Jadvar Hossein, Connolly Leonard P, Fahey Frederic H, Shulkin Barry L
Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, and Children's Hospital Boston, MA, USA.
Semin Nucl Med. 2007 Sep;37(5):316-31. doi: 10.1053/j.semnuclmed.2007.04.001.
18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET/computed tomography (CT) are becoming increasingly important imaging tools in the noninvasive evaluation and monitoring of children with known or suspected malignant diseases. In this review, we discuss the preparation of children undergoing PET studies and review radiation dosimetry and its implications for family and caregivers. We review the normal distribution of 18F-fluorodeoxyglucose (FDG) in children, common variations of the normal distribution, and various artifacts that may arise. We show that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology. We explore the use of FDG-PET in the study of children with the more common malignancies, such as brain neoplasms and lymphomas, and the less-common tumors, including neuroblastomas, bone and soft-tissue sarcomas, Wilms' tumors, and hepatoblastomas. For comparison, other PET tracers are included because they have been applied in pediatric oncology. Multiple multicenter trials are underway that use FDG-PET in the management of children with neoplastic disease; these studies should give us greater insight into the impact FDG-PET can make in their care. PET is emerging as an important diagnostic imaging tool in the evaluation of pediatric cancers. The recent advent of dual-modality PET-computed tomography (PET/CT) imaging systems has added unprecedented diagnostic capability by revealing the precise anatomical localization of metabolic information and metabolic characterization of normal and abnormal structures. The use of CT transmission scanning for attenuation correction has shortened the total acquisition time, which is an especially desirable attribute in pediatric imaging. Moreover, expansion of the regional distribution of the most common PET radiotracer, FDG, and the introduction of mobile PET units have greatly increased access to this powerful diagnostic imaging technology. Here, we review the clinical applications of PET and PET/CT in pediatric oncology. General considerations in patient preparation and radiation dosimetry will be discussed.
18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和FDG-PET/计算机断层扫描（CT）在已知或疑似恶性疾病儿童的无创评估和监测中，正日益成为重要的成像工具。在本综述中，我们讨论接受PET研究的儿童的准备工作，并回顾辐射剂量学及其对患儿家庭和护理人员的影响。我们回顾了18F-氟脱氧葡萄糖（FDG）在儿童体内的正常分布、正常分布的常见变异以及可能出现的各种伪影。我们发现，儿童的大多数肿瘤都会摄取并保留FDG，从而能够获得其分布及病理生理学的高质量图像。我们探讨了FDG-PET在患有较常见恶性肿瘤（如脑肿瘤和淋巴瘤）以及较罕见肿瘤（包括神经母细胞瘤、骨和软组织肉瘤、肾母细胞瘤和肝母细胞瘤）儿童研究中的应用。为作比较，还纳入了其他PET示踪剂，因为它们已应用于儿科肿瘤学。目前正在进行多项多中心试验，在患有肿瘤疾病的儿童管理中使用FDG-PET；这些研究应能让我们更深入地了解FDG-PET对患儿护理的影响。PET正成为评估儿科癌症的一种重要诊断成像工具。双模态PET-计算机断层扫描（PET/CT）成像系统的最新出现，通过揭示代谢信息的精确解剖定位以及正常和异常结构的代谢特征，增添了前所未有的诊断能力。使用CT透射扫描进行衰减校正缩短了总采集时间，这在儿科成像中是一个特别可取的特性。此外，最常见的PET放射性示踪剂FDG区域分布的扩大以及移动PET设备的引入，大大增加了获得这种强大诊断成像技术的机会。在此，我们回顾PET和PET/CT在儿科肿瘤学中的临床应用。还将讨论患者准备和辐射剂量学的一般注意事项。
