Practice

Practice Guidelines

The practice guidelines help to identify those elements of the procedure that are most important in obtaining a high-quality examination, while simultaneously controlling costs. Use of standardized procedures will increase the applicability of clinical research among multiple institutions, in turn, increasing the value of research studies, particularly in the field of technology assessment.

Comments or Questions?
The Committee on SNM Guidelines is continually developing new guidelines and reviewing and updating existing guidelines. If you have specific comments or questions on the content of any of the guidelines, or if you have suggestions for new guidelines that you feel should be written, please contact the Committee at hpra@snm.org. All comments will be considered in the guideline development process.

Cardiac
Date Approved Title
9/1/2008 Adobe Portable Document Format Myocardial Perfusion Imaging 3.3
6/15/2002 Adobe Portable Document Format Gated Equilibrium Radionuclide Ventriculography 3.0
Endocrine
Date Approved Title
9/17/2011 Adobe Portable Document Format Parathyroid Scintigraphy 4.0
9/10/2006 Adobe Portable Document Format Thyroid Scintigraphy 3.0
9/5/2006 Adobe Portable Document Format Scintigraphy for Differentiated Papillary and Follicular Thyroid Cancer
9/5/2006 Adobe Portable Document Format Thyroid Uptake Measurement 3.0
Gastrointestinal
Date Approved Title
6/4/2010 Adobe Portable Document Format Hepatobiliary Scintigraphy 4.0
2/8/2009 Adobe Portable Document Format Gastric Emptying 3.0
6/20/2003 Adobe Portable Document Format Hepatic and Splenic Imaging 3.0
General
Date Approved Title
6/8/2012 Adobe Portable Document Format Guideline Development 6.0
5/11/2011 Adobe Portable Document Format Performance and Responsibility Guidelines for NMT 3.1
9/12/2010 Adobe Portable Document Format General Imaging 6.0
2/7/2008 Adobe Portable Document Format Use of Radiopharmaceuticals 4.0
6/15/2002 Adobe Portable Document Format Telenuclear Medicine 1.0
Infection
Date Approved Title
6/2/2004 Adobe Portable Document Format Gallium Scintigraphy in Inflammation 3.0
6/2/2004 Adobe Portable Document Format Tc-99m Exametazime (HMPAO)-Labeled Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0
6/2/2004 Adobe Portable Document Format In-111 Leukocyte Scintigraphy for Suspected Infection/Inflammation 3.0
Musculoskeletal
Date Approved Title
12/2/2010 Adobe Portable Document Format Sodium 18-F Fluoride with PET/CT Bone Scans 1.1 – EANM Endorsement
6/20/2003 Adobe Portable Document Format Bone Scintigraphy 3.0
Neurology
Date Approved Title
6/8/2012 Adobe Portable Document Format Brain Death Scintigraphy 2.0
10/26/2011 Adobe Portable Document Format Dopamine Transporter Imaging with 123I-Ioflupane SPECT 1.0
2/8/2009 Adobe Portable Document Format FDG-PET Brain Imaging 1.0
2/8/2009 Adobe Portable Document Format Brain Perfusion Single Proton Emission Computed Tomography (SPECT) Using Tc-99m Radiopharmaceuticals 3.0
Oncology
Date Approved Title
6/8/2012 Adobe Portable Document Format Therapy of Thyroid Disease with Iodine-131 (Sodium Iodide) 3.0
7/19/2011 Adobe Portable Document Format Somatostatin Receptor Scintigraphy 2.0
6/4/2010 Adobe Portable Document Format Breast Scintigraphy with Breast-Specific Gamma Cameras 1.0 – EANM Endorsement
4/3/2006 Adobe Portable Document Format Procedure Guideline for SPECT/CT Imaging 1.0
2/11/2006 Adobe Portable Document Format Procedure Guidelines for Tumor Imaging with 18F-FDG PET/CT 1.0
6/2/2004 Adobe Portable Document Format Breast Scintigraphy 2.0
1/25/2003 Adobe Portable Document Format Palliative Treatment for Painful Bone Metastases 3.0
6/15/2002 Adobe Portable Document Format Lymphoscintigraphy and the Use of Intraoperative Gamma Probe for Sentinel Lymph Node Localization in Melanoma of Intermediate Thickness 1.0
Pediatric
Date Approved Title
10/1/2010 Adobe Portable Document Format Pediatric Dose Consensus Guidelines
9/1/2008 Adobe Portable Document Format Diuretic Renography in Children 3.0
6/20/2003 Adobe Portable Document Format Renal Cortical Scintigraphy in Children 3.0
1/25/2003 Adobe Portable Document Format Pediatric Sedation in Nuclear Medicine 3.0
1/25/2003 Adobe Portable Document Format Radionuclide Cystography in Children 3.0
Pulmonary
Date Approved Title
7/19/2011 Adobe Portable Document Format Lung Scintigraphy 4.0
EANM Guidelines

SNMMI endorses these guidelines. Dosage recommendations should be taken in the context of "good practice" of nuclear medicine and do not substitute for national and international legal or regulatory provisions.

SNMMI Approval Date Title
Adobe Portable Document Format 131I-meta-iodobenzylguanidine (131I-mIBG) therapy (2008)
3/20/2012 Adobe Portable Document Format 131I/123I- Metaiodobenzylguanidine (MIBG) scintigraphy (2010)
3/20/2012 Adobe Portable Document Format Radioimmunotherapy for B-cell lymphoma with 90Y-radiolabelled itribumomab tiuxetan (Zevalin) (2006) * Pretherapeutic imaging with 111In-ibritumomab tiuxetan is no longer mandatory in the United States.

Regulatory Issues for EANM Guidelines

Applicable to all countries: Clinicians involved in unsealed source therapy must be knowledgeable about and compliant with all applicable national and local legislation and regulations.

Applicable in the United States: The radiopharmaceutical(s) used for the diagnostic and therapeutic procedure(s) addressed in this guideline/guidance document is/are not approved by the Food and Drug Administration (FDA)in the United States. Therefore in the United States, these procedures should be performed only by physicians holding an FDA-approved Investigational New Drug (IND) application for the radiopharmaceutical.

Collaborative Guidelines

In the interest of creating strong, comprehensive documents, these guidelines were formally adopted by SNM in collaboration with other professional organizations.
Date Approved Title
2011 Adobe Portable Document Format ACR-SNM Technical Standard for Diagnostic Procedures Using Radiopharmaceuticals
2009 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Cardiac Scintigraphy
2010 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for Performance of Gastrointestinal Scintigraphy
2009 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Scintigraphy for Inflammation or Infection
2010 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Liver and Spleen Scintigraphy
2009 Adobe Portable Document Format ACR-SNM-SPR- Practice Guideline for the Performance of Parathyroid Scintigraphy
2009 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Pulmonary Scintigraphy in Adults and Children
2010 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Adult and Pediatric Radionuclide Cystography
2009 Adobe Portable Document Format ACR-SNM-SPR Practice Guideline for the Performance of Thyroid Scintigraphy and Uptake Measurements

Based on the findings of a survey conducted at 13 premier pediatric hospitals in North America indicating administered radiopharmaceutical activities in children varied greatly, a workgroup was established representing the Society of Nuclear Medicine (SNM) through the Pediatric Council, the Society for Pediatric Radiology and the Amercian College of Radiology (ACR). The Workgroup achieved concensus on pediatric administered radiopharmaceutical doses for 11 commonly used radiopharmaceuticals.
10/26/2010 Adobe Portable Document Format Pediatric Dose Consensus Guidelines
Retired Guidelines

Please note the below guidelines have been retired and thus not updated since their last approval. Therefore, these guidelines may not reflect current knowledge and practice in the field of nuclear medicine. SNM is providing these guidelines on an 'as is' basis for general information purposes only and does not accept any responsibility for accuracy, completeness, currency, relevance, reliability or suitability of the information contained therein.

Date Approved Title
6/23/2001 Adobe Portable Document Format Gallium Scintigraphy in the Evaluation of Malignant Disease 3.0
2/7/1999 Adobe Portable Document Format Tumor Imaging Using F-18 FDG 2.0
2/7/1999 Adobe Portable Document Format Gastrointestinal Bleeding/Meckel's Diverticulum Scintigraphy 1.0

 

Guidelines Available for Public Comment

As part of the revision or development process, the Committee on SNM Guidelines will seek public comment on draft documents in order to ensure we are creating the most accurate guidelines. To submit comments on a guideline, please download the response form and submit to Janette Merrill via email, jmerrill@snm.org. Below are guidelines currently for which we are seeking public input:
Comments
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