Semiquantitative analysis of cerebral [18F]FDG-PET uptake in pediatric patients

Abstract

Background Glycolytic metabolism in the brain of pediatric patients, imaged with [18F] fluorodeoxyglucose-positron emission tomography (FDG-PET) is incompletely characterized. Objective The purpose of the current study was to characterize [18F]FDG-PET brain uptake in a large sample of pediatric patients with non-central nervous system diseases as an alternative to healthy subjects to evaluate changes at different pediatric ages. Materials and Methods Seven hundred ninety-five [18F]FDG-PET examinations from children < 18 years of age without central nervous system diseases were included. Each brain image was spatially normalized, and the standardized uptake value (SUV) was obtained. The SUV and the SUV relative to different pseudo-references were explored as a function of age. Results At all evaluated ages, the occipital lobe showed the highest [18F]FDG uptake (0.27 ± 0.04 SUV/year), while the parietal lobe and brainstem had the lowest uptake (0.17 ± 0.02 SUV/year, for both regions). An increase [18F]FDG uptake was found for all brain regions until 12 years old, while no significant uptake differences were found between ages 13 (SUV = 5.39) to 17 years old (SUV = 5.52) (P < 0.0001 for the whole brain). A sex dependence was found in the SUVmean for the whole brain during adolescence (SUV 5.04–5.25 for males, 5.68–5.74 for females, P = 0.0264). Asymmetries in [18F]FDG uptake were found in the temporal and central regions during infancy. Conclusions Brain glycolytic metabolism of [18F]FDG, measured through the SUVmean, increased with age until early adolescence (< 13 years old), showing differences across brain regions. Age, sex, and brain region influence [18F]FDG uptake, with significant hemispheric asymmetries for temporal and central regions. Graphical Abstract

Establishment of a normal control model of children’s brain 18-fluorodeoxyglucose positron emission tomography and analysis of the changing pattern in patients aged 0–14 years

“…During childhood development, motor, language, and visual functions gradually mature, and these functions are widely distributed in the frontal, parietal, and occipital cortices. The accelerating loss of gray-matter density may explain the metabolism decrease at the ages from 10 to 17 years ( 9 ).…”

“…The treatment of oncology may bring potential downsides to intracranial PET results even if there are no obvious intracranial lesions. Moreover, obtaining data on PET in younger children (i.e., 0–2 years of age) is a nearly universal challenge ( 9 , 10 ). Due to factors such as growth and development in children, the PET of adults is not universally applicable, which poses considerable obstacles to pediatric brain network PET analysis.…”

“…Chugani et al concluded that brain metabolism reaches its peak between the ages of 8 and 10 years ( 11 ). A study from Cruz-Cortes et al showed that brain glycolytic metabolism increased with age until 13 years old ( 9 ). An established PET model can not only be used to analyze brain networks but also simulate brain metabolism in different age groups.…”