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The incremental value of 18F-FDG PET/CT in paediatric malignancies

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Abstract

Purpose

18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) imaging has been used in the assessment of paediatric malignancies. PET/CT increases the diagnostic accuracy in adult cancer patients. The present study assesses the incremental value of FDG PET/CT in paediatric malignancies.

Methods

A total of 118 18FDG PET/CT studies of 46 paediatric patients were reviewed retrospectively. PET and PET/CT results were classified as malignant, equivocal or benign, compared on a site- and study-based analysis, and also compared with the clinical outcome.

Results

Three hundred and twenty-four sites of increased FDG uptake were detected. Discordant PET and PET/CT interpretations were found in 97 sites (30%) in 27 studies (22%). PET yielded a statistically significant higher proportion of equivocal and a lower proportion of benign lesion and study results (p < 0.001) than PET/CT. With PET there were 153 benign (47%), 84 (26%) equivocal and 87 (27%) malignant sites, while PET/CT detected 226 benign (70%), 10 (3%) equivocal and 88 (27%) malignant lesions. PET/CT mainly improved the characterisation of uptake in brown fat (39%), bowel (17%), muscle (8%) and thymus (7%). The study-based analysis showed that 17 equivocal and seven positive PET studies (20%) were interpreted as benign on PET/CT, while three equivocal studies were interpreted as malignant. The study-based sensitivity and specificity of PET/CT were 92% and 78% respectively.

Conclusion

PET/CT significantly improved the characterisation of abnormal 18FDG foci in children with cancer, mainly by excluding the presence of active malignancy in sites of increased tracer activity.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach-Tikva, 49202, Israel

    Zvi Bar-Sever

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Zvi Bar-Sever

  3. Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel

    Zohar Keidar, Rachel Bar-Shalom & Ora Israel

  4. B. Rapaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Zohar Keidar & Ora Israel

  5. Department of Paediatric Oncology, Rambam Medical Center, Haifa, Israel

    Ayelet Ben-Barak, Sergey Postovsky & Myriam W. Ben Arush

  6. Department of Diagnostic Radiology, Rambam Medical Center, Haifa, Israel

    Luda Guralnik

Authors
  1. Zvi Bar-Sever
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  2. Zohar Keidar
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  3. Ayelet Ben-Barak
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  4. Rachel Bar-Shalom
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  5. Sergey Postovsky
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  6. Luda Guralnik
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  7. Myriam W. Ben Arush
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  8. Ora Israel
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Corresponding author

Correspondence to Zvi Bar-Sever.

Additional information

Institution from which this work originated: Rambam Medical Center, 8 Haaliya Hashniya Street, Haifa 31096, Israel.

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Bar-Sever, Z., Keidar, Z., Ben-Barak, A. et al. The incremental value of 18F-FDG PET/CT in paediatric malignancies. Eur J Nucl Med Mol Imaging 34, 630–637 (2007). https://doi.org/10.1007/s00259-006-0253-9

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  • DOI: https://doi.org/10.1007/s00259-006-0253-9

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