Early Postoperative 18F-FET PET/MRI for Pediatric Brain and Spinal Cord Tumors
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Early Postoperative 18F-FET PET/MRI for Pediatric Brain and Spinal Cord Tumors. / Marner, Lisbeth; Nysom, Karsten; Sehested, Astrid; Borgwardt, Lise; Mathiasen, René; Henriksen, Otto Mølby; Lundemann, Michael; Munck Af Rosenschöld, Per; Thomsen, Carsten; Bøgeskov, Lars; Skjøth-Rasmussen, Jane; Juhler, Marianne; Kruse, Anders; Broholm, Helle; Scheie, David; Lauritsen, Torsten; Forman, Julie Lyng; Wehner, Peder Skov; Højgaard, Liselotte; Law, Ian.
I: The Journal of Nuclear Medicine, Bind 60, Nr. 8, 2019, s. 1053-1058.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Early Postoperative 18F-FET PET/MRI for Pediatric Brain and Spinal Cord Tumors
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
N1 - Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2019
Y1 - 2019
N2 - Purpose: Complete resection is the treatment of choice for most pediatric brain tumors, but early postoperative MRI for detection of residual tumor may be misleading due to magnetic resonance imaging (MRI) signal changes caused by the operation. PET (positron emission tomography) imaging with amino acid tracers in adults increase 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 1) improve diagnostic accuracy for the detection of residual tumor as compared to MRI alone, and 2) assist clinical management. Methods: Twenty-two patients (7 males, mean age 9.5 years, range 0-19) were included prospectively and consecutively in the study and had twenty-seven early postoperative 18F-FET PET performed preferentially in a hybrid PET/MRI system (NCT03402425). Results: Using follow-up (93%) or re-operation (7%) as 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 to MRI alone: 0.80(0.57-1.00)/0.75(0.53-0.94)/0.77(0.65-0.90), i.e. the specificity for PET/MRI was 1.00 as compared to 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 as 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 re-operation for residual tumor is considered.
AB - Purpose: Complete resection is the treatment of choice for most pediatric brain tumors, but early postoperative MRI for detection of residual tumor may be misleading due to magnetic resonance imaging (MRI) signal changes caused by the operation. PET (positron emission tomography) imaging with amino acid tracers in adults increase 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 1) improve diagnostic accuracy for the detection of residual tumor as compared to MRI alone, and 2) assist clinical management. Methods: Twenty-two patients (7 males, mean age 9.5 years, range 0-19) were included prospectively and consecutively in the study and had twenty-seven early postoperative 18F-FET PET performed preferentially in a hybrid PET/MRI system (NCT03402425). Results: Using follow-up (93%) or re-operation (7%) as 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 to MRI alone: 0.80(0.57-1.00)/0.75(0.53-0.94)/0.77(0.65-0.90), i.e. the specificity for PET/MRI was 1.00 as compared to 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 as 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 re-operation for residual tumor is considered.
U2 - 10.2967/jnumed.118.220293
DO - 10.2967/jnumed.118.220293
M3 - Journal article
C2 - 30683767
VL - 60
SP - 1053
EP - 1058
JO - The Journal of Nuclear Medicine
JF - The Journal of Nuclear Medicine
SN - 0161-5505
IS - 8
ER -
ID: 217613868