ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2022-5-1-18-36ojrdrt-217Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEМетодологические основы ядерной медицины в педиатрииMethodological Basis of Nuclear Medicine in Pediatrichttps://orcid.org/0000-0002-8476-7879КрыловА. С.KrylovA. S.

Крылов Александр Сергеевич — заведующий лабораторией, врач-радиолог НИИ клинической и экспериментальной радиологии, кандидат медицинских наук

115478, Москва, Каширское шоссе, 24

SPIN-код: 4254-3930, AuthorID: 723683

24 Kashirskoye Highway, Moscow, 115478

krilovas@rambler.ruhttps://orcid.org/0000-0002-4293-7358НаркевичБ. Я.NarkevichB. Ya.

Наркевич Борис Ярославович — научный консультант, президент Ассоциации медицинских физиков России, доктор технических наук, кандидат физико-математических наук, профессор

115478, Москва, Каширское шоссе, 24

115478 Москва, Каширское шоссе, 23

SPIN‑код: 4931-8394, AuthorID: 600790

24 Kashirskoye Highway, Moscow, 115478

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0002-9571-801XРыжковА. Д.RyzhkovA. D.

Рыжков Алексей Дмитриевич — ведущий научный сотрудник, врач-радиолог, доктор медицинских наук

115478, Москва, Каширское шоссе, 24

SPIN-код: 6472-4859, AuthorID: 424746

24 Kashirskoye Highway, Moscow, 115478

Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России; Ассоциация медицинских физиков РоссииРоссияN.N. Blokhin National Medical Research Center of Oncology; Association of Medical Physicists of RussiaRussian Federation2022160320225118–36Copyright © Крылов А.С., Наркевич Б.Я., Рыжков А.Д., 20222022Крылов А.С., Наркевич Б.Я., Рыжков А.Д.Krylov A.S., Narkevich B.Y., Ryzhkov A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/217

На основе литературных данных и собственного опыта проанализированы методологические основы ядерной медицины в педиатрии. Кратко рассмотрены основные направления радионуклидной диагностики и радионуклидной терапии у детей. Отмечено важное значение точного определения оптимальной величины активности вводимого ребенку конкретного радиофармпрепарата с учетом массы его тела и протокола исследования. Показана тенденция возрастания лучевой нагрузки на пациентов вследствие повсеместного внедрения в клиническую практику гибридных установок для радионуклидных исследований, при использовании которых доза внутреннего облучения от радиофармпрепаратов дополняется дозой внешнего облучения от рентгеновской КТ. Подчеркнута необходимость учета риска возникновения радиационно-индуцированного канцерогенеза при ядерно-медицинских процедурах, вероятность которого у детей существенно выше по сравнению с взрослыми. Обсуждаются технологические и психологические особенности проведения указанных процедур у детей. Обоснована необходимость доработки отечественных нормативных документов, регламентирующих использование средств и методов ядерной медицины в педиатрии. 

Methodological foundations of nuclear medicine in pediatrics are analyzed on the basis of literature data and personal experience. The main directions of radionuclide diagnostics and radionuclide therapy in children are briefly considered. The importance of accurate determination of the optimal value of the activity of a specific radiopharmaceutical administered to a child, considering his body weight and the study protocol, was noted. A tendency to an increase in the radiation load on patients is shown due to the widespread introduction into clinical practice of hybrid installations for radionuclide studies, when using which the dose of internal radiation from radiopharmaceuticals is supplemented by the dose of external radiation from X-ray CT. The need to consider the risk of radiation-induced carcinogenesis during nuclear medical procedures, the likelihood of which in children is significantly higher than in adults, is emphasized. The technological and psychological features of these procedures in children are discussed. The necessity of revision of domestic normative documents regulating the use of means and methods of nuclear medicine in pediatrics has been substantiated. 

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The authors declare that there are no conflicts of interest present.