Where are we with nuclear medicine in pediatrics?

Nadel, Helen

doi:10.1007/bf01791153

Cited by 10 publications

(2 citation statements)

References 210 publications

(156 reference statements)

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“…1,9,12,16,[19][20][21]29,31,32,34,40,41,[47][48][49][50][51]56,63,64,66,68 Malignant tumors are characterized by increased FDG uptake so that the clinical interest in FDG-PET scanning resides in the information relating to the differential diagnosis, the degree of malignancy, the prognosis, the persistence or recurrence of malignant tissue, and the effect of adjuvant therapy. When combined with anatomical imaging techniques, FDG-PET scanning data can provide information regarding tumor grade, 29,30,40 response to therapy, 9,16,31,32 and prog-nosis.…”

Section: Stereotactic Pet Scanning Guidancementioning

confidence: 99%

Integrated positron emission tomography and magnetic resonance imaging–guided resection of brain tumors: a report of 103 consecutive procedures

Pirotte

Goldman

Dewitte

et al. 2006

JNS

133

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Object. The aim of this study was to evaluate the integration of positron emission tomography (PET) scanning data into the image-guided resection of brain tumors.Methods. Positron emission tomography scans obtained using fluorine-18 fluorodeoxyglucose (FDG) and L-[methyl-11C]methionine (MET) were combined with magnetic resonance (MR) images in the navigational planning of 103 resections of brain tumors (63 low-grade gliomas [LGGs] and 40 high-grade gliomas [HGGs]). These procedures were performed in 91 patients (57 males and 34 females) in whom tumor boundaries could not be accurately identified on MR images for navigation-based resection. The level and distribution of PET tracer uptake in the tumor were analyzed to define the lesion contours, which in turn yielded a PET volume. The PET scanning-demonstrated lesion volume was subsequently projected onto MR images and compared with MR imaging data (MR volume) to define a final target volume for navigation-based resection-the tumor contours were displayed in the microscope's eyepiece. Maximal tumor resection was accomplished in each case, with the intention of removing the entire area of abnormal metabolic activity visualized during surgical planning. Early postoperative MR imaging and PET scanning studies were performed to assess the quality of tumor resection. Both pre-and postoperative analyses of MR and PET images revealed whether integrating PET data into the navigational planning contributed to improved tumor volume definition and tumor resection.Metabolic information on tumor heterogeneity or extent was useful in planning the surgery. In 83 (80%) of 103 procedures, PET studies contributed to defining a final target volume different from that obtained with MR imaging alone. Furthermore, FDG-PET scanning, which was performed in a majority of HGG cases, showed that PET volume was less extended than the MR volume in 16 of 21 cases and contributed to targeting the resection to the hypermetabolic (anaplastic) area in 11 (69%) of 16 cases. Performed in 59 LGG cases and 23 HGG cases, MET-PET demonstrated that the PET volume did not match the MR volume and improved the tumor volume definition in 52 (88%) of 59 and 18 (78%) of 23, respectively. Total resection of the area of increased PET tracer uptake was achieved in 54 (52%) of 103 procedures.Conclusions. Imaging guidance with PET scanning provided independent and complementary information that helped to assess tumor extent and plan tumor resection better than with MR imaging guidance alone. The PET scanning guidance could help increase the amount of tumor removed and target image-guided resection to tumor portions that represent the highest evolving potential. KEY WORDS • neuronavigation • image-guided neurosurgery • positron emission tomography • brain tumor • stereotaxy J. Neurosurg. / Volume 104 / February, 2006HE increasing availability and routine application of image-guided neurosurgery, or neuronavigation, improves the accuracy and safety of neurosurgical interventions. It may help to optimize tumor resectio...

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Section: Stereotactic Pet Scanning Guidancementioning

confidence: 99%

Integrated positron emission tomography and magnetic resonance imaging–guided resection of brain tumors: a report of 103 consecutive procedures

Pirotte

Goldman

Dewitte

et al. 2006

JNS

133

View full text Add to dashboard Cite

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“…In all cases, good cooperation from the patient was obtained with no additional pain from the frame and no fear of imaging machinery. Technical considerations with regard to PET tracer dosimetry and image magnification in children have been previously discussed [21, 34]. The doses of radionuclide injected intravenously were calculated according to the body weight, especially in young children.…”

Section: Discussionmentioning

confidence: 99%

Combined Positron Emission Tomography and Magnetic Resonance Imaging for the Planning of Stereotactic Brain Biopsies in Children: Experience in 9 Cases

Pirotte¹,

Goldman²,

Salzberg³

et al. 2003

Pediatr Neurosurg

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Because brain tumors can be histologically heterogeneous, stereotactic brain biopsies (SBB) may lead to inaccurate diagnosis or grading. Positron emission tomography (PET) has been used in pediatric neuro-oncology to help in the understanding and management of brain neoplasms. We combined PET and magnetic resonance (MR) imaging in the planning of SBB in 9 children (5 males and 4 females, aged 2–14 years) with infiltrative, ill-defined brain lesions. Tracers used for PET were ¹⁸F-2-fluoro-2-deoxy-D-glucose in 4 cases, ¹¹C-methionine in 2 cases and both tracers in 3 cases. Biopsy targets were selected in hypermetabolic areas. PET-guided SBB provided accurate histological diagnosis in all patients and allowed a reduction of the number of trajectories in lesions located in functional areas. It also helped in better understanding and management of complex cases. This preliminary series suggests that combining PET and MR imaging in the planning of SBB in children (1) improves the diagnostic yield of SBB in infiltrative, ill-defined brain lesions, (2) makes it possible to reduce the sampling in high-risk/functional areas and (3) improves the quality of therapeutic management of pediatric brain tumors.

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Positron Emission Tomography

Vaquero

Bacharach²

2019

Cardiac CT, PET &Amp; MR

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Where are we with nuclear medicine in pediatrics?

Cited by 10 publications

References 210 publications

Integrated positron emission tomography and magnetic resonance imaging–guided resection of brain tumors: a report of 103 consecutive procedures

Integrated positron emission tomography and magnetic resonance imaging–guided resection of brain tumors: a report of 103 consecutive procedures

Combined Positron Emission Tomography and Magnetic Resonance Imaging for the Planning of Stereotactic Brain Biopsies in Children: Experience in 9 Cases

Positron Emission Tomography

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