Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;6(1):28.
doi: 10.1186/s13550-016-0179-6. Epub 2016 Mar 17.

Pharmacokinetic modeling of [(18)F]fluorodeoxyglucose (FDG) for premature infants, and newborns through 5-year-olds

Kitiwat Khamwan  1   2 , Donika Plyku  1 , Shannon E O'Reilly  3 , Alison Goodkind  4 , Xinhua Cao  4 , Frederic H Fahey  4 , S Ted Treves  5 , Wesley E Bolch  3 , George Sgouros  6
Affiliations

Pharmacokinetic modeling of [(18)F]fluorodeoxyglucose (FDG) for premature infants, and newborns through 5-year-olds

Kitiwat Khamwan et al. EJNMMI Res. 2016 Dec.

Abstract

Background: Absorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific. Such age-specific pharmacokinetic data are lacking for many of the diagnostic agents typically used in pediatric imaging. We have developed a pharmacokinetic model of [(18)F]fluorodeoxyglucose (FDG) applicable to premature infants and to 0- (newborns) to 5-year-old patients, which may be used to generate model-derived time-integrated activity coefficients and absorbed dose calculations for these patients.

Methods: The FDG compartmental model developed by Hays and Segall for adults was fitted to published data from infants and also to a retrospective data set collected at the Boston Children's Hospital (BCH). The BCH data set was also used to examine the relationship between uptake of FDG in different organs and patient weight or age.

Results: Substantial changes in the structure of the FDG model were required to fit the pediatric data. Fitted rate constants and fractional blood volumes were reduced relative to the adult values.

Conclusions: The pharmacokinetic models developed differ substantially from adult pharmacokinetic (PK) models which can have considerable impact on the dosimetric models for pediatric patients. This approach may be used as a model for estimating dosimetry in children from other radiopharmaceuticals.

Keywords: Compartmental modeling; FDG; Pediatric imaging; Pharmacokinetics.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
FDG compartment model used to fit the kinetic data in premature infants and newborns to 5-year-olds
Fig. 2
Fig. 2
Plot of time-activity curves of the source organs that derived from the premature infant model
Fig. 3
Fig. 3
a–e Plot of BCH data and model-derived curves obtained from of each source organ. The error bars represent the standard deviation for each time point derived from the variability of %IA in multiple patients in each bin of 5-min intervals. The SD was also considered for the compartmental model fitting. In cases when literature data are available (e.g., brain, lungs, heart wall, and kidneys), these data points have been plotted to compare with the model fit to the BCH data. In the lungs, heart wall, kidneys, and liver, data points that are exclusively derived from patients <1 year old (newborns) are indicated in red. Other points (blue) are a composite of binned newborns and 1- to 5-year-olds
Fig. 4
Fig. 4
a–e The relationship between the patient body weight and percent injected activity in each source organ for newborns (red) and 1- to 5-year-olds (blue). Each data point corresponds to an individual patient
Fig. 5
Fig. 5
Quadratic model used to estimate %IA/g of the FDG in each organ based on a function of patient weight for 60–81 min after injection. Each data point corresponds to an individual patient
Fig. 6
Fig. 6
Quadratic model used to estimate %IA/g of the FDG in each organ based on a function of patient weight for 82–126 min after injection. Each data point corresponds to an individual patient
See this image and copyright information in PMC

References

    1. Schauer DA, Linton OW. NCRP report No. 160, ionizing radiation exposure of the population of the United States, medical exposure—are we doing less with more, and is there a role for health physicists? Health Phys. 2009;97(1):1–5. doi: 10.1097/01.HP.0000356672.44380.b7. - DOI - PubMed
    1. Hricak H, Brenner DJ, Adelstein SJ, Frush DP, Hall EJ, Howell RW, et al. Managing radiation use in medical imaging: a multifaceted challenge. Radiology. 2011;258(3):889–905. doi: 10.1148/radiol.10101157. - DOI - PubMed
    1. Mettler FAJ, Thomadsen BR, Bhargavan M, Gilley DB, Gray JE, Lipoti JA, et al. Medical radiation exposure in the US in 2006: preliminary results. Health Phys. 2008;95(5):502–7. doi: 10.1097/01.HP.0000326333.42287.a2. - DOI - PubMed
    1. National Research Council . Health risks from exposure to low levels of ionizing radiation: BEIR VII—phase 2. Washington, DC: National Research Council; 2005. - PubMed
    1. ICRP Publication 103: the 2007 recommendations of the International Commission on Radiological Protection. Ann ICRP. 2007;37(2-4):1–332. doi: 10.1016/j.icrp.2007.11.001. - DOI - PubMed

LinkOut - more resources