18F-FDG PET/CT fusion imaging in paediatric solid extracranial tumours. | Semantic Scholar (2024)

The preliminary uses of PET–CT in extracranial paediatric oncology are discussed, key aspects to consider in imaging children and adolescents are addressed, and potential issues specific to this patient population are discussed.

It is shown that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology, and the use of FDG-PET in the study of children with the more common malignancies and the less-common tumors is explored.

The relatively high PPV in patients with histologically proven high grade solid tumors, advanced stages of NHL and with nodular sclerosing, lymphocyte-rich and lymphocyte depleted subtypes of HL warrant a confirmation by biopsy, whereas the watch-and-wait approach can be used in other forms of childhood cancer patients with a positive FDG-PET/CT result in course of follow-up examinations.

FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma and might be eliminated in the evaluation of neuroblastomas when FDG PET is performed.

This comparative study shows FDG PET to be more accurate than CI in evaluating children with lymphoma and confirms that (18)F-FDG PET may show false-positive findings.

In this study, 18F-DOPA PET/CT results more accurate than CT/MR in advanced stage NB therefore should be taken into consideration for the diagnostic workup of these patients.

I-MIBG is superior for delineating primary tumor sites, and F-FDG PET could aid in discriminating inconclusive findings on bony metastatic NBL during follow-up.

The case of a 10‐month‐old female infant with a metastatic neuroblastoma which became MIBG‐negative at time of relapse is reported, and the potential utility of FDG‐PET as an alternative to follow up the residual disease at this stage is discussed.

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Staging of childhood lymphoma using FDGPET shows differences compared with CT resulting in a different staging in 6 of 25 patients, and Prospective studies are required to evaluate the impact of these discrepancies on the clinical management of pediatric patients.

Some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients are discussed.

Specific advantages of MR include determination of resectability of hepatic tumors using MRI and MRA; staging of neuroblastoma in the bone marrow, lymph nodes, liver, and spinal canal; response of bilateral Wilms tumor and nephroblastomatosis; detection of pelvic tumors with sagittal sectioning, and peritoneal tumors with contrast enhancement.

Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

Three cases of recurrent hepatoblastoma in which positron emission tomography using F18-fluoro-deoxy-glucose (FDG-PET) was used to locate the site of recurrence are described, finding the recurrent disease in an MRI-identified adrenal metastasis.

There is a need for large, systematic studies evaluating FDG PET in therapy monitoring, but also in grading, staging, and in the diagnosis of recurrences in pediatric malignancies.

This paper focuses on the experience in implementing PET–CT in a tertiary pediatric referral center and the details and logistics required to set up a smoothly functioning process.

Ongoing prospective studies of PET in pediatric patients will increase understanding about the optimal use of this modality in children with cancer and define the characteristics of FDG-avid nonmalignant conditions that may be problematic in the interpretation of tumor activity.

This preliminary study suggests that 11C-choline PET may provide more accurate information regarding the localisation of main primary prostate cancer lesions than MR imaging/MR spectroscopy.

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