Comparison of 18F-FDG-PET and standard procedures for the pretreatment staging of children and adolescents with Hodgkin’s disease

Abstract

Our study showed that whole-body FDG-PET is an efficient and useful method for the initial staging of children with HD. FDG-PET in combination with lung CT should be recommended as a screening method prior to other conventional imaging modalities to plan a rational staging protocol. Large multicentre prospective studies are necessary to verify this conclusion.

Value of18F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies

“…The sensitivities and specificities of 18 F-FDG PET/CT or 18 F-FDG PET for initial staging of malignant lymphomas are 96%-99% and 95%-100%, respectively (Table 1) (11,12,14,33,34). 18 F-FDG PET is more sensitive than CT in detecting nodal and extranodal lesions in HL and NHL, including lesions in the spleen and bone marrow ( Fig.…”

“…18 F-FDG PET is more sensitive than CT in detecting nodal and extranodal lesions in HL and NHL, including lesions in the spleen and bone marrow ( Fig. 1) (11,13). CT, on the other hand, is more sensitive in the evaluation of pulmonary involvement: the positron range of 18 F-FDG limits the spatial resolution of PET, and continuous breathing during PET data acquisition impairs the detection of small pulmonary nodules (11,13).…”

“…Many studies have shown that 18 F-FDG PET or PET/CT is superior for staging malignant lymphomas when compared with conventional imaging modalities, including contrast-enhanced CT, MR imaging, bone scintigraphy, ultrasonography, and 67 Gascintigraphy (11,12,14,(25)(26)(27). Most histologic subtypes of NHL in children are of high histologic grade and show strong 18 F-FDG uptake (28,29).…”

“…1) (11,13). CT, on the other hand, is more sensitive in the evaluation of pulmonary involvement: the positron range of 18 F-FDG limits the spatial resolution of PET, and continuous breathing during PET data acquisition impairs the detection of small pulmonary nodules (11,13). Although lung metastases are not common in HL, thoracic CT was reported to be more sensitive than 18 F-FDG PET in the detection of pulmonary lesions in HL patients (70% vs. 100%) (11).…”

“…Although staging tests for pediatric cancers were originally performed with stand-alone 18 F-FDG PET scanners (10)(11)(12), these have been largely replaced by integrated 18 F-FDG PET/CT scanners (13,14). The added CT component improves the diagnostic accuracy of PET alone by adding a higher anatomic resolution to the acquired image information, thus improving lesion detection and characterization (15).…”