PT  - JOURNAL ARTICLE
AU  - Marner, Lisbeth
AU  - Nysom, Karsten
AU  - Sehested, Astrid
AU  - Borgwardt, Lise
AU  - Mathiasen, René
AU  - Henriksen, Otto Mølby
AU  - Lundemann, Michael
AU  - Munck af Rosenschöld, Per
AU  - Thomsen, Carsten
AU  - Bøgeskov, Lars
AU  - Skjøth-Rasmussen, Jane
AU  - Juhler, Marianne
AU  - Kruse, Anders
AU  - Broholm, Helle
AU  - Scheie, David
AU  - Lauritsen, Torsten
AU  - Forman, Julie Lyng
AU  - Wehner, Peder Skov
AU  - Højgaard, Liselotte
AU  - Law, Ian
TI  - Early Postoperative <sup>18</sup>F-FET PET/MRI for Pediatric Brain and Spinal Cord Tumors
AID  - 10.2967/jnumed.118.220293
DP  - 2019 Aug 01
TA  - Journal of Nuclear Medicine
PG  - 1053--1058
VI  - 60
IP  - 8
4099  - http://jnm.snmjournals.org/content/60/8/1053.short
4100  - http://jnm.snmjournals.org/content/60/8/1053.full
SO  - J Nucl Med2019 Aug 01; 60
AB  - Complete resection is the treatment of choice for most pediatric brain tumors, but early postoperative MRI for detection of residual tumor may be misleading because of MRI signal changes caused by the operation. PET imaging with amino acid tracers in adults increases the diagnostic accuracy for brain tumors, but the literature in pediatric neurooncology is limited. A hybrid PET/MRI system is highly beneficial in children, reducing the number of scanning procedures, and this is to our knowledge the first larger study using PET/MRI in pediatric neurooncology. We evaluated if additional postoperative 18F-fluoro-ethyl-tyrosine (18F-FET) PET in children and adolescents would improve diagnostic accuracy for the detection of residual tumor as compared with MRI alone and would assist clinical management. Methods: Twenty-two patients (7 male; mean age, 9.5 y; range, 0–19 y) were included prospectively and consecutively in the study and had 27 early postoperative 18F-FET PET exams performed preferentially in a hybrid PET/MRI system (NCT03402425). Results: Using follow-up (93%) or reoperation (7%) as the reference standard, PET combined with MRI discriminated tumor from treatment effects with a lesion-based sensitivity/specificity/accuracy (95% confidence intervals) of 0.73 (0.50–1.00)/1.00 (0.74–1.00)/0.87 (0.73–1.00) compared with MRI alone: 0.80 (0.57–1.00)/0.75 (0.53–0.94)/0.77 (0.65–0.90); that is, the specificity for PET/MRI was 1.00 as compared with 0.75 for MRI alone (P = 0.13). In 11 of 27 cases (41%), results from the 18F-FET PET scans added relevant clinical information, including one scan that directly influenced clinical management because an additional residual tumor site was identified. 18F-FET uptake in reactive changes was frequent (52%), but correct interpretation was possible in all cases. Conclusion: The high specificity for detecting residual tumor suggests that supplementary 18F-FET PET is relevant in cases where reoperation for residual tumor is considered.