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Use of positron emission tomography for staging, preoperative response assessment and posttherapeutic evaluation in children with Wilms tumour

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate FDG-PET for staging, grading, preoperative response assessment and posttherapeutic evaluation in children with Wilms tumour (WT).

Methods

In this study, 23 FDG-PET examinations in 12 paediatric patients (female, n = 5; male, n = 7; age, 1–19 years) with WT (primary, n = 9; relapsed, n = 3) were analysed. All patients were examined with conventional imaging methods (CIM) according to the SIOP2001/GPOH trial protocol. Additionally, FDG-PET/PET-CT was performed for staging (n = 12), preoperative response assessment (n = 6) and posttherapeutic evaluation (n = 5). Imaging results of FDG-PET and CIM were analysed regarding the accuracy in tumour visualisation, impact on therapeutic management and preoperative response assessment, with clinical follow-up and histopathology as the standard of reference.

Results

FDG-PET and CIM showed concordant results for staging of primary WT, whereas FDG-PET was superior in 1/3 cases with recurrent WT. Concerning histological differentiation, one case with anaplastic WT had an standard uptake value (SUV) of 12.3, which was remarkably higher than the average SUV in the eight cases with intermediate risk histology. No parameter analysed for PET or CIM was reliably predictive for histological regression or clinical outcome. After completion of therapy, FDG-PET was superior to CIM in 2/5 cases in detecting residual disease with therapeutic relevance.

Conclusion

FDG-PET does not provide additional information to the traditional imaging work-up for staging WT patients, preoperative response assessment and clinical outcome. FDG-PET was advantageous in ruling out residual disease after completion of first line treatment and in pretherapeutic staging of relapse patients. Furthermore, there seems to be a good correlation of initial SUV and histological differentiation.

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Acknowledgement

This study was financially supported by the Deutsche Krebshilfe e.V.

Conflict of interest statement

All authors disclose no conflict of interest.

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Authors and Affiliations

  1. Klinik für Strahlenheilkunde, Bereiche Nuklearmedizin und Radiologie, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Daniel Misch, Ingo G. Steffen, Christian Furth, Brigitte Stöver, Holger Amthauer & Timm Denecke

  2. Klinik für Pädiatrie m.S. Onkologie und Hämatologie, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, Berlin, Germany

    Thomas Voelker & Günter Henze

  3. Klinik für Kinder-Onkologie, -Hämatologie und Klinische -Immunologie, Universitätsklinikum Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany

    Stefan Schönberger

  4. Nuklearmedizinische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

    Hubertus Hautzel

Authors
  1. Daniel Misch
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  2. Ingo G. Steffen
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  3. Stefan Schönberger
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  4. Thomas Voelker
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  5. Christian Furth
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  9. Holger Amthauer
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Correspondence to Daniel Misch.

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Misch, D., Steffen, I.G., Schönberger, S. et al. Use of positron emission tomography for staging, preoperative response assessment and posttherapeutic evaluation in children with Wilms tumour. Eur J Nucl Med Mol Imaging 35, 1642–1650 (2008). https://doi.org/10.1007/s00259-008-0819-9

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  • DOI: https://doi.org/10.1007/s00259-008-0819-9

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