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Mhlanga J, Alazraki A, Cho SY, Lai H, Nadel H, Pandit-Taskar N, Qi J, Rajderkar D, Voss S, Watal P, McCarten K. Imaging recommendations in pediatric lymphoma: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29968. [PMID: 36114654 PMCID: PMC10641880 DOI: 10.1002/pbc.29968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/08/2022]
Abstract
Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are both malignancies originating in the lymphatic system and both affect children, but many features differ considerably, impacting workup and management. This paper provides consensus-based imaging recommendations for evaluation of patients with HL and NHL at diagnosis and response assessment for both interim and end of therapy (follow-up).
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Affiliation(s)
- Joyce Mhlanga
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, Saint Louis, Missouri, USA
| | - Adina Alazraki
- Departments of Pediatrics and Radiology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Steve Y Cho
- Department of Radiology, Nuclear Medicine and Molecular Imaging Section, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Hollie Lai
- Department of Radiology, Children's Health of Orange County, Orange, California, USA
| | - Helen Nadel
- Department of Pediatric Radiology, Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California, USA
| | - Neeta Pandit-Taskar
- Department of Radiology, Molecular imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Department of Radiology, Weill Cornell Medical College, New York City, New York, USA
| | - Jing Qi
- Department of Radiology, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin, USA
| | - Dhanashree Rajderkar
- Department of Radiology, Division of Pediatric Radiology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Stephan Voss
- Harvard Medical School, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Pankaj Watal
- University of Central Florida College of Medicine, Nemours Children's Hospital, Orlando, Florida, USA
| | - Kathleen McCarten
- Diagnostic Imaging and Pediatrics, Imaging and Radiation Oncology Core, Lincoln, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
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Guja KE, Nadel H, Iagaru A. Overview and Recent Advances in 18F-FDG PET/CT for Evaluation of Pediatric Lymphoma. Semin Nucl Med 2022. [DOI: 10.1053/j.semnuclmed.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Patient preparation for PET studies. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cerci JJ, Etchebehere EC, Nadel H, Brink A, Bal CS, Rangarajan V, Pfluger T, Kagna O, Alonso O, Begum FK, Mir KB, Magboo VP, Menezes LJ, Paez D, Pascual TN. Is True Whole-Body 18F-FDG PET/CT Required in Pediatric Lymphoma? An IAEA Multicenter Prospective Study. J Nucl Med 2019; 60:1087-1093. [PMID: 30683766 DOI: 10.2967/jnumed.118.222299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/19/2018] [Indexed: 01/22/2023] Open
Abstract
Guidelines recommend true whole-body 18F-FDG PET/CT scans from vertex to toes in pediatric lymphoma patients, although this suggestion has not been validated in large clinical trials. The objective of the study was to evaluate the incidence and clinical impact of lesions outside the "eyes to thighs" regular field of view (R-FOV) in 18F-FDG PET/CT staging (sPET) and interim (iPET) scans in pediatric lymphoma patients. Methods: True whole-body sPET and iPET scans were prospectively obtained in pediatric lymphoma patients (11 worldwide centers). Expert panel central review of sPET and iPET scans were evaluated for lymphoma lesions outside the R-FOV and clinical relevance of these findings. Results: A total of 610 scans were obtained in 305 patients. The sPET scans did not show lesions outside the R-FOV in 91.8% of the patients, whereas in 8.2% patients the sPET scans demonstrated lesions also outside the R-FOV (soft tissue, bone, bone marrow, and skin); however, the presence of these lesions did not change the clinical stage of any patient and did not affect treatment decision. Among the 305 iPET scans, there were no new positive 18F-FDG-avid lesions outside the R-FOV, when compared with their paired sPET scans. A single lesion outside the R-FOV on iPET occurred in 1 patient (0.3%), with the primary lesion diagnosed in the femur on sPET that persisted on iPET. Conclusion: The identification of additional lesions outside the R-FOV (eyes to thighs) using 18F-FDG PET/CT has no impact in the definition of the clinical stage of disease and minimal impact in the treatment definition of patients with pediatric lymphoma. As so, R-FOV for both sPET and iPET scans could be performed.
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Affiliation(s)
| | | | - Helen Nadel
- University of British Columbia, Vancouver, Canada
| | - Anita Brink
- University of Cape Town, Cape Town, South Africa
| | | | | | - Thomas Pfluger
- Ludwig-Maximillian University of Munich, Munich, Germany
| | - Olga Kagna
- Rambam Health Care Campus, Rambam, Israel
| | - Omar Alonso
- Centro Uruguayo de Imagenología Molecular, Montevideo, Uruguay
| | - Fatima K Begum
- National Institute of Nuclear Medicine and Allied Sciences, Bangladesh, Bangladesh
| | | | | | - Leon J Menezes
- Institute of Nuclear Medicine, London, United Kingdom; and
| | - Diana Paez
- International Atomic Energy Agency, Vienna, Austria
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Abstract
Nuclear medicine has a central role in the diagnosis, staging, response assessment and long-term follow-up of neuroblastoma, the most common solid extracranial tumour in children. These EANM guidelines include updated information on 123I-mIBG, the most common study in nuclear medicine for the evaluation of neuroblastoma, and on PET/CT imaging with 18F-FDG, 18F-DOPA and 68Ga-DOTA peptides. These PET/CT studies are increasingly employed in clinical practice. Indications, advantages and limitations are presented along with recommendations on study protocols, interpretation of findings and reporting results.
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(18)F-FDG PET as a single imaging modality in pediatric neuroblastoma: comparison with abdomen CT and bone scintigraphy. Ann Nucl Med 2014; 28:304-13. [PMID: 24481823 DOI: 10.1007/s12149-014-0813-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 01/13/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the diagnostic performance of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a single imaging agent in neuroblastoma in comparison with other imaging modalities. METHODS A total of 30 patients with pathologically proven neuroblastoma who underwent FDG PET for staging were enrolled. Diagnostic performance of FDG PET and abdomen CT was compared in detecting soft tissue lesions. FDG PET and bone scintigraphy (BS) were compared in bone metastases. Maximal standardized uptake value (SUVmax) of primary or recurrent lesions was calculated for quantitative analysis. RESULTS Tumor FDG uptake was detected in 29 of 30 patients with primary neuroblastoma. On initial FDG PET, SUVmax of primary lesions were lower in early stage (I-II) than in late stage (III-IV) (3.03 vs. 5.45, respectively, p = 0.019). FDG PET was superior to CT scan in detecting distant lymph nodes (23 vs. 18 from 23 lymph nodes). FDG PET showed higher accuracy to identify bone metastases than BS both on patient-based analyses (100 vs. 94.4 % in sensitivity, 100 vs. 77.8 % in specificity), and on lesion-based analyses (FDG PET: 203 lesions, BS: 86 lesions). Sensitivity and specificity of FDG PET to detect recurrence were 87.5 % and 93.8, respectively. CONCLUSION FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma. BS might be eliminated in the evaluation of neuroblastoma when FDG PET is performed.
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Grant FD, Treves ST. Nuclear Medicine and Molecular Imaging of the Pediatric Chest: Current Practical Imaging Assessment. Radiol Clin North Am 2011; 49:1025-51. [DOI: 10.1016/j.rcl.2011.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Houseni M, Chamroonrat W, Servaes S, Alavi A, Zhuang H. Applications of PET/CT in Pediatric Patients with Fever of Unknown Origin. PET Clin 2008; 3:605-19. [DOI: 10.1016/j.cpet.2009.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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