Gennari Antonio G, Waelti Stephan, Schwyzer Moritz, Treyer Valerie, Rossi Alexia, Sartoretti Thomas, Maurer Alexander, Ramantani Georgia, Tuura O'Gorman Ruth, Kellenberger Christian J, Hüllner Martin W, Messerli Michael
Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Eur J Nucl Med Mol Imaging. 2025 Jan;52(2):574-585. doi: 10.1007/s00259-024-06902-8. Epub 2024 Oct 1.
To assess the trends in administered 2-[F]fluoro-2-deoxy-D-glucose ([F]FDG) doses, computed tomography (CT) radiation doses, and image quality over the last 15 years in children with drug-resistant epilepsy (DRE) undergoing hybrid positron emission tomography (PET) brain scans.
We retrospectively analyzed data from children with DRE who had [F]FDG-PET/CT or magnetic resonance scans for presurgical evaluation between 2005 and 2021. We evaluated changes in injected [F]FDG doses, administered activity per body weight, CT dose index volume (CTDIvol), and dose length product (DLP). PET image quality was assessed visually by four trained raters. Conversely, CT image quality was measured using region-of-interest analysis, normalized by signal-to-noise (SNR) and contrast-to-noise ratio (CNR).
We included 55 children (30 male, mean age: 9 ± 6 years) who underwent 61 [F]FDG-PET scans (71% as PET/CT). Annually, the injected [F]FDG dose decreased by ~ 1% (95% CI: 0.92%-0.98%, p < 0.001), with no significant changes in administered activity per body weight (p = 0.51). CTDIvol and DLP decreased annually by 16% (95% CI: 9%-23%) and 15% (95% CI: 8%-21%, both p < 0.001), respectively. PET image quality improved by 9% year-over-year (95% CI: 6%-13%, p < 0.001), while CT-associated SNR and CNR decreased annually by 7% (95% CI: 3%-11%, p = 0.001) and 6% (95% CI: 2%-10%, p = 0.008), respectively.
Our findings indicate stability in [F]FDG administered activity per body weight alongside improvements in PET image quality. Conversely, CT-associated radiation doses reduced. These results reaffirm [F]FDG-PET as an increasingly safer and higher-resolution auxiliary imaging modality for children with DRE. These improvements, driven by technological advancements, may enhance the diagnostic precision and patient outcomes in pediatric epilepsy surgery.
评估过去15年中，接受混合正电子发射断层扫描（PET）脑部扫描的耐药性癫痫（DRE）患儿的2-[F]氟-2-脱氧-D-葡萄糖（[F]FDG）给药剂量、计算机断层扫描（CT）辐射剂量及图像质量的变化趋势。
我们回顾性分析了2005年至2021年间因术前评估接受[F]FDG-PET/CT或磁共振扫描的DRE患儿的数据。我们评估了注射的[F]FDG剂量、每体重给药活性、CT剂量指数体积（CTDIvol）和剂量长度乘积（DLP）的变化。PET图像质量由四名经过培训的评估人员进行视觉评估。相反，CT图像质量使用感兴趣区域分析进行测量，并通过信噪比（SNR）和对比噪声比（CNR）进行归一化。
我们纳入了55名儿童（30名男性，平均年龄：9±6岁），他们接受了61次[F]FDG-PET扫描（71%为PET/CT）。每年，注射的[F]FDG剂量下降约1%（95%CI：0.92%-0.98%，p<0.001），每体重给药活性无显著变化（p=0.51）。CTDIvol和DLP每年分别下降16%（95%CI：9%-23%）和15%（95%CI：8%-21%，p均<0.001）。PET图像质量逐年提高9%（95%CI：6%-13%，p<0.001），而与CT相关的SNR和CNR每年分别下降7%（95%CI：3%-11%，p=0.001）和6%（95%CI：2%-10%，p=0.008）。
我们的研究结果表明，每体重[F]FDG给药活性稳定，同时PET图像质量有所改善。相反，与CT相关的辐射剂量降低。这些结果再次证实[F]FDG-PET是一种对DRE患儿越来越安全、分辨率更高的辅助成像方式。这些由技术进步推动的改进可能会提高小儿癫痫手术的诊断精度和患者预后。
