Empfehlungen zur Durchführung der Ganz körper-18F-FDG-PET und -PET/CT bei Kindern mit onkologischen Erkrankungen

Abstract

The purpose of these guidelines is to offer the nuclear medicine and the appropriate interdisciplinary team a framework for performing and reporting positron emission tomography (PET) and the combination with computed tomography (PET/CT) in children with malignant diseases mainly using the radiopharmaceutical 18F-fluorodeoxy-glucose (FDG). These guidelines are based on the recent guidelines of the Paediatric Committee of the European Association of Nuclear Medicine (EANM) (57) and have been translated and adapted to the current conditions in Germany. The adaptation of CT-parameters using PET/CT in children is covered in a more detailed way than in the EANM guideline taking into account that in Germany already a good portion of PET examinations is performed using an integrated PET/CT-scanner. Furthermore, a CT-scan without adoption of the CT acquisition parameters would result in a not tolerably high radiation exposition of the child. There are excellent guidelines for FDG PET and PET/CT in oncology published by the German Society of Nuclear Medicine (Deutsche Gesellschaft für Nuklearmedizin, DGN) (42) and EANM (4). These guidelines aim at providing additional information on issues particularly relevant to PET and PET/CT imaging in children. These guidelines should be taken in the context of local and national current standards of quality and rules.

PET/MR in children. Initial clinical experience in paediatric oncology using an integrated PET/MR scanner

“…Patient preparation, FDG dose and the PET acquisition protocol follow the guidelines of the European and German societies of nuclear medicine for FDG PET examinations in children [11, 19]. Imaging started 70 ±15 min after intravenous FDG administration.…”

Therapiesteuerung in der Hämatologie und Onkologie

“…Gleichwohl ist die Verfügbarkeit einer qualitätsgesicherten PET hierzulande ebenso gegeben, wie die Quali-tätssicherung bei der PET bereits langjährig implementiert ist. In den Leitlinien der Deutschen Gesellschaft für Nuklearmedizin (DGN) sind Standards für die Indikationsstellung, Durchführung, Auswertung und Dokumentation der Befunde bei einer 18 F-Fluordeoxyglukose (FDG)-PET/CT-Untersuchung bei Erwachsenen («FDG-PET/CT in der Onkologie») [14] und Kindern mit malignen Erkrankungen definiert (Handlungsempfehlung «Ganzkörper-18 F-FDG-PET und PET/CT bei Kindern mit onkologischen Erkrankungen») [15]. Radiopharmaka unterliegen wie andere Arzneimittel auch pharmazeutischen Regularien (Produktsicherheit), ihre Anwendung am Menschen ist im Arzneimittelgesetz (AMG) geregelt.…”

Pediatric Oncologic Imaging: A Key Application of Combined PET/MRI

“…Available data show that PET measurements acquired on PET/MRI systems have equivalent qualitative and quantitative characteristics compared to PET measurements of PET/CT in adult and pediatric patients [7,8,18,21]. According to national [22,23] and international [12] guidelines for PET in children with cancer, 18F-FDG-PET is indicated for diagnosis, staging, and restaging in a number of tumor entities, which are mainly lymphoma, sarcoma, neuroblastoma, and CNS tumors.…”