FDG-PET in Pediatric Posterior Fossa Brain Tumors

Jm, Hoffman; Hanson, Mark D.; Hs, Friedman; Bm, Hockenberger; Wj, Oakes; Ec, Halperin; Coleman, RE

doi:10.1097/00004728-199201000-00011

Cited by 60 publications

(31 citation statements)

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“…There has been limited application in pediatric oncology; however, there is increasing data relating to PET imaging in the management of brain tumors, primary bone tumors, lymphoma, neuroblastoma, and soft tissue sarcoma [4][5][6][7][8]. There has been one report of the application of FDG-PET in a 4-year-old boy with recurrent hepatoblastoma in an orthotopic transplanted liver [9].…”

Section: Discussionmentioning

confidence: 99%

“…A further dimension of information based on the regional biochemical and physiological abnormalities is provided by positron emission tomography (PET) using F 18 -fluoro-deoxy-glucose (FDG), which has been successfully used for the last two decades in localizing primary and metastatic tumors in adults [1][2][3]. There is limited experience in using F 18 -FDG in pediatric practice, but the current literature indicates increased application in many pediatric solid tumors [4][5][6][7][8]. There has been only one report of the application of FDG-PET imaging in hepatoblastoma [9] and variable application and success of PET in hepatocellular carcinoma in adults [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Positron emission tomography in recurrent hepatoblastoma

et al. 2005

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Early detection of recurrent hepatoblastoma is not always possible with conventional imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI). This article describes three cases of recurrent hepatoblastoma in which positron emission tomography (PET) using F(18)-fluoro-deoxy-glucose (FDG-PET) was used to locate the site of recurrence. In the first two patients, FDG-PET accurately located recurrent disease where it was not detected by conventional imaging modalities, including CT and MRI. In the third patient, FDG-PET imaging also located the recurrent disease in an MRI-identified adrenal metastasis. The technique of "coregistration" using PET with CT and MRI scans was used in the cases described. This improves the anatomical localization of metabolically active sites and was particularly useful for determining the surgical approach. The difficulties of conventional imaging in locating early tumor recurrence or metastatic disease in hepatoblastoma make FDG-PET imaging an important investigation that may impact patient management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Positron emission tomography in recurrent hepatoblastoma

et al. 2005

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“…Early reports of PET imaging for tumors in children have included brain tumors, neuroblastoma, lymphoma, and musculoskeletal lesions [38,[152][153][154][155]. FDG is the commonest tracer used, but amino acids and other tumor-specific agents have also been employed [156].…”

Section: Pet In Pediatric Tumor Evaluationmentioning

confidence: 99%

Where are we with nuclear medicine in pediatrics?

Nadel

1995

Eur J Nucl Med

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The practice of nuclear medicine in children is different from that in adults. Technical considerations including immobilization, dosing of radiopharmaceuticals, and instrumentation are of major importance. Image magnification and the capability to perform single-photon emission tomography are essential to performing state of the art pediatric nuclear medicine. New advances in instrumentation with multiple detector imaging, the possibility of clinical positron emission tomography imaging in children, and new radiopharmaceuticals will further enhance pediatric scintigraphic imaging. This review highlights advances in pediatric nuclear medicine and discusses selected clinical problems.

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“…Noninvasive techniques are rapidly emerging as the most useful tools in the presurgical assessment of epilepsy [11][12][13][14][15][16][17][18], vascular malformations [19][20][21][22], and brain tu mor resection [1,9,[23][24][25][26][27][28][29], PET brain mapping [1,[19][20][21], 3-dimensional MR imaging [20,30], magnetoencephalographic mapping and functional MR imaging [1.9, 31] are all techniques currently under investigation. To identify the anatomic relationship of the lesion to elo quent cortex and improve spatial resolution these tech niques are now coregistered with MR imaging and/or computerized tomography (CT) [32], Based on this infor mation, the surgeon can theoretically achieve a more aggressive resection of the seizure focus with preservation of eloquent cortex.…”

Section: Introductionmentioning

confidence: 99%

Use of Positron Emission Tomography for Presurgical Localization of Eloquent Brain Areas in Children with Seizures

et al. 1997

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Successful surgical management of a neoplastic or nonneoplastic seizure focus in close proximity to or within eloquent brain areas relies on precise delineation of the relationship between the lesion and functional brain areas. The aim of this series was to validate the usefulness and test the efficacy of noninvasive presurgical PET mapping of eloquent brain areas to predict surgical morbidity and outcome in children with seizures. To identify eloquent brain areas in 15 children (6 female and 9 male; mean age 11 years) with epileptogenic lesions PET images of regional cerebral blood flow were performed following the administration of [¹⁵O]water during motor, visual, articulation, and receptive language tasks. These images with coregistered magnetic resonance (MR) images were then used to delineate the anatomic relationship of a seizure focus to eloquent brain areas. Additional PET images using [¹⁸F]fluoro-2-deoxy-D-glucose (FDG) and [¹¹C]methionine (CMET) were acquired to help localize the seizure focus, as well as characterize the lesion. Patient surgical management decisions were based on PET mapping in combination with coregistered MR images, PET-FDG findings, and the anatomic characteristics of the lesion. At follow-up 1–26 months after surgery, all patients that underwent temporal lobectomy (9 patients) and extratemporal resection (4 patients) for a neoplastic or nonneoplastic seizure focus are seizure-free with minimal postoperative morbidity. Of prime importance, no child sustained a postoperative speech or language deficit. PET imaging was also well tolerated without procedural complications. Based on PET mapping, a nonoperative approach was used for 2 children and a biopsy only was used in one child. When cortical injury involved prenatally determined eloquent cortex, PET demonstrated reorganization of language areas to new adjacent areas or even to the contralateral hemisphere. Integration of anatomical and functional data enhanced the surgical safety, defined optimal surgical approach, delineated the seizure focus from eloquent brain areas, facilitated maximum resection and optimized the timing of surgery, thereby minimizing surgical morbidity while maximizing surgical goals. PET measurements of FDG and CMET uptake were also helpful in localizing the seizure focus and grading the tumors. PET used for brain mapping in children provides the surgeon with strategic preoperative information not readily attainable with traditional invasive Wada testing or intraoperative cortical stimulation. PET mapping may also improve the outcome of extratemporal resections by allowing aggressive seizure focus resection. In addition, serial brain maps may optimize timing for surgical intervention by demonstrating reorganization of eloquent cortex often seen in younger children after cortical injury. Our results suggest that noninvasive presurgical brain mapping has the potential to reduce risk and improve neurologic outcome.

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FDG-PET in Pediatric Posterior Fossa Brain Tumors

Cited by 60 publications

References 0 publications

Positron emission tomography in recurrent hepatoblastoma

Positron emission tomography in recurrent hepatoblastoma

Where are we with nuclear medicine in pediatrics?

Use of Positron Emission Tomography for Presurgical Localization of Eloquent Brain Areas in Children with Seizures

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