Article Figures & Data
Tables
- TABLE 1.
Duration of Breastfeeding Interruption (Studies Listed Alphabetically from A to I)
Study Radiopharmaceutical Administered dose Institution guidelines, 2022 SNMMI/EANM procedure guideline (7)* Stabin and Breitz (2) ICRP 106 (8) Leide- Svegborn (1)† ACMUI (9)‡ Adrenal medulla 131I-MIBG 37 MBq Stop Stop NA >3 wk NA NA Adrenal medulla 123I-MIBG 370 MBq 48 h 48 h 48 h >3 wk NA NA Bone scan 99mTc-MDP 11 MBq/kg 4 h 4–24 h 0 0 0 24 h Bone scan PET 18F-fluoride 185–370 MBq — NA NA NA NA 4 h Bone marrow 99mTc-SC 555 MBq 4 h NA 0 0 NA 24 h Brain perfusion 99mTc-ECD 555–1,110 MBq 4 h NA NA 0 NA 24 h Brain perfusion 99mTc-HMPAO 555–1,110 MBq 4 h NA NA 0 NA 24 h Brain amyloid 18F-florbetapir 370 MBq — 24 h NA NA NA NA Brain amyloid 18F-flutemetamol 185 MBq — 24 h NA NA NA NA Brain amyloid 18F-florbetaben 300 MBq — 24 h NA NA NA NA Breast imaging 99mTc-sestamibi 300–600 MBq — 0 0 0 NA 24 h Breast imaging 99mTc-testrofosmin 300–600 MBq — 0 NA 0 NA 24 h Cardiac necrosis 99mTc-PYP 740 MBq 4 h NA 0 0 NA 24 h Cisternography 111In-DTPA 18–27.8 MBq 0 NA NA NA NA NA Cerebrospinal fluid shuntogram 111In-DTPA 28 MBq 0 NA NA NA NA NA DaTScan 123I-ioflupane 111–185 MBq 3 d 1–6 d NA NA NA NA Brain scan 18F-FDG 4.9 MBq/kg 12 h 24 h NA 0 0 4 h Esophageal transit 99mTc-SC 40 MBq 4 h NA 0 0 NA 24 h 18F-FDG PET (oncology) 18F-FDG 4.9 MBq/kg 12 h 12 h NA 0 0 4 h 67Ga scan 67Ga-citrate 148–333 MBq Stop 2–4 wk Stop >3 wk NA 28 d Gastric emptying/transit (liquid) 99mTc-DTPA 37 MBq 4 h NA 0 0 NA 24 h Gastric emptying (solid) 99mTc-SC 18.5 MBq 4 h NA 0 0 NA 24 h Gastrointestinal bleed 99mTc-RBC in vitro 555–1,110 MBq 4 h 0 0 0 NA 24 h Heat-damaged RBC scan 99mTc-RBC in vitro 370 MBq 4 h NA 0 0 NA 24 h Hepatic hemangioma 99mTc-RBC in vitro 750–925 MBq 4 h NA 0 0 NA 24 h Hepatobiliary scan 99mTc-DISIDA 185 MBq 4 h 0 0 0 NA 24 h Hepatobiliary scan 99mTc-mebrofenin 185 MBq 4 h 0 NA NA NA 24 h Iodine whole-body imaging 131I-NaI 185 MBq Stop NA Stop >3 wk Stop Stop Iodine whole-body imaging 123I-NaI 74–185 MBq 4 d NA Stop >3 wk NA 3 d ↵* Or publicly available guidance documents.
↵† Recommendation was based on both internal and external radiation exposure.
↵‡ Single 24-h interruption period is recommended for 99mTc-labeled radiopharmaceuticals to simplify guidance.
MIBG = metaiodobenzylguanidine; NA = data not available; MDP = methyl diphosphonate; 0 = no breastfeeding cessation is necessary; — = not institutional procedure; SC = sulfur colloid; ECD = ethyl cysteinate dimer; HMPAO = hexamethylpropyleneamine oxime; PYP = pyrophosphate; DTPA = diethylenetriaminepentaacetic acid; RBC = red blood cell; DISIDA = diisopropyl iminodiacetic acid.
Study Radiopharmaceutical Administered dose (MBq) Institution guidelines, 2022 SNMMI/EANM procedure guideline (7)* Stabin and Breitz (2) ICRP 106 (8) Leide- Svegborn (1)† ACMUI (9)‡ Lacrimal gland 99mTc-pertechnetate 7.4 0 NA NA NA NA NA Liver, spleen 99mTc-SC 200 4 h NA 0 0 NA 24 h Lung perfusion 99mTc-MAA 74–185 12 h NA 12 h 12 h 12 h 24 h Lung ventilation 99mTc-Technegas 18–37 0 NA NA 0 NA 24 h Lung ventilation 99mTc-DTPA aerosol 20–40 — NA 0 NA NA 24 h Lung ventilation 99mTc-SC aerosol 20–40 — 0 NA NA NA 24 h Lung ventilation 81mKr gas 40–400 — 0 NA 0 NA NA Lung ventilation 133Xe gas 200–750 — 0 NA 0 NA NA Lymphoscintigraphy 99mTc-filtered SC 37 4 h 24 h 0 0 NA 24 h Lymphoscintigraphy 99mTc-unfiltered SC 185 4 h 24 h 0 0 NA 24 h Lymphoscintigraphy 99mTc-sulphide nanocolloid 3.7−370 — 24 h NA NA NA 24 h Lymphoscintigraphy 99mTc-nanocolloidal albumin 3.7–370 — 24 h NA NA NA 24 h Lymphoscintigraphy 99mTc-antimony trisulfide 3.7−370 — 24 h NA NA NA 24 h Lymphoscintigraphy 99mTc-tilmanocept 3.7−370 — 24 h NA NA NA 24 h 177Lu-DOTATATE 177Lu-oxodotreotide 3,700 Stop 2.5 mo NA NA NA Stop ↵* Or publicly available guidance documents.
↵† Recommendation was based on both internal and external radiation exposure.
↵‡ Single 24-h interruption period is recommended for 99mTc-labeled radiopharmaceuticals to simplify guidance.
NA = data not available; 0 = no breastfeeding cessation is necessary; SC = sulfur colloid; DTPA = diethylenetriaminepentaacetic acid; — = not institutional procedure.
- TABLE 3.
Duration of Breastfeeding Interruption (Studies Listed Alphabetically from M to S)
Study Radiopharmaceutical Administered dose Institution guidelines, 2022 SNMMI/EANM procedure guideline (7)* Stabin and Breitz (2) ICRP 106 (8) Leide- Svegborn (1)† ACMUI (9)‡ Meckel diverticulum 99mTc-pertechnetate 555 MBq 12 h 12 h 4 h 12 h 12 h 24 h Multigated acquisition 99mTc-RBC modified in vivo 925 MBq 12 h 24 h 12 h 12 h 0 24 h Myocardial perfusion (rest + stress) 99mTc-tetrofosmin 1,184 MBq 4 h 4 h NA 0 NA 24 h Myocardial perfusion (rest + stress) 99mTc-sestamibi 1,184 MBq 4 h 4 h 0 0 0 24 h Myocardial perfusion 201Tl-chloride 111 MBq 4 d 48 h 96 h 48 h NA 4 d Myocardial perfusion 82Rb 1,100–1,850 MBq — NA NA NA NA 0 Myocardial perfusion 13N-ammonia 370–740 MBq — NA NA 0 NA 1 h Sodium fluoride PET 18F-NaF 2.22 MBq/kg 0 NA NA NA NA 4 h Octreotide scan 111In-octreotide 111 MBq 0 0 NA 0 NA 6 d Parathyroid scan 99mTc-sestamibi 740 MBq 4 h 0 0 0 NA 24 h Parathyroid scan 99mTc-tetrofosmin 185–925 MBq — 0 NA 0 NA 24 h Parathyroid scan (for dual phase) 99mTc-pertechnetate 75–150 MBq — 12 h 4 h 12 h NA 24 h Parathyroid scan (for dual tracer) 123I-NaI and 99mTc-sestamibi 7.5–20 and 740 MBq 4 d 3 wk Stop >3 wk NA 3 d R to L shunt 99mTc-MAA 37 MBq 12 h NA NA NA NA 24 h Renal cortical 99mTc-gluceptate 296 MBq 4 h NA 0 0 NA 24 h Renal cortical 99mTc-DMSA 111 MBq 4 h NA NA 0 NA 24 h Renal function 99mTc-MAG-3 260 MBq 4 h 4 h 0 0 0 24 h Renal function 99mTc-DTPA 370 MBq 4 h 12 h 0 0 0 24 h Renal GFR 99mTc-DTPA 37 MBq 4 h NA 0 0 0 24 h Salivary gland scan 99mTc-pertechnetate 555 MBq 12 h NA 4 h 12 h 12 h 24 h SeHCAT scan 75Se-tauroselcholic acid 0.37 MBq >3 wk NA NA >3 wk NA NA Small-bowel and colon transit 99mTc-SC 18.5–37 MBq — NA 0 0 NA 24 h ↵* Or publicly available guidance documents.
↵† Recommendation was based on both internal and external radiation exposure.
↵‡ Single 24-h interruption period is recommended for 99mTc-labeled radiopharmaceuticals to simplify guidance.
RBC = red blood cell; 0 = no breastfeeding cessation is necessary; NA = data not available; — = not institutional procedure; DMSA = dimercaptosuccinic acid; MAG = mercaptoacetyltriglycine; DTPA = diethylenetriaminepentaacetic acid; SC = sulfur colloid.
- TABLE 4.
Duration of Breastfeeding Interruption (Studies Listed Alphabetically from T to Z)
Study Radiopharmaceutical Administered dose Institution guidelines, 2022 SNMMI/EANM procedure guideline (7)* Stabin and Breitz (2) ICRP 106 (8) Leide- Svegborn (1)† ACMUI (9)‡ Thyroid scan 123I-NaI 18.5 MBq 4 d NA 0 >3 wk NA 3 d Thyroid scan 99mTc-pertechnetate 370 MBq 12 h NA 4 h 12 h 12 h 24 h Thyroid uptake 131I-NaI 0.37 MBq Stop NA Stop >3 wk Stop Stop Thyroid ablation (hyperthyroidism) 131I-NaI 185–1,110 MBq Stop Stop Stop >3 wk Stop Stop Thyroid cancer ablation§ 131I-NaI 1,100–7,400 MBq Stop 3 mo prior Stop Stop >3 wk Stop Stop Urea breath test 14C-urea 0.037 MBq 0 NA NA 0 NA NA WBC scan 111In-oxine WBC 10–40 MBq 0 NA 0 0 NA 6 d WBC scan 99mTc-HMPAO WBC 370–740 MBq 24 h NA 48 h 12 h 0 24 h 90Y-radiolabeled therapy 90Y-ibritumomab tiuxetan 15 MBq/kg — Stop NA NA NA NA ↵* Or publicly available guidance documents.
↵† Recommendation was based on both internal and external radiation exposure.
↵‡ Single 24-h interruption period is recommended for 99mTc-labeled radiopharmaceuticals to simplify guidance.
↵§ For radioiodine ablation for thyroid cancer, discontinuation of breastfeeding of 3 mo is recommended before therapy to reduce radiation exposure to lactating breast.
NA = data not available; 0 = no breastfeeding cessation is necessary; WBC = white blood cell; HMPAO = hexamethylpropyleneamine oxime; — = not institutional procedure.
