PT  - JOURNAL ARTICLE
AU  - Kim Kramer
AU  - Maria Donzelli
AU  - Emmanuela Nwora
AU  - Neeta Pandit-Taskar
TI  - Assessing Cerebrospinal Fluid Flow Dynamics in Pediatric Patients with Central Nervous System Tumors Treated with Intraventricular Radioimmunotherapy
AID  - 10.2967/jnumed.119.232678
DP  - 2020 May 01
TA  - Journal of Nuclear Medicine
PG  - 662--664
VI  - 61
IP  - 5
4099  - http://jnm.snmjournals.org/content/61/5/662.short
4100  - http://jnm.snmjournals.org/content/61/5/662.full
SO  - J Nucl Med2020 May 01; 61
AB  - The incidence of abnormal cerebrospinal fluid (CSF) flow dynamics in children with central nervous system (CNS) tumors before intraventricular therapy has not been described. Methods: We performed a single-institution, retrospective review of patients with primary or metastatic CNS tumors treated between 2003 and 2018 (15 y). Patients underwent 111In-diethylenetriaminepentaacetic acid injection into the CSF intraventricular space followed by nuclear medicine imaging at 90 min, 4 h, 24 h, and 48 h (if required). CSF flow was classified as normal, delayed, asymmetric, or obstructed. Results: In total, 278 CSF flow studies were performed on 224 patients, 202 of whom (90%) were less than 18 y old. Of these, 116 patients (52%) had metastatic CNS neuroblastoma, 57 (25%) had medulloblastoma, and 51 (23%) had other histologic types of CNS tumors. Of the 278 studies, 237 (85%) were normal, 9 (3%) required neurosurgical intervention, 25 (9%) were delayed, and 7 (3%) were asymmetric. Conclusion: Abnormal CSF flow and the necessity for neurosurgical intervention must be considered when attempting to ensure appropriate intraventricular therapy in the pediatric population.