Document Detail


Diagnostic value of PET/CT for the staging and restaging of pediatric tumors.
MedLine Citation:
PMID:  18719909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this retrospective study was to compare the diagnostic value of 2-[(18)F]fluoro-2-deoxy-D: -glucose positron emission tomography ((18)F-FDG PET)/CT versus (18)F-FDG PET and CT alone for staging and restaging of pediatric solid tumors. METHODS: Forty-three children and adolescents (19 females and 24 males; mean age, 15.2 years; age range, 6-20 years) with osteosarcoma (n = 1), squamous cell carcinoma (n = 1), synovial sarcoma (n = 2), germ cell tumor (n = 2), neuroblastoma (n = 2), desmoid tumor (n = 2), melanoma (n = 3), rhabdomyosarcoma (n = 5), Hodgkin's lymphoma (n = 7), non-Hodgkin-lymphoma (n = 9), and Ewing's sarcoma (n = 9) who had undergone (18)F-FDG PET/CT imaging for primary staging or follow-up of metastases were included in this study. The presence, location, and size of primary tumors was determined separately for PET/CT, PET, and CT by two experienced reviewers. The diagnosis of the primary tumor was confirmed by histopathology. The presence or absence of metastases was confirmed by histopathology (n = 62) or clinical and imaging follow-up (n = 238). RESULTS: The sensitivities for the detection of solid primary tumors using integrated (18)F-FDG PET/CT (95%), (18)F-FDG PET alone (73%), and CT alone (93%) were not significantly different (p > 0.05). Seventeen patients showed a total of 153 distant metastases. Integrated PET/CT had a significantly higher sensitivity for the detection of these metastases (91%) than PET alone (37%; p < 0.05), but not CT alone (83%; p > 0.05). When lesions with a diameter of less than 0.5 cm were excluded, PET/CT (89%) showed a significantly higher specificity compared to PET (45%; p < 0.05) and CT (55%; p < 0.05). In a sub-analysis of pulmonary metastases, the values for sensitivity and specificity were 90%, 14%, 82% and 63%, 78%, 65%, respectively, for integrated PET/CT, stand-alone PET, and stand-alone CT. For the detection of regional lymph node metastases, (18)F-FDG PET/CT, (18)F-FDG PET alone, and CT alone were diagnostically correct in 83%, 61%, and 42%. A sub-analysis focusing on the ability of PET/CT, PET, and CT to detect osseous metastases showed no statistically significant difference between the three imaging modalities (p > 0.05). CONCLUSION: Our study showed a significantly increased sensitivity of PET/CT over that of PET for the detection of distant metastases but not over that of CT alone. However, the specificity of PET/CT for the characterization of pulmonary metastases with a diameter > 0.5 cm and lymph node metastases with a diameter of <1 cm was significantly increased over that of CT alone.
Authors:
Margit Kleis; Heike Daldrup-Link; Katherine Matthay; Robert Goldsby; Ying Lu; Tibor Schuster; Carole Schreck; Philip W Chu; Randall A Hawkins; Benjamin L Franc
Related Documents :
19105709 - Pet and pet-ct imaging of gynecological malignancies: present role and future promise.
7835779 - Pelvic staging of advanced and recurrent gynecologic cancers: contribution of endosonog...
16724209 - Evaluation of the impact of addition of pet to ct and mr scanning in the staging of pat...
21070439 - Additional value of pet-ct in staging of clinical stage iib and iii breast cancer.
7653969 - Imaging thoracic malignancy.
17631559 - 68ga-labeled bombesin studies in patients with gastrointestinal stromal tumors: compari...
8777909 - Use of 201thallium brain spect, image registration, and semi-quantitative analysis in t...
18972359 - Ability of diffusion-weighted imaging for the differential diagnosis between chronic ex...
3039829 - Ct-guided stereotactic biopsy of brain tumors: pathologic considerations.
Publication Detail:
Type:  Journal Article     Date:  2008-08-22
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  36     ISSN:  1619-7089     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-05     Completed Date:  2009-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  23-36     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of California, 505 Parnassus Avenue, San Francisco, CA 94143-0628, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Neoplasm Metastasis / radiography,  radionuclide imaging
Neoplasm Staging
Neoplasms / diagnosis*,  pathology*,  radiography,  radionuclide imaging
Positron-Emission Tomography
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Infarct size in primary angioplasty without on-site cardiac surgical backup versus transferal to a t...
Next Document:  Immune stimulatory antigen loaded particles combined with depletion of regulatory T-cells induce pot...