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Functional and anatomical imaging in pediatric oncology: which is best for which tumors. Pediatr Radiol 2019; 49:1534-1544. [PMID: 31620853 DOI: 10.1007/s00247-019-04489-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/19/2019] [Accepted: 07/29/2019] [Indexed: 02/07/2023]
Abstract
Functional imaging techniques are playing an increasingly important role in the management of pediatric cancer. Technological advances have pushed the development of hybrid imaging techniques, including positron emission tomography (PET)/CT, PET/MR and single-photon emission computed tomography (SPECT)/CT. Together with an increasing need to identify surrogate biomarkers for response to novel therapies, the use of functional imaging techniques, which had been reserved primarily for lymphoma patients, is now being recognized as standard of care for the management of many other pediatric solid tumors. The purpose of this review is to summarize recent data describing the use of functional and metabolic imaging strategies for the staging and response assessment of common pediatric solid tumors, and to offer some guidance as to which techniques are most appropriate for which tumor types.
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Gold SA, Sabarwal VK, Gordhan C, Hale GR, Winer A. Lymph node imaging of pediatric renal and suprarenal malignancies. Transl Androl Urol 2018; 7:774-782. [PMID: 30456181 PMCID: PMC6212619 DOI: 10.21037/tau.2018.07.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Pediatric renal and suprarenal cancers are relatively rare malignancies, but are not without significant consequence to both the patient and caretakers. These tumors are often found incidentally and present as large abdominal masses. Standard of care management involves surgical excision of the mass, but contemporary treatment guidelines advocate for use of neoadjuvant or adjuvant chemotherapy for advanced stage disease, such as those cases with lymph node involvement (LNI). However, LNI detection is based primarily on surgical pathology and performing extended lymph node dissection can add significant morbidity to a surgical case. In this review, we focus on the use and performance of imaging modalities to detect LNI in Wilms’ tumor (WT), neuroblastoma, and pediatric renal cell carcinoma (RCC). We report on how imaging impacts management of these cases and the clinical implications of LNI. A literature search was conducted for studies published on imaging-based detection of LNI in pediatric renal and suprarenal cancers. Further review focused on surgical and medical management of those cases with suspected LNI. Current imaging protocols assisting in diagnosis and staging of pediatric renal and suprarenal cancers are generally limited to abdominal ultrasound and cross-sectional imaging, mainly computed tomography (CT). Recent research has investigated the role of more advance modalities, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), in the management of these malignancies. Special consideration must be made for pediatric patients who are more vulnerable to ionizing radiation and have characteristic imaging features different from adult controls. Management of pediatric renal and suprarenal cancers is influenced by LNI, but the rarity of these conditions has limited the volume of clinical research regarding imaging-based staging. As such, standardized criteria for LNI on imaging are lacking. Nevertheless, advanced imaging modalities are being investigated and potentially represent more accurate and safer options.
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Affiliation(s)
- Samuel A Gold
- SUNY Downstate College of Medicine, Downstate Medical Center, Brooklyn, NY, USA
| | - Vikram K Sabarwal
- Department of Urology, George Washington University Hospital, Washington, DC, USA
| | - Chirag Gordhan
- Department of Urology, George Washington University Hospital, Washington, DC, USA
| | - Graham R Hale
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, NY, USA
| | - Andrew Winer
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Hu J, Jin LU, He T, Li Y, Zhao Y, Ding YU, Li X, Liu Y, Gui Y, Mao X, Lai Y, Ni L. Wilms' tumor in a 51-year-old patient: An extremely rare case and review of the literature. Mol Clin Oncol 2016; 4:1013-1016. [PMID: 27313862 DOI: 10.3892/mco.2016.839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/22/2016] [Indexed: 12/20/2022] Open
Abstract
Wilms tumor or nephroblastoma is a common kidney malignant tumor in childhood, accounting for ~5% of all pediatric tumors. At present, reports on Wilms' tumor occurring in adults, particularly at ages >30 years, are extremely rare. The majority of the cases of adult Wilms' tumor are closely associated with chemotherapy. Furthermore, in rare cases, Wilms' tumor is characterized by three classic types of cells, namely blastemal, stromal and epithelial cells. We herein report a case of Wilms' tumor with three classic types of cells on histological examination in a 51 year-old male patient who had received prior chemotherapy. The patient promptly underwent radical nephrectomy and remains alive. A review of previously presented cases of adult Wilms' tumor from PubMed database was also performed.
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Affiliation(s)
- Jia Hu
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangzhou Medical University, Guangzhou, Guangdong 510182, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - L U Jin
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - Tao He
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangzhou Medical University, Guangzhou, Guangdong 510182, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - Yifan Li
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - Yang Zhao
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Y U Ding
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Xianxin Li
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yunchu Liu
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yaoting Gui
- Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - Xiangming Mao
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yongqing Lai
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
| | - Liangchao Ni
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Guangdong Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China
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Aminzadeh S, Vidali S, Sperl W, Kofler B, Feichtinger RG. Energy metabolism in neuroblastoma and Wilms tumor. Transl Pediatr 2015; 4:20-32. [PMID: 26835356 PMCID: PMC4729069 DOI: 10.3978/j.issn.2224-4336.2015.01.04] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
To support high proliferation, the majority of cancer cells undergo fundamental metabolic changes such as increasing their glucose uptake and shifting to glycolysis for ATP production at the expense of far more efficient mitochondrial energy production by oxidative phosphorylation (OXPHOS), which at first glance is a paradox. This phenomenon is known as the Warburg effect. However, enhanced glycolysis is necessary to provide building blocks for anabolic growth. Apart from the generation of ATP, intermediates of glycolysis serve as precursors for a variety of biosynthetic pathways essential for cell proliferation. In the last 10-15 years the field of tumor metabolism has experienced an enormous boom in interest. It is now well established that tumor suppressor genes and oncogenes often play a central role in the regulation of cellular metabolism. Therefore, they significantly contribute to the manifestation of the Warburg effect. While much attention has focused on adult solid tumors, so far there has been comparatively little effort directed at elucidation of the mechanism responsible for the Warburg effect in childhood cancers. In this review we focus on metabolic pathways in neuroblastoma (NB) and Wilms tumor (WT), the two most frequent solid tumors in children. Both tumor types show alterations of the OXPHOS system and glycolytic features. Chromosomal alterations and activation of oncogenes like MYC or inactivation of tumor suppressor genes like TP53 can in part explain the changes of energy metabolism in these cancers. The strict dependence of cancer cells on glucose metabolism is a fairly common feature among otherwise biologically diverse types of cancer. Therefore, inhibition of glycolysis or starvation of cancer cells through glucose deprivation via a high-fat low-carbohydrate diet may be a promising avenue for future adjuvant therapeutic strategies.
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