Elsevier

Journal of Pediatric Surgery

Volume 43, Issue 12, December 2008, Pages 2186-2192
Journal of Pediatric Surgery

PAPS Papers
Early experience with PET/CT scan in the evaluation of pediatric abdominal neoplasms

https://doi.org/10.1016/j.jpedsurg.2008.08.064Get rights and content

Abstract

Purpose

Positron emission tomography/computerized tomography (PET/CT) scan provides both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the evaluation of pediatric abdominal tumors. The goal of this study is to report our early experience with this technology.

Methods

Children who underwent PET/CT scan in the workup for abdominal neoplasms between July 2005 and January 2008 were identified. Retrospective review of all radiologic studies, operative notes, and pathologic reports was undertaken.

Results

A total of 36 patients were collected. These included Burkitt's lymphoma (8), neuroblastoma (7), rhabdomyosarcoma (6), ovarian tumor (3), Wilms' tumor (2), hepatocellular carcinoma (2), paraganglioma (1), germ cell tumor (1), undifferentiated sarcoma (1), renal primitive neuroectodermal tumor (1), gastrointestinal stromal tumor (1), adrenocortical carcinoma (1), inflammatory pseudotumor (1), and adrenal adenoma (1). All neoplasms were fluorodeoxyglucose (FDG) were avid. Our experience identified several potential uses for PET/CT scan in this group of patients. These include (1) preoperative staging, (2) selection of appropriate site for biopsy, (3) identification of occult metastatic disease, (4) follow-up for residual or recurrent disease, and (5) assessment of response to chemotherapy. It can also be valuable when the standard diagnostic studies are equivocal or conflicting.

Conclusions

Preliminary data indicate that PET/CT is a promising tool in the evaluation of pediatric abdominal malignancies. The delineation of the exact role of this diagnostic modality will require additional experience.

Section snippets

Methods

Children who underwent FDG PET/CT in the workup of abdominal neoplasms between July 2005 and January 2008 were identified. Retrospective review of the radiology reports, operative notes, and pathology reports was undertaken. Institutional review board approval was obtained. Information obtained from radiology reports included preoperative or postoperative timing of the study, location of primary tumor as well as the presence of metastatic disease. Avidity of the primary as well as metastatic

Results

A total of 36 patients were collected. These included Burkitt's lymphoma (8), neuroblastoma (7), rhabdomyosarcoma (6): abdominal wall, biliary, prostatic [2], paraspinal, and paratesticular), ovarian tumor (3): dysgerminoma [2], granulosa cell tumor [1]), Wilms' tumor (2), hepatocellular carcinoma (2), undifferentiated sarcoma (1): postradiotherapy for neuroblastoma), metastatic germ cell tumor (1), gastrointestinal stromal tumor (1), adrenocortical carcinoma (1), renal primitive

Discussion

The PET scan has been increasingly incorporated into diagnostic and follow-up protocols of adult and pediatric malignancies, especially in lymphomas and sarcomas [3], [4], [5]. The PET/CT scan in pediatric sarcoma was found to have a high sensitivity (92%) in the detection of malignant sites, similar to results reported in adult patients [3]. In December 2007, Volker [4] reported one of the few prospective studies using PET scan in pediatric sarcoma. The study included 46 patients (Ewing's

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Presented at the 41st annual meeting of the Pacific Association of Pediatric Surgeons, Jackson Lodge, Grand Teton National Park, Wyoming, June 29-July 3, 2008.

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