A third of the radiotracer dose: two decades of progress in pediatric [18F]fluorodeoxyglucose PET/CT and PET/MR imaging

Objectives To assess the evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (F-18-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between years 2000 and 2021.Methods Pediatric patients (<= 16 years) referred for F-18-FDG PET/CT or PET/MR imaging of the body during 2000 and 2021 were retrospectively included. The amount of administered radiotracer activity in megabecquerel (MBq) was recorded, and signal-to-noise ratio (SNR) was measured in the right liver lobe with a 4 cm3 volume of interest as an indicator for objective image quality. Descriptive statistics were computed.Results Two hundred forty-three children and adolescents underwent a total of 466 examinations. The median injected F-18-FDG activity in MBq decreased significantly from 296 MBq in 2000-2005 to 100 MBq in 2016-2021 (p < 0.001), equaling approximately one-third of the initial amount. The median SNR ratio was stable during all years with 11.7 (interquartile range [IQR] 10.7-12.9, p = 0.133).Conclusions Children have benefited from a massive reduction in the administered F-18-FDG dose over the past 20 years without compromising objective image quality.