London Kevin, Howman-Giles Robert
Department of Nuclear Medicine, The Children's Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Westmead, Sydney, NSW, 2145, Australia,
Eur J Nucl Med Mol Imaging. 2014 Apr;41(4):723-35. doi: 10.1007/s00259-013-2639-9. Epub 2013 Dec 10.
Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population.
We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUV(max), and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake.
Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUV(max) with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus.
Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes.
目前对儿童期脑氟代脱氧葡萄糖（FDG）摄取的认识源于对少数神经功能异常患者的研究。我们的目的是在一个更可能代表正常人群的儿童FDG正电子发射断层扫描（PET）数据集里描述脑FDG摄取情况。
我们回顾了年龄达16岁、疑似/确诊颅外恶性肿瘤且符合以下排除标准的儿童脑FDG PET扫描结果：中枢神经系统转移、既往恶性肿瘤、既往化疗或放疗、治疗期间发生脑转移、神经疾病、服用抗癫痫药物或可能干扰脑代谢的药物，以及在24小时内接受全身麻醉。使用区域最大标准摄取值（SUV(max)）分析白质、基底神经节、丘脑和小脑皮质，并通过与最大皮质摄取相比的区域相对摄取分析来分析大脑皮质、基底神经节、丘脑和小脑。
纳入了30例患者（年龄范围11个月至16岁，平均年龄10岁5个月）的扫描结果。所有区域的SUV(max)均随年龄增长。顶叶、枕叶、颞叶外侧和颞叶内侧的FDG摄取增加率较低，导致儿童期区域FDG摄取模式发生变化。幼儿期摄取最强烈的皮质区域是顶叶和枕叶。大约7岁时，这些区域的摄取相对少于额叶，大约10岁时，这些区域的摄取相对少于丘脑。
1岁时脑内FDG的相对摄取尚未达到成人模式，但在16岁之前仍持续变化。这种变化模式是由于皮质FDG摄取增加的区域速率不同，顶叶、枕叶和颞叶的增加速率比额叶慢。
