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

Gatidis, Sergios; Fougère, Christian la; Schaefer, Jürgen F.

doi:10.1055/s-0041-109513

Cited by 22 publications

(15 citation statements)

References 45 publications

(43 reference statements)

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“…Special additional information can be derived from PET/MR or PET/CT. PET/MR imaging offers the diagnostic advantage of multiparametric characterization of pathophysiologic processes combined with a significant reduction in radiation exposure of about 50-75% compared to CT or PET/CT imaging (Gatidis et al 2017(Gatidis et al , 2016Schäfer et al 2020). However, reading and interpreting PET/MR data are a complex task, as numerous sequences have to be analyzed together with PET data.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary surgical approach enables complete tumor resection with preservation of neurological function in specific conditions of pediatric solid malignancies

Urla

Fuchs

Grimm³

et al. 2022

J Cancer Res Clin Oncol

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Purpose Success of pediatric solid tumor surgery is regularly hampered by infiltration of essential neurovascular structures. A surgical dilemma arises when imaging data suggest a conflict between complete resection and preservation of neurological function. The aim of the study was to analyze data of children harboring tumors with involvement of neurovascular structure treated by an interdisciplinary pediatric surgical/neurosurgical team. Methods We retrospectively analyzed data of 25 children undergoing surgery for solid tumors, in whom preoperative imaging showed a relevant involvement of nerve structures. Surgery was simultaneously performed by a pediatric onco-surgeon and a pediatric neurosurgeon with peripheral nerve expertise, including intraoperative electrophysiological monitoring. Results The following tumors were treated: NF1 associated neurofibromas (10), neuroblastomas (5), desmoid tumors (2), MPNST (2), ganglioneuroma (1), Ewing sarcoma (1), infantile fibromatosis (1), PNET (1), rhabdomyosarcoma (1), angiolipoma (1). The most frequent tumor localizations were the pelvis (n = 7) and retroperitoneal region (n = 6). Median age at surgery was 8 years (1.5–16). Macroscopically complete tumor resection was achieved in 24/25 patients. In 2/4 patients with limb tumors an amputation was planned externally. In both, a limb-salvage procedure was possible. Transient postoperative neurological deficits occurred in 2/25 patients. Four patients had tumor relapses. All but one are alive after a median follow-up of 46 months (2–155). Conclusions Simultaneous interdisciplinary pediatric surgical/neurosurgical approach enables radical tumor resection with preservation of neurological function in patients suffering from solid tumors with involvement of relevant neurovascular structures. This approach should be performed by experienced surgeons in reference pediatric onco-surgical centers.

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Section: Discussionmentioning

confidence: 99%

Interdisciplinary surgical approach enables complete tumor resection with preservation of neurological function in specific conditions of pediatric solid malignancies

Urla

Fuchs

Grimm³

et al. 2022

J Cancer Res Clin Oncol

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“…We recommend performing FDG PET/CT in line with current EANM guidelines [49,50], or FDG PET/MRI, wherefore there are no guidelines, only recommendations [92][93][94]. It is important to image the whole body, including the skull and the extremities, because silent lesions can be missed based on clinical symptoms [41].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

European guideline for imaging in paediatric and adolescent rhabdomyosarcoma — joint statement by the European Paediatric Soft Tissue Sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology

et al. 2021

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Appropriate imaging is essential in the treatment of children and adolescents with rhabdomyosarcoma. For adequate stratification and optimal individualised local treatment utilising surgery and radiotherapy, high-quality imaging is crucial. The paediatric radiologist, therefore, is an essential member of the multi-disciplinary team providing clinical care and research. This manuscript presents the European rhabdomyosarcoma imaging guideline, based on the recently developed guideline of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) Imaging Committee. This guideline was developed in collaboration between the EpSSG Imaging Committee, the Cooperative Weichteilsarkom Studiengruppe (CWS) Imaging Group, and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR). MRI is recommended, at diagnosis and follow-up, for the evaluation of the primary tumour and its relationship to surrounding tissues, including assessment of neurovascular structures and loco-regional lymphadenopathy. Chest CT along with [F-18]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/CT or PET/MRI are recommended for the detection and evaluation of loco-regional and distant metastatic disease. Guidance on the estimation of treatment response, optimal long-term follow-up, technical imaging settings and standardised reporting are described. This European imaging guideline outlines the recommendations for imaging in children and adolescents with rhabdomyosarcoma, with the aim to harmonise imaging and to advance patient care.

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“…Although anatomical MRI has been used in most PET/ MRI studies, a hybrid PET/MRI system [7][8][9][10][11][12] has shown several potential advantages over the PET/CT and SPET/CT systems: a reduction in radiation exposure from CT, 13,14 simultaneous multimodal imaging, superior soft-tissue contrast by MRI, and functional MRI and magnetic resonance spectroscopic (MRS) imaging by the same MRI system. 7,15 Some studies have recently reported on PET/MRS imaging as well.…”

Section: Major Papermentioning

confidence: 99%

Microstrip Transmission Line RF Coil for a PET/MRI Insert

2020

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We proposed and developed a new microstrip transmission line radiofrequency (RF) coil for a positron emission tomography (PET) insert for MRI, which has low electrical interactions with PET shield boxes. We performed imaging experiments using a single-channel and a four-channel proposed RF coils for proof-of-concept. Methods: A conventional microstrip coil consists of a microstrip conductor, a ground conductor, and a dielectric between the two conductors. We proposed a microstrip coil for the PET insert that replaced the conventional single-layer ground conductor with the RF shield of the PET insert. A dielectric material, which could otherwise attenuate gamma photons radiated from the PET imaging tracer, was not used. As proof-of-concept, we compared conventional and the proposed single-channel coils. To study multichannel performance, we further developed a four-channel proposed RF coil. Since the MRI system had a singlechannel transmission port, an interfacing four-way RF power division circuit was designed. The coils were implemented as both RF transmitters and receivers in a cylindrical frame of diameter 150 mm. Coil bench performances were tested with a network analyzer (Rohde & Schwarz, Germany), and a homogeneous phantom study was conducted for gradient echo imaging and RF field (B 1) mapping in a 3T clinical system (Verio, Siemens, Erlangen, Germany). Results: For all coils, the power reflection coefficient was below −30 dB, and the transmission coefficients in the four-channel configuration were near or below −20 dB. The comparative single-channel coil study showed good similarity between the conventional and proposed coils. The gradient echo image of the fourchannel coil showed expected flashing image intensity near the coils and no phase distortion was visible. Transmit B 1 field map resembled the image performance. Conclusion: The proposed PET-microstrip coil performed similarly to the conventional microstrip transmission line coil and is promising for the development of a compact coil-PET system capable of simultaneous PET/MRI analysis with an existing MRI system.

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

Cited by 22 publications

References 45 publications

Interdisciplinary surgical approach enables complete tumor resection with preservation of neurological function in specific conditions of pediatric solid malignancies

Interdisciplinary surgical approach enables complete tumor resection with preservation of neurological function in specific conditions of pediatric solid malignancies

European guideline for imaging in paediatric and adolescent rhabdomyosarcoma — joint statement by the European Paediatric Soft Tissue Sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology

Microstrip Transmission Line RF Coil for a PET/MRI Insert

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