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Waelti S, Skawran S, Sartoretti T, Schwyzer M, Gennari AG, Mader C, Treyer V, Kellenberger CJ, Burger IA, Hany T, Maurer A, Huellner MW, Messerli M. A third of the radiotracer dose: two decades of progress in pediatric [ 18F]fluorodeoxyglucose PET/CT and PET/MR imaging. Eur Radiol 2024; 34:3252-3259. [PMID: 37855853 PMCID: PMC11126459 DOI: 10.1007/s00330-023-10319-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES To assess the evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between years 2000 and 2021. METHODS Pediatric patients (≤ 16 years) referred for 18F-FDG PET/CT or PET/MR imaging of the body during 2000 and 2021 were retrospectively included. The amount of administered radiotracer activity in megabecquerel (MBq) was recorded, and signal-to-noise ratio (SNR) was measured in the right liver lobe with a 4 cm3 volume of interest as an indicator for objective image quality. Descriptive statistics were computed. RESULTS Two hundred forty-three children and adolescents underwent a total of 466 examinations. The median injected 18F-FDG activity in MBq decreased significantly from 296 MBq in 2000-2005 to 100 MBq in 2016-2021 (p < 0.001), equaling approximately one-third of the initial amount. The median SNR ratio was stable during all years with 11.7 (interquartile range [IQR] 10.7-12.9, p = 0.133). CONCLUSIONS Children have benefited from a massive reduction in the administered 18F-FDG dose over the past 20 years without compromising objective image quality. CLINICAL RELEVANCE STATEMENT Radiotracer dose was reduced considerably over the past two decades of pediatric F-18-fluorodeoxyglucose PET/CT and PET/MR imaging highlighting the success of technical innovations in pediatric PET imaging. KEY POINTS • The evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between 2000 and 2021 was assessed. • The injected tracer activity decreased by 66% during the study period from 296 megabecquerel (MBq) to 100 MBq (p < 0.001). • The continuous implementation of technical innovations in pediatric hybrid 18F-FDG PET has led to a steady decrease in the amount of applied radiotracer, which is particularly beneficial for children who are more sensitive to radiation.
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Affiliation(s)
- Stephan Waelti
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Thomas Sartoretti
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Moritz Schwyzer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Antonio G Gennari
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Cäcilia Mader
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Christian J Kellenberger
- University of Zurich, Zurich, Switzerland
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Zurich, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland
| | - Thomas Hany
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- MRI Bahnhofplatz, Zurich, Switzerland
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
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Papadopoulos M, Mutalib M, Nikaki K, Volonaki E, Rybak A, Thapar N, Lindley K, Borrelli O, Das A, Crespi D, Cleeve S, Athanasakos E. Radiopaque marker colonic transit study in the pediatric population BSPGHAN Motility Working Group consensus statement. Neurogastroenterol Motil 2024; 36:e14776. [PMID: 38454312 DOI: 10.1111/nmo.14776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Functional constipation (FC) is a common condition in childhood in the United Kingdom and worldwide. Various radiological approaches have been established for diagnostic purposes. The radiopaque marker study (ROMS) is universally accepted and used to assess colonic transit time (CTT) in children with FC. Despite being widely used, there is a lack of standardization with various technical protocols, reproducibility of different populations, the purpose for using investigation, variance in the number of markers used, the amount of study days and calculations, the need to empty the colon before performing the test, and whether to perform on medication or off, or the use of specific diets. As part of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) motility working group (MWG), we decided to explore further into the evidence, in order to provide guidance regarding the use of ROMS in dealing with FC in the pediatric population.
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Affiliation(s)
- M Papadopoulos
- Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
| | - M Mutalib
- Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
| | - K Nikaki
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - E Volonaki
- Department of Paediatric Gastroenterology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A Rybak
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - N Thapar
- Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Centre for Child Nutrition Research, Queensland University of Technology, Brisbane, Queensland, Australia
- Stem Cells and Regenerative Medicine, UCL Institute of Child Health, London, UK
| | - K Lindley
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - O Borrelli
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - A Das
- Paediatric Department, Broomfield Hospital, Broomfield, UK
| | - D Crespi
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
| | - S Cleeve
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
| | - E Athanasakos
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
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3
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Storgaard L, Greiber IK, Pedersen BW, Nielsen BB, Karlsen MA. Cancer in pregnancy - The obstetrical management. Acta Obstet Gynecol Scand 2024; 103:630-635. [PMID: 37596726 PMCID: PMC10993351 DOI: 10.1111/aogs.14653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/20/2023]
Abstract
Cancer in pregnancy, defined as a cancer diagnosed during pregnancy, is a rare but severe condition presenting both clinical and ethical challenges. During the last two decades a paradigm shift has occurred towards recommending similar staging and treatment regimens of pregnant and non-pregnant cancer patients. This strategy is a result of an increasing number of reassuring reports on chemotherapy treatment in pregnancy after the first trimester. The management of cancer in pregnancy should be managed in a multidisciplinary team where staging, oncological treatment, social and mental care, timing of delivery, and follow-up of the infant should be planned. Due to the rarity, centralization is recommended to allow experience accumulation. Furthermore, national and international advisory boards are supportive when there is a lack of expertise.
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Affiliation(s)
- Lone Storgaard
- Obstetric DepartmentCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Iben Katinka Greiber
- Obstetric DepartmentCopenhagen University Hospital RigshospitaletCopenhagenDenmark
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4
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Cruz-Cortes Á, Avendaño-Estrada A, Alcauter S, Núñez-Enríquez JC, Rivera-Bravo B, Olarte-Casas MÁ, Ávila-Rodríguez MÁ. Semiquantitative analysis of cerebral [ 18F]FDG-PET uptake in pediatric patients. Pediatr Radiol 2023; 53:2574-2585. [PMID: 37910188 PMCID: PMC10698097 DOI: 10.1007/s00247-023-05794-4] [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: 06/01/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Glycolytic metabolism in the brain of pediatric patients, imaged with [18F] fluorodeoxyglucose-positron emission tomography (FDG-PET) is incompletely characterized. OBJECTIVE The purpose of the current study was to characterize [18F]FDG-PET brain uptake in a large sample of pediatric patients with non-central nervous system diseases as an alternative to healthy subjects to evaluate changes at different pediatric ages. MATERIALS AND METHODS Seven hundred ninety-five [18F]FDG-PET examinations from children < 18 years of age without central nervous system diseases were included. Each brain image was spatially normalized, and the standardized uptake value (SUV) was obtained. The SUV and the SUV relative to different pseudo-references were explored as a function of age. RESULTS At all evaluated ages, the occipital lobe showed the highest [18F]FDG uptake (0.27 ± 0.04 SUV/year), while the parietal lobe and brainstem had the lowest uptake (0.17 ± 0.02 SUV/year, for both regions). An increase [18F]FDG uptake was found for all brain regions until 12 years old, while no significant uptake differences were found between ages 13 (SUV = 5.39) to 17 years old (SUV = 5.52) (P < 0.0001 for the whole brain). A sex dependence was found in the SUVmean for the whole brain during adolescence (SUV 5.04-5.25 for males, 5.68-5.74 for females, P = 0.0264). Asymmetries in [18F]FDG uptake were found in the temporal and central regions during infancy. CONCLUSIONS Brain glycolytic metabolism of [18F]FDG, measured through the SUVmean, increased with age until early adolescence (< 13 years old), showing differences across brain regions. Age, sex, and brain region influence [18F]FDG uptake, with significant hemispheric asymmetries for temporal and central regions.
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Affiliation(s)
- Álvaro Cruz-Cortes
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Arturo Avendaño-Estrada
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico.
| | - Sarael Alcauter
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Belen Rivera-Bravo
- División de Investigación Facultad de Medicina Universidad Nacional Autónoma de México, Unidad PET/CT, Ciudad de Mexico, Mexico
| | - Miguel Ángel Olarte-Casas
- División de Investigación Facultad de Medicina Universidad Nacional Autónoma de México, Unidad PET/CT, Ciudad de Mexico, Mexico
| | - Miguel Ángel Ávila-Rodríguez
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
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5
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Skawran S, Sartoretti T, Gennari AG, Schwyzer M, Sartoretti E, Treyer V, Maurer A, Huellner MW, Waelti S, Messerli M. Evolution of CT radiation dose in pediatric patients undergoing hybrid 2-[ 18F]FDG PET/CT between 2007 and 2021. Br J Radiol 2023; 96:20220482. [PMID: 37751216 PMCID: PMC10646648 DOI: 10.1259/bjr.20220482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES To evaluate the evolution of CT radiation dose in pediatric patients undergoing hybrid 2-[18F]fluoro-2-deoxy-D-glucose (2-[18F]FDG) PET/CT between 2007 and 2021. METHODS AND MATERIALS Data from all pediatric patients aged 0-18 years who underwent hybrid 2-[18F]FDG PET/CT of the body between January 2007 and May 2021 were reviewed. Demographic and imaging parameters were collected. A board-certified radiologist reviewed all CT scans and measured image noise in the brain, liver, and adductor muscles. RESULTS 294 scans from 167 children (72 females (43%); median age: 14 (IQR 10-15) years; BMI: median 17.5 (IQR 15-20.4) kg/m2) were included. CT dose index-volume (CTDIvol) and dose length product (DLP) both decreased significantly from 2007 to 2021 (both p < 0.001, Spearman's rho coefficients -0.46 and -0.35, respectively). Specifically, from 2007 to 2009 to 2019-2021 CTDIvol and DLP decreased from 2.94 (2.14-2.99) mGy and 309 (230-371) mGy*cm, respectively, to 0.855 (0.568-1.11) mGy and 108 (65.6-207) mGy*cm, respectively. From 2007 to 2021, image noise in the brain and liver remained constant (p = 0.26 and p = 0.06), while it decreased in the adductor muscles (p = 0.007). Peak tube voltage selection (in kilovolt, kV) of CT scans shifted from high kV imaging (140 or 120kVp) to low kV imaging (100 or 80kVp) (p < 0.001) from 2007 to 2021. CONCLUSION CT radiation dose in pediatric patients undergoing hybrid 2-[18F]FDG PET/CT has decreased in recent years equaling approximately one-third of the initial amount. ADVANCES IN KNOWLEDGE Over the past 15 years, CT radiation dose decreased considerably in pediatric patients undergoing hybrid imaging, while objective image quality may not have been compromised.
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6
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Ho ML. Pediatric Spine Tumors and Dysontogenetic Masses. Neuroimaging Clin N Am 2023; 33:375-388. [PMID: 37356857 DOI: 10.1016/j.nic.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
The pediatric spine undergoes complex stages of development and growth, resulting in highly age-dependent physiology and variable susceptibility to certain pathologies. Optimal radiologic evaluation requires image acquisition tailored to the clinical history and an interpretive approach that accounts for demographic variations. In this article, the author discusses the diagnostic approach to pediatric spine masses, beginning with a discussion of normal anatomy and variants, clinical evaluation, and imaging techniques and protocols. The author then covers the major etiologies, imaging appearances, and mimics of pediatric spine masses in the following categories: congenital malformations, genetic syndromes, intramedullary, intradural, epidural, bone, and paraspinal lesions.
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Affiliation(s)
- Mai-Lan Ho
- University of Missouri, University Hospital, 1 Hospital Drive, Columbia, MO 65212, USA.
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7
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Montante C, Fabozzi F, Villani MF, D’Andrea ML, Stracuzzi A, Natali GL, Del Baldo G, Del Bufalo F, Garganese MC, Serra A, Tomà P, Alaggio R, Vennarini S, Colafati GS, Mastronuzzi A, De Ioris MA. The Pitfall of Ganglioneuroblastoma-Nodular Diagnosis: Clinical and Imaging Considerations over a Rare Bifocal Sporadic Case. Diagnostics (Basel) 2022; 12:diagnostics12123221. [PMID: 36553228 PMCID: PMC9777706 DOI: 10.3390/diagnostics12123221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Neuroblastic tumors (NTs) represent the most common extracranial neoplasm occurring in childhood. Although ganglioneuroblastoma intermixed (GNBI) and ganglioneuroma (GN) are classified as very low-risk tumors, neuroblastoma (NB) and ganglioneuroblastoma-nodular (GNBN) may represent a serious risk to survival. Unfortunately, areas of GNBI and GNBN can coexist in the same mass, leading to incorrect risk staging when only biopsy is performed. Herein, we describe a case of multifocal NT (thoracic and abdominal localization) occurring in a 4-year-old male. Different histological subtypes, namely GNBI and GNBN, were revealed in the two lesions. We focus on the difficulties of proper diagnosis and risk stratification, underlining the usefulness of several diagnostic tools for appropriate management and therapeutic choices.
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Affiliation(s)
- Claudio Montante
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Francesco Fabozzi
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | | | - Maria Luisa D’Andrea
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Alessandra Stracuzzi
- Department of Pathology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Gian Luigi Natali
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Giada Del Baldo
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Francesca Del Bufalo
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | | | - Annalisa Serra
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Paolo Tomà
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Rita Alaggio
- Department of Pathology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Sabina Vennarini
- Pediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy
| | | | - Angela Mastronuzzi
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Maria Antonietta De Ioris
- Department of Onco-Hematology, Cell and Gene Therapies, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
- Correspondence:
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8
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Bildgebende Untersuchungen bei der Ureterabgangsstenose. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01651-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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9
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Schäfer FM, Stehr M. Nierenfunktion nach Pyeloplastik im Langzeitverlauf. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01646-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Noriega-Álvarez E, Orduña Díez M, Sanz Viedma S, Peiró Valgañón V, Velasco Nuño M, Orcajo Rincón J, Rodríguez Alfonso B, Domínguez Gadea L. Aportaciones de la medicina nuclear en la enfermedad musculoesquelética tumoral maligna en niños. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Contributions of nuclear medicine to malignant musculoskeletal tumor disease in children. Rev Esp Med Nucl Imagen Mol 2022; 41:395-407. [DOI: 10.1016/j.remnie.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
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12
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Colonic Function Investigations in Children: Review by the ESPGHAN Motility Working Group. J Pediatr Gastroenterol Nutr 2022; 74:681-692. [PMID: 35262513 DOI: 10.1097/mpg.0000000000003429] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Disorders of colonic motility, most often presenting as constipation, comprise one of the commonest causes of outpatient visits in pediatric gastroenterology. This review, discussed and created by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Motility Working Group, is a practical guide, which highlights the recent advances in pediatric colonic motility testing including indications, technical principles of the tests, patient preparation, performance and basis of the results' analysis of the tests. classical methods, such as colonic transit time (cTT) with radiopaque markers and colonic scintigraphy, as well as manometry and novel techniques, such as wireless motility capsule and electromagnetic capsule tracking systems are discussed.
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13
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Yuan MK, Chang SC, Yuan MC, Foo NP, Chan SH, Wang SY, Lin CL, Hsu CY, Kao CH. Pediatric Nuclear Medicine Examinations and Subsequent Risk of Neoplasm: A Nationwide Population-Based Cohort Study. Front Med (Lausanne) 2022; 8:764849. [PMID: 34988089 PMCID: PMC8720959 DOI: 10.3389/fmed.2021.764849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/01/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: To evaluate the association between radiation exposure from repeated nuclear medicine (NM) examinations and the subsequent risk of neoplasm in pediatric patients. Methods: From 2000 to 2017, participants under 18 years of age who underwent NM scanning were identified using the Health and Welfare Data Science Center (HWDC) dataset, which was extracted from the Taiwan National Health Insurance Research Database (NHIRD). Both the exposed cohort and unexposed subjects were followed up with until the presence of any malignancy arose, including malignant brain, lymphoid and hematopoietic tumors and benign brain or other central nervous tumors. Results: There were 35,292 patients in the exposed cohort and 141,152 matched subjects in the non-exposed group. The exposed cohort had an overall higher IR (IR: incidence rate, per 100,000 person-years) of any malignancy and benign central nervous tumor than the non-exposed group [IR, 16.9 vs. 1.54; adjusted hazard ratio (HR), 10.9; 95% CI, 6.53–18.2]. Further stratifying the number of NM examinations into 1-2, 3-4, and 5 or more times revealed that the IR of pediatric neoplasms increased gradually with the increased frequency of NM examinations (IR, 11.5; adjusted HR, 7.5; 95% CI, 4.29–13.1; IR, 25.8; adjusted HR, 15.9; 95% CI, 7.00–36.1; IR, 93.8; adjusted HR, 56.4; 95% CI, 28.8–110.3). Conclusion: NM examination is significantly associated with a higher risk of pediatric neoplasms, according to our population-based data. Thorough radiation protection and dose reduction in pediatric NM procedures should be an issue of concern.
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Affiliation(s)
- Mei-Kang Yuan
- Department of Radiology, An Nan Hospital, China Medical University, Tainan, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Shih-Chieh Chang
- Division of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.,Department of Critical Care Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.,Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mei-Chun Yuan
- Department of Information Management, Meiho University, Pingtung, Taiwan
| | - Ning-Ping Foo
- Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan.,Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan
| | - Shan-Ho Chan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Shyh-Yau Wang
- Department of Radiology, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Cheng-Li Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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14
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Abstract
Nuclear medicine provides methods and techniques in that has benefited pediatric patients and their referring physicians for over 40 years. Nuclear medicine provides qualitative and quantitative information about overall and regional function of organs, systems, and lesions in the body. This involves applications in many organ systems including the skeleton, the brain, the kidneys and the heart as well as in the diagnosis and treatment of cancer. The practice of nuclear medicine requires the administration of radiopharmaceuticals which expose the patient to very low levels of ionizing radiation. Advanced approaches in the estimation of radiation dose from the internal distribution of radiopharmaceuticals in patients of various sizes and shapes have been developed in the past 20 years. Although there is considerable uncertainty in the estimation of the risk of adverse health effects from radiation at the very low exposure levels typically associated with nuclear medicine, some considers it prudent to be more cautious when applied to children as they are generally considered to be at higher risk than adults. Standard guidelines for administered activities for nuclear medicine procedures in children have been established including the North American consensus guidelines and the Paediatric Dosage Card developed by the European Association of Nuclear Medicine. As we move into the future, these guidelines would likely be reviewed in response to changes in clinical practice, a better understanding of radiation dosimetry as applied to children as well as new clinical applications, new advancements in the field with respect to both instrumentation and image reconstruction and processing.
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Affiliation(s)
- S Ted Treves
- Harvard Medical School; Brigham and Women's Hospital.
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SK P, Kandasamy D, Jana M, Sharma R, Gupta AK. Pediatric Stomach and Duodenal Imaging. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1723926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
AbstractPediatric stomach and duodenum abnormalities constitute a unique spectrum of conditions unlike adults which are categorized broadly into congenital, inflammatory, neoplastic and miscellaneous conditions. The aim of this article is to describe the role of imaging modalities in gastric and duodenal pathology in children. Some of the entities are unique to this age group and their imaging findings are also highlighted.
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Affiliation(s)
- Pritviraj SK
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | | | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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Lecoq P, Morel C, Prior JO, Visvikis D, Gundacker S, Auffray E, Križan P, Turtos RM, Thers D, Charbon E, Varela J, de La Taille C, Rivetti A, Breton D, Pratte JF, Nuyts J, Surti S, Vandenberghe S, Marsden P, Parodi K, Benlloch JM, Benoit M. Roadmap toward the 10 ps time-of-flight PET challenge. Phys Med Biol 2020; 65:21RM01. [PMID: 32434156 PMCID: PMC7721485 DOI: 10.1088/1361-6560/ab9500] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Since the seventies, positron emission tomography (PET) has become an invaluable medical molecular imaging modality with an unprecedented sensitivity at the picomolar level, especially for cancer diagnosis and the monitoring of its response to therapy. More recently, its combination with x-ray computed tomography (CT) or magnetic resonance (MR) has added high precision anatomic information in fused PET/CT and PET/MR images, thus compensating for the modest intrinsic spatial resolution of PET. Nevertheless, a number of medical challenges call for further improvements in PET sensitivity. These concern in particular new treatment opportunities in the context personalized (also called precision) medicine, such as the need to dynamically track a small number of cells in cancer immunotherapy or stem cells for tissue repair procedures. A better signal-to-noise ratio (SNR) in the image would allow detecting smaller size tumours together with a better staging of the patients, thus increasing the chances of putting cancer in complete remission. Moreover, there is an increasing demand for reducing the radioactive doses injected to the patients without impairing image quality. There are three ways to improve PET scanner sensitivity: improving detector efficiency, increasing geometrical acceptance of the imaging device and pushing the timing performance of the detectors. Currently, some pre-localization of the electron-positron annihilation along a line-of-response (LOR) given by the detection of a pair of annihilation photons is provided by the detection of the time difference between the two photons, also known as the time-of-flight (TOF) difference of the photons, whose accuracy is given by the coincidence time resolution (CTR). A CTR of about 10 picoseconds FWHM will ultimately allow to obtain a direct 3D volume representation of the activity distribution of a positron emitting radiopharmaceutical, at the millimetre level, thus introducing a quantum leap in PET imaging and quantification and fostering more frequent use of 11C radiopharmaceuticals. The present roadmap article toward the advent of 10 ps TOF-PET addresses the status and current/future challenges along the development of TOF-PET with the objective to reach this mythic 10 ps frontier that will open the door to real-time volume imaging virtually without tomographic inversion. The medical impact and prospects to achieve this technological revolution from the detection and image reconstruction point-of-views, together with a few perspectives beyond the TOF-PET application are discussed.
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Affiliation(s)
- Paul Lecoq
- CERN, department EP, Geneva, Switzerland
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Orunmuyi AT, Lawal IO, Omofuma OO, Taiwo OJ, Sathekge MM. Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research. Ecancermedicalscience 2020; 14:1093. [PMID: 33014135 PMCID: PMC7498276 DOI: 10.3332/ecancer.2020.1093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Nuclear medicine needs better integration into the Nigerian health system. To understand the relevant public health initiatives that will be required, this study assessed the pattern of nuclear medicine imaging services at the first nuclear medicine centre in Nigeria from January 2010 to December 2018. Methods The data of consecutive nuclear medicine (NM) scans performed between 1st January 2010 and 31st December 2018 at the NM department in a tertiary hospital in Nigeria were extracted from patient records and analysed using SAS version 9.4 (SAS Institute, Cary, NC). The National Cancer Institute’s Joinpoint software and QCIS (QGIS project) were used to estimate imaging trends and geographical spread of patients. Results An average of 486 scans per year was performed during the study period. Patients travelled from 32 of Nigeria’s 36 states, and the majority (65%) travelled more than 100 km to obtain NM scans. Bone scans accounted for 88.1% of the studies. The remainder were renal scintigraphy (7.3%), thyroid scans (2.5%), whole-body iodine scans (1.7%) and others (0.4%). Conclusions NM in Nigeria appears underutilised. Furthermore, the studies to characterise the access gaps and implementation needs will contribute to the design of practical strategies to strengthen NM services in Nigeria.
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Affiliation(s)
- Akintunde T Orunmuyi
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ismaheel O Lawal
- Department of Nuclear Medicine, Steve Biko Academic Hospital and University of Pretoria, Pretoria, South Africa
| | - Omonefe O Omofuma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
| | - Olalekan J Taiwo
- Department of Geography, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Mike M Sathekge
- Department of Nuclear Medicine, Steve Biko Academic Hospital and University of Pretoria, Pretoria, South Africa
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Zhang H, Xing X, Wang Z, He M. Evaluation of Split Renal Function for Children with Kidney Diseases by Renal and Vascular Color Ultrasonography. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2602-2608. [PMID: 30185386 DOI: 10.1016/j.ultrasmedbio.2018.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
Renal dynamic imaging and radionuclide renography use radioactivity to evaluate split renal function. We aimed to investigate the use of renal vascular color Doppler ultrasonography for evaluation of split renal function in children. Thirty-five children with unilateral kidney diseases were enrolled. For patients with unilateral renal tumor, peak systolic velocity (Vmax = 113.04 ± 13.59 cm/s) and resistance index (RI = 0.73 ± 0.02) were higher on abnormal compared with normal sides (Vmax = 86.03 ± 6.49 cm/s, RI = 0.62 ± 0.01), and blood perfusion was good, indicating compensatory enhancement in split renal function. For unilateral renal cyst, Vmax (58.20 ± 7.38 cm/s) was lower on the abnormal compared with the normal (87.71 ± 14.83 cm/s) size, and perfusion was poor. For unilateral hydronephrosis and renal atrophy, the parameters were similar to those of renal cyst, suggesting a weakening of renal function. For unilateral renal agenesis, Vmax (106.07 ± 13.07 cm/s) and RI (0.71 ± 0.05) were higher, and perfusion was good. Renal vascular color Doppler ultrasonography was superior in the evaluation of split renal function in children, without being invasive or radioactive.
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Affiliation(s)
- Hui Zhang
- Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
| | - Xuexue Xing
- Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zheng Wang
- Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Min He
- Ultrasonic Department, West China Second University Hospital of Sichuan University, Chengdu, China
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