Role of 18-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Predicting Residual Disease Posttreatment Completion in Retinoblastoma Patients

Abstract

Background: Retinoblastoma (RB) is the most common primary intraocular malignancy of childhood. Magnetic resonance imaging (MRI) of the orbit and brain is the preferred imaging modality to diagnose and define extent of disease as well as to assess response to therapy. Sometimes, it may be difficult to differentiate the presence of active residual disease from therapy-related changes based on posttreatment completion MRI. Materials and Methods: RB patients who completed treatment between January 2017 and October 2019 were retrospectively analyzed. We evaluated the utility of F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) to predict active disease in RB patients who continued to have residual disease on MRI at completion of treatment. Results: Out of the 89 patients who completed treatment, dilemma regarding remission status was present in 11 children. All 11 patients underwent FDG-PET-CT. None of them had evidence of metabolically active disease in the orbit, optic nerve, brain, or rest of the body. After a median follow-up of 24 months, no children developed any evidence of disease progression in the form of local or distant relapse. Conclusion: Our results showed that in MRI doubtful cases, a nonavid FDG-PET is reassuring in avoiding further therapy as long as close follow-up can be ensured. FDG-PET-CT may emerge as a useful functional modality to predict disease activity in RB.

Guiding function of positron emission tomography-computed tomography examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma

“…While PET-CT examination has been widely used in the detection, staging, diagnosis, and treatment of tumors, coronary artery atherosclerosis, and neurological diseases, its application in ocular tumors has only recently gained attention. PET-CT examination has shown potential in the detection, staging, diagnosis, and treatment of ocular tumors [11][12] , although its application in OAML has been less frequently reported. In the present study, clinical data and postoperative PET-CT findings…”

“…Most mucosa associated lymphoid tissue (MALT) lymphomas have a relatively favorable prognosis, but a minority of cases experience recurrence, dissemination, and even progression to higher-grade invasive lymphomas, with localized tumor recurrence, extraorbital spread, and transformation associated with poorer outcomes [8][9][10] . Positron emission tomography-computed tomography (PET-CT) imaging has shown potential in the detection, staging, diagnosis, and treatment of ocular tumors [11][12] , although its application in OAML patients has been relatively limited. In recent years, there has been a gradual increase in the incidence of OAML, particularly in Asian countries, where the incidence is significantly higher than that in Western countries [13][14] .…”

An Interesting Case of Post-enucleation Retinoblastoma Presenting With Distant Liver and Skeletal Metastases Detected on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

“…Overall, hepatic metastasis is rare in retinoblastoma and is generally accompanied by skeletal and/or CNS metastases [ 11 , 12 ]. 18F-FDG PET-CT has been shown to play a role in detecting residual/recurrent disease in retinoblastoma patients with locally advanced disease in whom the post-treatment magnetic resonance imaging (MRI) findings were indeterminate [ 13 , 14 ]. 18F-FDG PET-CT does not provide any significant advantage over MRI/CT other than detecting any metastatic lesions that can be missed on conventional imaging [ 13 ].…”

“…18F-FDG PET-CT has been shown to play a role in detecting residual/recurrent disease in retinoblastoma patients with locally advanced disease in whom the post-treatment magnetic resonance imaging (MRI) findings were indeterminate [ 13 , 14 ]. 18F-FDG PET-CT does not provide any significant advantage over MRI/CT other than detecting any metastatic lesions that can be missed on conventional imaging [ 13 ]. Despite doing a rigorous review of the literature, no case report describing the utility of 18F-FDG PET-CT in detecting hepatic metastasis could be found.…”

Retinoblastoma: present scenario and future challenges

“…Unsuccessful attempts at detecting retinoblastoma using positron emission tomography (which relied on detecting increased glucose consumption by the tumour) were made using Flourine-18-fluorodeoxyglucose throughout many years. The conclusion that FDG-PET is not currently widely established and does not provide any significant advantage over MRI/CT except in metastasis rendered MRI as the gold standard [ 40 ]. Early detection using an ultrasonogram in-utero to study the face and eyes can help in detection of the cancer, resulting in earlier detection and potential cure [ 41 ].…”