in the Post-McMath Era
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