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Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2008

01-08-2008 | Guidelines

Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology

Authors: J. Stauss, C. Franzius, T. Pfluger, K. U. Juergens, L. Biassoni, J. Begent, R. Kluge, H. Amthauer, T. Voelker, L. Højgaard, S. Barrington, S. Hain, T. Lynch, K. Hahn

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2008

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Abstract

Objective

The purpose of these guidelines is to offer to the nuclear medicine team a framework that could prove helpful in daily practice. These guidelines contain information related to the indications, acquisition, processing and interpretation of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in paediatric oncology. The Oncology Committee of the European Association of Nuclear Medicine (EANM) has published excellent procedure guidelines on tumour imaging with 18F-FDG PET (Bombardieri et al., Eur J Nucl Med Mol Imaging 30:BP115–24, 2003 [2]. These guidelines, published by the EANM Paediatric Committee, do not intend to compete with the existing guidelines, but rather aim at providing additional information on issues particularly relevant to PET imaging of children with cancer.

Conclusion

The guidelines summarize the views of the Paediatric Committee of the European Association of Nuclear Medicine. They should be taken in the context of “good practice” of nuclear medicine and of any national rules, which may apply to nuclear medicine examinations. The recommendations of these guidelines cannot be applied to all patients in all practice settings. The guidelines should not be deemed inclusive of all proper procedures or exclusive of other procedures reasonably directed to obtaining the same results.
Literature
1.
go back to reference Bartenstein P, Asenbaum S, Catafau A, Halldin C, Pilowski L, Pupi A, et al. European Association of Nuclear Medicine. European Association of Nuclear Medicine procedure guidelines for brain imaging using [(18)F]FDG. Eur J Nucl Med Mol Imaging 2002;29:BP43–8.PubMed Bartenstein P, Asenbaum S, Catafau A, Halldin C, Pilowski L, Pupi A, et al. European Association of Nuclear Medicine. European Association of Nuclear Medicine procedure guidelines for brain imaging using [(18)F]FDG. Eur J Nucl Med Mol Imaging 2002;29:BP43–8.PubMed
2.
go back to reference Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. FDG-PET: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2003;30:BP115–24.PubMed Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. FDG-PET: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2003;30:BP115–24.PubMed
3.
go back to reference Chugani HT. A critical period of brain development: studies of cerebral glucose utilization with PET. Prev Med 1998;27:184–8.PubMedCrossRef Chugani HT. A critical period of brain development: studies of cerebral glucose utilization with PET. Prev Med 1998;27:184–8.PubMedCrossRef
4.
go back to reference El Fakhri G, Holdsworth C, Badawi RD, Santos PA, Moore SC, Van den Abbeele AD, Kijewski MF. Impact of acquisition geometry and patient habitus on lewsion detectability in whole body FDG-PET: a channelized hotelling observer study. In: IEEE Nuclear Science Symposium Conference Record. Piscataway, NJ: IEEE, 2002:3:1402–1405. El Fakhri G, Holdsworth C, Badawi RD, Santos PA, Moore SC, Van den Abbeele AD, Kijewski MF. Impact of acquisition geometry and patient habitus on lewsion detectability in whole body FDG-PET: a channelized hotelling observer study. In: IEEE Nuclear Science Symposium Conference Record. Piscataway, NJ: IEEE, 2002:3:1402–1405.
5.
go back to reference Franzius C, Juergens KU, Vormoor J. PET/CT with diagnostic CT in the evaluation of childhood sarcoma. AJR Am J Roentgenol 2006;186:581.PubMedCrossRef Franzius C, Juergens KU, Vormoor J. PET/CT with diagnostic CT in the evaluation of childhood sarcoma. AJR Am J Roentgenol 2006;186:581.PubMedCrossRef
6.
go back to reference Franzius C, Juergens KU, Schober O. Is PET/CT necessary in paediatric oncology?: For. Eur J Nucl Med Mol Imaging 2006;33:960–5.PubMedCrossRef Franzius C, Juergens KU, Schober O. Is PET/CT necessary in paediatric oncology?: For. Eur J Nucl Med Mol Imaging 2006;33:960–5.PubMedCrossRef
7.
go back to reference Franzius C, Vormoor J, Weckesser M, Jürgens KU, Schober O. Optimised PET/CT protocols with diagnostic contrast enhanced multi-slice CT and low-dose CT in paediatric patients: Analysis of more than 350 examinations. Eur J Nucl Med Mol Imaging 2006;33(Suppl 2):124. Franzius C, Vormoor J, Weckesser M, Jürgens KU, Schober O. Optimised PET/CT protocols with diagnostic contrast enhanced multi-slice CT and low-dose CT in paediatric patients: Analysis of more than 350 examinations. Eur J Nucl Med Mol Imaging 2006;33(Suppl 2):124.
8.
go back to reference Gelfand M, O’Hara S, Curtwright L, et al. Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients. Pediatr Radiol 2005;35:984–90.PubMedCrossRef Gelfand M, O’Hara S, Curtwright L, et al. Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients. Pediatr Radiol 2005;35:984–90.PubMedCrossRef
9.
go back to reference Hahn K, Pfluger T. Is PET/CT necessary in paediatric oncology?: Against. Eur J Nucl Med Mol Imaging 2006;33:966–8.PubMedCrossRef Hahn K, Pfluger T. Is PET/CT necessary in paediatric oncology?: Against. Eur J Nucl Med Mol Imaging 2006;33:966–8.PubMedCrossRef
10.
go back to reference Holm S, Borgwardt L, Loft A, Graff J, Law I, Hojgaard L. Paediatric doses-a critical appraisal of the EANM paediatric dosage card. Eur J Nucl Med Mol Imaging. 2007 Nov;34:1713–8.PubMedCrossRef Holm S, Borgwardt L, Loft A, Graff J, Law I, Hojgaard L. Paediatric doses-a critical appraisal of the EANM paediatric dosage card. Eur J Nucl Med Mol Imaging. 2007 Nov;34:1713–8.PubMedCrossRef
11.
go back to reference ICRP Publication 80. Radiation dose to patients from radiopharmaceuticals. Annals of ICRP 1998;28:3, Pergamon Press, Oxford. ICRP Publication 80. Radiation dose to patients from radiopharmaceuticals. Annals of ICRP 1998;28:3, Pergamon Press, Oxford.
12.
go back to reference Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F. EANM Dosimetry and Paediatrics Committees. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 2007;34:796–8.PubMedCrossRef Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F. EANM Dosimetry and Paediatrics Committees. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 2007;34:796–8.PubMedCrossRef
13.
go back to reference Lassmann M, Biassoni L, Monsieurs M, Franzius C. The new EANM Paediatric Dosage Card. Additional notes with respect to F-18. Eur J Nucl Med Mol Imaging 2008; (in press). Lassmann M, Biassoni L, Monsieurs M, Franzius C. The new EANM Paediatric Dosage Card. Additional notes with respect to F-18. Eur J Nucl Med Mol Imaging 2008; (in press).
14.
go back to reference Parysow O, Mollerach AM, Jager V, Racioppi S, San Roman J, Gerbaudo VH. Low-dose oral propranolol could reduce brown adipose tissue F-18 FDG uptake in patients undergoing PET scans. Clin Nucl Med 2007;32:351–7.PubMedCrossRef Parysow O, Mollerach AM, Jager V, Racioppi S, San Roman J, Gerbaudo VH. Low-dose oral propranolol could reduce brown adipose tissue F-18 FDG uptake in patients undergoing PET scans. Clin Nucl Med 2007;32:351–7.PubMedCrossRef
15.
go back to reference Söderlund V, Larsson SA, Jacobsson H. Reduction of FDG uptake in brown adipose tissue in clinical patients by a single dose of propranolol. Eur J Nucl Med Mol Imaging 2007;34:1018–22.PubMedCrossRef Söderlund V, Larsson SA, Jacobsson H. Reduction of FDG uptake in brown adipose tissue in clinical patients by a single dose of propranolol. Eur J Nucl Med Mol Imaging 2007;34:1018–22.PubMedCrossRef
16.
go back to reference Warbey VS, Schleyer PJ, Barrington SF, O’Doherty MJ. The new EANM paediatric dosage card - does it conform to ALARA for PET/CT? Eur J Nucl Med Mol Imaging 2007;34:1881–82.PubMedCrossRef Warbey VS, Schleyer PJ, Barrington SF, O’Doherty MJ. The new EANM paediatric dosage card - does it conform to ALARA for PET/CT? Eur J Nucl Med Mol Imaging 2007;34:1881–82.PubMedCrossRef
1.
go back to reference Amthauer H, Furth C, Denecke T, Hundsdoerfer P, Voelker T, Seeger K, et al. FDG-PET in 10 children with non-Hodgkin’s lymphoma: initial experience in staging and follow-up. Klin Padiatr 2005;217:327–33.PubMedCrossRef Amthauer H, Furth C, Denecke T, Hundsdoerfer P, Voelker T, Seeger K, et al. FDG-PET in 10 children with non-Hodgkin’s lymphoma: initial experience in staging and follow-up. Klin Padiatr 2005;217:327–33.PubMedCrossRef
2.
go back to reference Barrington SF, Begent J, Lynch T, Schleyer P, Biassoni L, Ramsden W, et al. Guidelines for the use of PET-CT in children. Nucl Med Commun 2008;29(5):418–24.PubMedCrossRef Barrington SF, Begent J, Lynch T, Schleyer P, Biassoni L, Ramsden W, et al. Guidelines for the use of PET-CT in children. Nucl Med Commun 2008;29(5):418–24.PubMedCrossRef
3.
go back to reference Borgwardt L, Larsen HJ, Pedersen K, Hojgaard L. Practical use and implementation of PET in children in a hospital PET centre. Eur J Nucl Med Mol Imaging 2003;30:1389–97.PubMedCrossRef Borgwardt L, Larsen HJ, Pedersen K, Hojgaard L. Practical use and implementation of PET in children in a hospital PET centre. Eur J Nucl Med Mol Imaging 2003;30:1389–97.PubMedCrossRef
4.
go back to reference Brink I, Reinhardt MJ, Hoegerle S, Altehoefer C, Moser E, Nitzsche EU. Increased metabolic activity in the thymus gland studied with 18F -FDG PET: age dependency and frequency after chemotherapy. J Nucl Med 2001;42:591–5.PubMed Brink I, Reinhardt MJ, Hoegerle S, Altehoefer C, Moser E, Nitzsche EU. Increased metabolic activity in the thymus gland studied with 18F -FDG PET: age dependency and frequency after chemotherapy. J Nucl Med 2001;42:591–5.PubMed
5.
go back to reference Fahey FH, Palmer MR, Strauss KJ, et al. Dosimetry and adequacy of CT-based attenuation correction for pediatric PET: phantom study. Radiology 2007;243:96–104.PubMedCrossRef Fahey FH, Palmer MR, Strauss KJ, et al. Dosimetry and adequacy of CT-based attenuation correction for pediatric PET: phantom study. Radiology 2007;243:96–104.PubMedCrossRef
6.
go back to reference Franzius C, Sciuk J, Brinkschmidt C, Jurgens H, Schrober O. Evaluation of chemotherapy response in primary bone tumours with F-18 FDG positron emission tomography compared with histologically assessed tumour necrosis. Clin Nucl Med 2000;25:874–1.PubMedCrossRef Franzius C, Sciuk J, Brinkschmidt C, Jurgens H, Schrober O. Evaluation of chemotherapy response in primary bone tumours with F-18 FDG positron emission tomography compared with histologically assessed tumour necrosis. Clin Nucl Med 2000;25:874–1.PubMedCrossRef
7.
go back to reference Franzius C, Sciuk J, Daldrup-Link HE, Jurgens H, Schober O. FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy. Eur J Nucl Med 2000;27:1305–11.PubMedCrossRef Franzius C, Sciuk J, Daldrup-Link HE, Jurgens H, Schober O. FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy. Eur J Nucl Med 2000;27:1305–11.PubMedCrossRef
8.
go back to reference Franzius C, Daldrup-Link HE, Sciuk J, Rummeny EJ, Bielack S, Jurgens H, et al. FDG-PET for detection of pulmonary metastases from malignant primary bone tumors: comparison with spiral CT. Ann Oncol 2001;12:479–86.PubMedCrossRef Franzius C, Daldrup-Link HE, Sciuk J, Rummeny EJ, Bielack S, Jurgens H, et al. FDG-PET for detection of pulmonary metastases from malignant primary bone tumors: comparison with spiral CT. Ann Oncol 2001;12:479–86.PubMedCrossRef
9.
go back to reference Franzius C, Daldrup-Link HE, Wagner-Bohn A, Sciuk J, Heindel WL, Jürgens H, et al. FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional staging. Ann Oncol 2002;13:157–60.PubMedCrossRef Franzius C, Daldrup-Link HE, Wagner-Bohn A, Sciuk J, Heindel WL, Jürgens H, et al. FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional staging. Ann Oncol 2002;13:157–60.PubMedCrossRef
10.
go back to reference Franzius C, Schober O. Assessment of therapy response by FDG PET in pediatric patients. Q J Nucl Med 2003;47:41–5.PubMed Franzius C, Schober O. Assessment of therapy response by FDG PET in pediatric patients. Q J Nucl Med 2003;47:41–5.PubMed
11.
go back to reference Gutzeit A, Debatin JF, Antoch G. Tumor staging with PET/CT. Detection of a second tumor. Rofo 2004;176:122–4.PubMed Gutzeit A, Debatin JF, Antoch G. Tumor staging with PET/CT. Detection of a second tumor. Rofo 2004;176:122–4.PubMed
12.
go back to reference Hahn K, Pfluger T. Has PET become an important clinical tool in paediatric imaging? Eur J Nucl Med Mol Imaging 2004;31:615–21.PubMedCrossRef Hahn K, Pfluger T. Has PET become an important clinical tool in paediatric imaging? Eur J Nucl Med Mol Imaging 2004;31:615–21.PubMedCrossRef
13.
go back to reference Hawkins DS, Rajendran JG, Conrad EU 3rd, Bruckner JD, Eary JF. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-d-glucose positron emission tomography. Cancer 2002;94:3277–84.PubMedCrossRef Hawkins DS, Rajendran JG, Conrad EU 3rd, Bruckner JD, Eary JF. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-d-glucose positron emission tomography. Cancer 2002;94:3277–84.PubMedCrossRef
14.
go back to reference Herrmann S, Wormanns D, Pixberg M, Hunold A, Heindel WL, Jurgens H, et al. Staging in childhood lymphoma: differences between FDG-PET and CT. Nuklearmedizin 2005;44:1–7. Herrmann S, Wormanns D, Pixberg M, Hunold A, Heindel WL, Jurgens H, et al. Staging in childhood lymphoma: differences between FDG-PET and CT. Nuklearmedizin 2005;44:1–7.
15.
go back to reference Jacobs F, Thierens H, Piepsz A, Bacher K, Van de Wiele C, Ham H, Dierckx RA, European Association of Nuclear Medicine. Optimised tracer-dependent dosage cards to obtain weight-independent effective doses. Eur J Nucl Med Mol Imaging 2005;32:581–8.PubMedCrossRef Jacobs F, Thierens H, Piepsz A, Bacher K, Van de Wiele C, Ham H, Dierckx RA, European Association of Nuclear Medicine. Optimised tracer-dependent dosage cards to obtain weight-independent effective doses. Eur J Nucl Med Mol Imaging 2005;32:581–8.PubMedCrossRef
16.
go back to reference Juergens KU, Weckesser M, Stegger L, Franzius C, Beetz M, Schober O, et al. Tumor staging using whole-body high-resolution 16-channel PET-CT: does additional low-dose chest CT in inspiration improve the detection of solitary pulmonary nodules? Eur Radiol 2006;16:1131–7.PubMedCrossRef Juergens KU, Weckesser M, Stegger L, Franzius C, Beetz M, Schober O, et al. Tumor staging using whole-body high-resolution 16-channel PET-CT: does additional low-dose chest CT in inspiration improve the detection of solitary pulmonary nodules? Eur Radiol 2006;16:1131–7.PubMedCrossRef
17.
go back to reference Kaste S, Howard S, McCarville E, et al. 18F-FDG-avid sites mimicking active disease in pediatric Hodgkin’s. Pediatr Radiol. 2005;35:141–54.PubMedCrossRef Kaste S, Howard S, McCarville E, et al. 18F-FDG-avid sites mimicking active disease in pediatric Hodgkin’s. Pediatr Radiol. 2005;35:141–54.PubMedCrossRef
18.
go back to reference Kaste S. Issues specific to implementing PET-CT for pediatric oncology: what have we learned along the way? Pediatr Radiol 2004;34:205–13.PubMedCrossRef Kaste S. Issues specific to implementing PET-CT for pediatric oncology: what have we learned along the way? Pediatr Radiol 2004;34:205–13.PubMedCrossRef
19.
go back to reference Körholz D, Kluge R, Wickmann L, Hirsch W, Lüders H, Lotz I, et al. Importance of 18F-Fluorodeoxy-d-2-glucose positron emission tomography (FDG-PET) for staging and therapy control of Hodgkin’s lymphoma in childhood and adolescence—consequences for the GPOH-HD 2003 protocol. Onkologie 2003;26:489–93.PubMedCrossRef Körholz D, Kluge R, Wickmann L, Hirsch W, Lüders H, Lotz I, et al. Importance of 18F-Fluorodeoxy-d-2-glucose positron emission tomography (FDG-PET) for staging and therapy control of Hodgkin’s lymphoma in childhood and adolescence—consequences for the GPOH-HD 2003 protocol. Onkologie 2003;26:489–93.PubMedCrossRef
20.
go back to reference Kushner BH, Yeung HW, Larson SM, Kramer K, Cheung NK. Extending positron emission tomography scan utility to high-risk neuroblastoma: fluorine-18 fluorodeoxyglucose positron emission tomography as sole imaging modality in follow-up of patients. J Clin Oncol 2001;19:3397–405.PubMed Kushner BH, Yeung HW, Larson SM, Kramer K, Cheung NK. Extending positron emission tomography scan utility to high-risk neuroblastoma: fluorine-18 fluorodeoxyglucose positron emission tomography as sole imaging modality in follow-up of patients. J Clin Oncol 2001;19:3397–405.PubMed
21.
go back to reference Lucas JD, O’Doherty MJ, Wong JCH, et al. Evaluation of fluorodeoxyglucose positron emission tomography in the management of soft-tissue sarcomas. J Bone Joint Surg (Br) 1998;80:441–7.CrossRef Lucas JD, O’Doherty MJ, Wong JCH, et al. Evaluation of fluorodeoxyglucose positron emission tomography in the management of soft-tissue sarcomas. J Bone Joint Surg (Br) 1998;80:441–7.CrossRef
22.
go back to reference Lucas JD, O’Doherty MJ, Cronin BF, Marsden PK, Lodge MA, McKee PH, et al. Prospective evaluation of soft tissue masses and sarcomas using fluorodeoxyglucose positron emission tomography. Br J Surg 1999;86:550–6.PubMedCrossRef Lucas JD, O’Doherty MJ, Cronin BF, Marsden PK, Lodge MA, McKee PH, et al. Prospective evaluation of soft tissue masses and sarcomas using fluorodeoxyglucose positron emission tomography. Br J Surg 1999;86:550–6.PubMedCrossRef
23.
go back to reference McCarville MB, Christie R, Daw NC, Spunt SL, Kaste SC. PET/CT in evaluation of childhood sarcomas. Am J Roentgenol 2005;184:1293–304. McCarville MB, Christie R, Daw NC, Spunt SL, Kaste SC. PET/CT in evaluation of childhood sarcomas. Am J Roentgenol 2005;184:1293–304.
24.
go back to reference Montravers F, McNamara D, Landman-Parker J, et al. [18F]FDG in childhood lymphoma: clinical utility and impact on management. Eur J Nucl Med Mol Imaging 2002;29:1155–65.PubMedCrossRef Montravers F, McNamara D, Landman-Parker J, et al. [18F]FDG in childhood lymphoma: clinical utility and impact on management. Eur J Nucl Med Mol Imaging 2002;29:1155–65.PubMedCrossRef
25.
go back to reference O’Hara SM, Donnelly LF, Coleman RE. Pediatric body applications of FDG PET. AJR Am J Roentgenol 1999;172:1019–24.PubMed O’Hara SM, Donnelly LF, Coleman RE. Pediatric body applications of FDG PET. AJR Am J Roentgenol 1999;172:1019–24.PubMed
26.
go back to reference Shulkin BL. PET applications in pediatrics. Q J Nucl Med 1997;41:281–91.PubMed Shulkin BL. PET applications in pediatrics. Q J Nucl Med 1997;41:281–91.PubMed
27.
go back to reference Shulkin BL, Hutchinson RJ, Castle VP, Yanik GA, Shapiro B, Sisson JC. Neuroblastoma: positron emission tomography with 2-[fluorine-18]-fluoro-2-deoxy-d-glucose compared with metaiodobenzylguanidine scintigraphy. Radiology 1996;199:743–50.PubMed Shulkin BL, Hutchinson RJ, Castle VP, Yanik GA, Shapiro B, Sisson JC. Neuroblastoma: positron emission tomography with 2-[fluorine-18]-fluoro-2-deoxy-d-glucose compared with metaiodobenzylguanidine scintigraphy. Radiology 1996;199:743–50.PubMed
28.
go back to reference Stabin MG, Gelfand MJ. Dosimetry of pediatric nuclear medicine procedures. Q J Nucl Med 1998;42:93–112.PubMed Stabin MG, Gelfand MJ. Dosimetry of pediatric nuclear medicine procedures. Q J Nucl Med 1998;42:93–112.PubMed
29.
go back to reference Wegner E, Barrington S, Kingston J, et al. The impact of PET scanning on management of paediatric oncology patients. Eur J Nucl Med Mol Imaging 2005;32:23–30.PubMedCrossRef Wegner E, Barrington S, Kingston J, et al. The impact of PET scanning on management of paediatric oncology patients. Eur J Nucl Med Mol Imaging 2005;32:23–30.PubMedCrossRef
Metadata
Title
Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology
Authors
J. Stauss
C. Franzius
T. Pfluger
K. U. Juergens
L. Biassoni
J. Begent
R. Kluge
H. Amthauer
T. Voelker
L. Højgaard
S. Barrington
S. Hain
T. Lynch
K. Hahn
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-008-0826-x

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