ACR–ACNM–SNMMI–SPR PRACTICE PARAMETER FOR THE PERFORMANCE OF NEUROENDOCRINE TUMOR GAMMA CAMERA SCINTIGRAPHY

PREAMBLE

I. INTRODUCTION

II. INDICATIONS

III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

IV. SPECIFICATIONS OF THE EXAMINATION

A. Radiopharmaceuticals

IV. SPECIFICATIONS OF THE EXAMINATION

B. Patient Preparation and Imaging

V. DOCUMENTATION

VI. EQUIPMENT SPECIFICATIONS

VII. RADIATION SAFETY

VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION

ACKNOWLEDGEMENTS

Writing Committee – members represent their societies in the initial and final revision of this practice parameter

ACR
Clemenshaw, Michael N MD, MS, Chair
Shah, Summit MD
Trout, Andrew T MD

ACNM
Bodei, Lisa MD, PhD
Mari Aparici, Carina MD

SNMMI
Brandon, David MD
Graham, Michael M MD, PhD

SPR
Guja, Kip MD, PhD
States, Lisa J MD

Committee on Practice Parameters – Nuclear Medicine and Molecular Imaging

(ACR Committee responsible for sponsoring the draft through the process)

Bartel, Twyla B DO, MBA, Chair	Aboian, Mariam MD, PhD	Berenji, G. Reza MD	Bradley, Yong C MD
Gerard, Perry S MD	Kamat, Bhishak H MD	Karagulle Kendi, A. Tuba MD	Marcus, Charles MD
Mercier, Gustavo A MD, PhD	Radut, Bianca DO	Solnes, Lilja B MBA, MD	Surasi, Devaki Shilpa MD
Viglianti, Benjamin L MD, PhD	Wong, Terence Z MD, PhD	Zukotynski, Katherine MD, PhD

Committee on Practice Parameters and Technical Standards

(ACR Committee responsible for sponsoring the draft through the process)

Caplin, Drew M MD, Chair

Committee on Practice Parameters – Pediatric Imaging

(ACR Committee responsible for sponsoring the draft through the process)

Amodio, John B MD, Chair	Alizai, Hamza MD	Bhimaniya, Sudhir X MBBS, MD	Blumfield, Einat MD
Collard, Michael MD	Goldman-Yassen, Adam MD	Lai, Hollie A MD	Lala, Shailee V MD
Lasiecka, Zofia M MD, PhD	Laufer, Adina MD	Li, Arleen MD	Maloney, John A MD
Noda, Sakura MD	Shah, Summit MD	Vatsky, Seth DO

Bulas, Dorothy I MD, Chair, Commission on Pediatric Radiology

Larson, David B MBA, MD, Chair, Commission on Quality and Safety

Rohren, Eric MD, PhD, Chair, Commission on Nuclear Medicine & Molecular Imaging

Comments Reconciliation Committee

Lee, Ryan K MBA, MD - CSC, Co-Chair	Rathi, Alisha MD - CSC, Chair	Amodio, John B MD	Bartel, Twyla B DO, MBA
Bodei, Lisa MD, PhD	Brandon, David MD	Bulas, Dorothy I MD	Caplin, Drew M MD
Clemenshaw, Michael N MD, MS	Crummy, Timothy MD, MHA - CSC	Graham, Michael M MD, PhD	Guja, Kip MD, PhD
Larson, David B MBA, MD	Mari Aparici, Carina MD	Rohren, Eric MD, PhD	Schoppe, Kurt MD - CSC
Shah, Summit MD	States, Lisa J MD	Trout, Andrew T MD

REFERENCES

1. [-3197674] American College of Radiology. ACR–ACNM–SNMMI–SPR Practice Parameter for the Use of Radiopharmaceuticals in Diagnostic Procedures. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=171+&releaseId=2
2. [-3197669] American College of Radiology. ACR–ACNM–SNMMI–SPR Practice Parameter for Performing FDG-PET/CT in Oncology. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=173+&releaseId=2
3. [-3197668] American College of Radiology. ACR–ACNM–SNMMI Practice Parameter for the Performance of Gallium-68 and Copper-64 DOTATATE PET/CT Imaging for Neuroendocrine Tumors. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=18+&releaseId=2
4. [-3120926] American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=23+&releaseId=2.
5. [20644928] Bombardieri E, Giammarile F, Aktolun C, et al. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010 Dec;37(12):2436-46.
6. [11158063] Kaltsas G, Korbonits M, Heintz E, et al. Comparison of somatostatin analog and meta-iodobenzylguanidine radionuclides in the diagnosis and localization of advanced neuroendocrine tumors. J Clin Endocrinol Metab. 2001 Feb;86(2):895-902.
7. [3890187] McEwan AJ, Shapiro B, Sisson JC, Beierwaltes WH, Ackery DM. Radio-iodobenzylguanidine for the scintigraphic location and therapy of adrenergic tumors. Semin Nucl Med. 1985 Apr;15(2):132-53.
8. [12375024] Nakatani T, Hayama T, Uchida J, Nakamura K, Takemoto Y, Sugimura K. Diagnostic localization of extra-adrenal pheochromocytoma: comparison of (123)I-MIBG imaging and (131)I-MIBG imaging. Oncol Rep. 2002;9(6):1225-7.
9. [12658506] Olivier P, Colarinha P, Fettich J, et al. Guidelines for radioiodinated MIBG scintigraphy in children. Eur J Nucl Med Mol Imaging. 2003 May;30(5):B45-50.
10. [21803184] Sharp SE, Gelfand MJ, Shulkin BL. Pediatrics: diagnosis of neuroblastoma. Semin Nucl Med. 2011 Sep;41(5):345-53.
11. [22926712] Taieb D, Timmers HJ, Hindie E, et al. EANM 2012 guidelines for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 39(12):1977-95, 2012 Dec.
12. [-3197850] Biersack HJ, Freeman LM. Clinical Nuclear Medicine. New York, NY: Springer Medical Publishing; 2007.
13. [-3197765] GE Healthcare. Highlights of Prescribing Information: These highlights do not include all the information needed to use VIZAMYL safely and effectively. See full prescribing information for VIZAMYL. VIZAMYL (flutemetamol F 18 injection) for intravenous use. ; Initial U.S. Approval: 2013.
14. [21233182] Gelfand MJ, Parisi MT, Treves ST, Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J Nucl Med. 2011 Feb;52(2):318-22.
15. [24599377] Lassmann M, Treves ST, Paediatric radiopharmaceutical administration: harmonization of the 2007 EANM paediatric dosage card (version 1.5.2008) and the 2010 North American consensus guidelines. Eur J Nucl Med Mol Imaging. 2014 May;41(5):1036-41.
16. [-3199123] 2024 Update of the North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities. Available at: https://snmmi.org/Web/Web/Clinical-Practice/Procedure-Standards/Standards/2024-Update-of-the-North-American-Consensus-Guidelines-for-Pediatric-Administered-Radiopharmaceutica.Mobile.aspx. https://snmmi.org/Web/Web/Clinical-Practice/Procedure-Standards/Standards/2024-Update-of-the-North-American-Consensus-Guidelines-for-Pediatric-Administered-Radiopharmaceutica.Mobile.aspx.
17. [19713709] Kwekkeboom DJ, Krenning EP, Scheidhauer K, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: somatostatin receptor imaging with (111)In-pentetreotide. [46 refs]. Neuroendocrinology. 90(2):184-9, 2009.
18. [2170840] Lamberts SW, Bakker WH, Reubi JC, Krenning EP. Somatostatin-receptor imaging in the localization of endocrine tumors. N Engl J Med. 1990 Nov 01;323(18):1246-9.
19. [9618580] Seregni E, Chiti A, Bombardieri E. Radionuclide imaging of neuroendocrine tumours: biological basis and diagnostic results. Eur J Nucl Med. 1998 Jun;25(6):639-58.
20. [20461371] Bombardieri E, Ambrosini V, Aktolun C, et al. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010 Jul;37(7):1441-8.
21. [11965603] Kwekkeboom DJ, Krenning EP. Somatostatin receptor imaging. [Review] [70 refs]. Semin Nucl Med. 32(2):84-91, 2002 Apr.
22. [35210659] Cavicchioli M, Bitencourt AGV, Lima ENP. 68Ga-DOTATATE PET/CT versus 111In-octreotide scintigraphy in patients with neuroendocrine tumors: a prospective study. Radiol Bras. 2022;55(1):13-18.
23. [-3197851] United States Nuclear Regulatory Commission. Nursing mother guidelines for the medical administration of radioactive materials. Available at: https://www.nrc.gov/docs/ML1817/ML18177A451.pdf. .
24. [11158032] van der Harst E, de Herder WW, Bruining HA, et al. [(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in begnign and malignant pheochromocytomas. J Clin Endocrinol Metab. 2001 Feb;86(2):685-93.
25. [21157198] Fukuoka M, Taki J, Mochizuki T, Kinuya S. Comparison of diagnostic value of I-123 MIBG and high-dose I-131 MIBG scintigraphy including incremental value of SPECT/CT over planar image in patients with malignant pheochromocytoma/paraganglioma and neuroblastoma. Clin Nucl Med. 36(1):1-7, 2011 Jan.
26. [19949879] Meyer-Rochow GY, Schembri GP, Benn DE, et al. The utility of metaiodobenzylguanidine single photon emission computed tomography/computed tomography (MIBG SPECT/CT) for the diagnosis of pheochromocytoma. Ann Surg Oncol. 17(2):392-400, 2010 Feb.
27. [8790194] Rufini V, Fisher GA, Shulkin BL, Sisson JC, Shapiro B. Iodine-123-MIBG imaging of neuroblastoma: utility of SPECT and delayed imaging. J Nucl Med. 1996 Sep;37(9):1464-8.
28. [-3197621] American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=74+&releaseId=2
29. [-3197885] American College of Radiology. ACR–AAPM Technical Standard for Nuclear Medical Physics Performance Monitoring of Gamma Cameras. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=196+&releaseId=2