Potential Pediatric Applications of PET/MR

Abstract

Medical imaging with multimodality and whole-body technologies has continuously improved in recent years. The advent of combined modalities such as PET/CT and PET/MR offers new tools with an exact fusion of molecular imaging and high-resolution anatomic imaging. For noninvasive pediatric diagnostics, molecular imaging and whole-body MR have become important, especially in pediatric oncology. Because it has a lower radiation exposure than PET/CT, combined PET/MR is expected to be of special use in pediatric diagnostics. This review focuses on possible pediatric applications of PET/MR hybrid imaging, particularly pediatric oncology and neurology but also the diagnosis of infectious or inflammatory diseases.

Unusual Cause of Weight Loss, Fever and Sweats

“…It has been primarily used for oncology imaging but has shown utility when performed for evaluation of fever without focus, allowing the minimisation of other screening investigations and improved targeting of subsequent diagnostic procedures. 1 In this case, fluorodeoxyglucose positron emission tomography/magnetic resonance imaging revealed patchy myositis and vasculitis, consistent with a widespread inflammatory process (Fig. 1).…”

“…2 Laboratory findings include raised ANA and ESR, whilst the presence of antibodies to histone and lack of antibodies to DNA helps distinguish this disorder from systemic lupus erythematosus (although not in this case). 1 While there is no specific test for minocycline-induced vasculitis or lupus erythematosus, the resolution of symptoms after stopping the drug is considered highly suggestive. 2 This case highlights the importance of taking a careful drug history, especially in patients presenting with non-specific symptoms.…”

Daily Workflow and Protocol Optimization in Positron Emission Tomography/Magnetic Resonance Imaging Use

“…Pediatrik hastalarda yağ dokusu daha az olduğundan yumuşak doku lezyonlarının normal dokulardan ayırt edilebilirliği PET/BT sistemlerinde zor olabilir. MR görüntülemenin sahip olduğu yüksek yumuşak doku kontrastı nedeniyle bu durum pediatrik yaş grubunda PET/MR görüntülemenin tercih edilmesi için başka bir gerekçe oluşturur (5,6,8,9,33,34,35,36). Özellikle pediatrik yaş grubunda sık olarak gözlenen yumuşak doku ve santral sinir sistemi tümörlerinin ve kemik iliği tutulumlarının değerlendirilmesi bakımından PET/MR sistemi PET/ BT'ye üstünlük sağlayabilir.…”

“…Özellikle pediatrik yaş grubunda sık olarak gözlenen yumuşak doku ve santral sinir sistemi tümörlerinin ve kemik iliği tutulumlarının değerlendirilmesi bakımından PET/MR sistemi PET/ BT'ye üstünlük sağlayabilir. Ayrıca tümörün hücresel yoğunluğunu ve hücrenin çekirdek/sitoplazma oranını gösteren difüzyon ağırlıklı MR görüntülemenin ek olarak yapılması FDG PET incelemesi için tamamlayıcı olabilir (5,6,35). Ancak bu konuda literatürde farklı sonuçlar olduğu görülmektedir.…”

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

“…In general, combined PET/MRI is clinically indicated in all pediatric patients with indication for a PET scan [20]. 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].…”