Masselli Gabriele, Casciani Emanuele, De Angelis Cristina, Sollaku Saadi, Gualdi Gianfranco
Department of Radiological Sciences, Oncology and Anatomo-Pathology, "Sapienza" University of Rome Italy.
PET/CT Section, Pio XI Private Hospital Rome, Italy.
Am J Nucl Med Mol Imaging. 2021 Apr 15;11(2):64-76. eCollection 2021.
The use F-DOPA PET/CT for oncologic and non-oncologic pediatric diseases is well consolidated in clinical practice. The indications include brain tumors, neuroendocrine malignancies and congenital hyperinsulinism. The number of papers involving pediatric subjects is steadily growing. However, literature still lacks clinical trials and large multicentric studies in contrast with the extensive literature available for adult patients. The aim of this review is to discuss the main clinical indications of F-DOPA in pediatric oncologic and nononcologic diseases and to analyze its role in diagnosis, staging, biopsy and surgical planning. The high resolution of PET/CT tomographs in addition to the high sensitivity and specificity of F-DOPA imaging exceeds the downsides linked to this nuclear medicine imaging modality. In fact, few potential limitations could discourage the use of PET/CT imaging. For example, similarly to MRI studies the long acquisition time of a PET/CT scan often requires sedation especially in infants. Moreover, the radiation exposure of a PET/CT scan may be high, but the clinical benefit deriving from nuclear medicine imaging outruns the risk connected to the use of ionizing radiations.
在临床实践中，F-DOPA PET/CT在儿科肿瘤和非肿瘤疾病中的应用已得到充分巩固。其适应症包括脑肿瘤、神经内分泌恶性肿瘤和先天性高胰岛素血症。涉及儿科患者的论文数量正在稳步增长。然而，与针对成年患者的大量文献相比，目前仍缺乏临床试验和大型多中心研究。本综述的目的是讨论F-DOPA在儿科肿瘤和非肿瘤疾病中的主要临床适应症，并分析其在诊断、分期、活检和手术规划中的作用。PET/CT断层扫描仪的高分辨率以及F-DOPA成像的高灵敏度和特异性弥补了这种核医学成像方式的缺点。事实上，一些潜在的局限性可能会阻碍PET/CT成像的使用。例如，与MRI研究类似，PET/CT扫描的长时间采集通常需要镇静，尤其是在婴儿中。此外，PET/CT扫描的辐射暴露可能很高，但核医学成像带来的临床益处超过了与使用电离辐射相关的风险。
