Nav: Home

PET/CT imaging proves golden for detecting cancer in children

December 12, 2007

RESTON, Va.--PET/CT imaging exhibits significantly higher sensitivity, specificity and accuracy than conventional imaging when it comes to detecting malignant tumors in children, according to research published in the December issue of the Journal of Nuclear Medicine. And that's not all: PET/CT imaging provides doctors with additional information about cancer in children, possibly sparing young patients from being overtreated.

"PET/CT is useful in finding small tumors in small children and is a promising imaging tool in evaluating pediatric malignancies," said Richard L. Wahl, the Henry N. Wagner, Jr., M.D., Professor in Nuclear Medicine at Johns Hopkins Medical Institutions in Baltimore, Md. "In our study, we found that PET/CT can detect small lymph node lesions diagnosed as negative with conventional (or anatomical) imaging and deny the presence of active disease in soft-tissue masses post-treatment--especially in children with a wide range of malignant cancers," explained the Hopkins professor of radiology and oncology. "Using PET/CT could help spare children from overtreatment while fighting their disease," he added.

There are few findings about the use of PET/CT imaging in comparison with conventional imaging with pediatric patients, said Wahl, explaining that investigators retrospectively reviewed cases to evaluate the efficacy of PET/CT when compared with other imaging methods. Researchers reviewed 151 FDG PET/CT exams that were performed on 55 children with non-central nervous system malignancies (30 patients had lymphoma--cancer that affects the body's lymph nodes and other organs that are part of the body's immune and blood-forming systems).

PET (positron emission tomography) with CT (computed tomography) imaging--with the radiotracer fluorodeoxyglucose (FDG)--enables the collection of both biological and anatomical information during a single exam, with PET picking up metabolic signals of body cells and tissues and CT offering a detailed map of internal anatomy. "PET/CT showed its broad applicability and utility by providing additional information--in more than one third of the children's exams--that could be used by doctors to more appropriately manage or treat the disease in children," added the director of nuclear medicine/PET and vice chair of new technology and business development in the Russell H. Morgan Department of Radiology and Radiological Science. When there were discrepancies between PET/CT and conventional anatomical imaging in analyzing cancer lesions, PET/CT was diagnostically accurate 90 percent of the time, added Wahl, who pioneered the use of PET with FDG and fusion imaging in a wide range of common adult cancers.

Doctors monitor the radiation dose given to children in imaging exams, generally using lower doses than that of adult patients, to get adequate exam results, said Wahl. "Especially as a follow-up examination, PET/CT appears to be the best imaging modality currently, as it provides both PET and CT information simultaneously in pediatric patients, in whom fewer examinations are preferable," he added. Wahl indicated that additional studies with specific childhood cancers are warranted.

PET is a powerful molecular imaging procedure that noninvasively demonstrates the function of organs and other tissues. When PET is used to image cancer, a radiopharmaceutical (such as FDG, which includes both a sugar and a radionuclide) is injected into a patient. Cancer cells metabolize sugar at higher rates than normal cells, and the radiopharmaceutical is drawn in higher amounts to cancerous areas. PET scans show where FDG is by tracking the gamma rays given off by the radionuclide tagging the drug and producing three-dimensional images of their distribution within the body. PET/CT offers precise fusion of metabolic PET images with high-quality anatomical CT images.

Besides Wahl, co-authors of "18F-FDG PET/CT in Evaluating Non-CNS Pediatric Malignancies" include Mitsuaki Tatsumi, nuclear medicine division, radiology department, and John H. Miller, pediatric radiology, radiology department, all from the Johns Hopkins Medical Institutions, Baltimore, Md.

Related Articles

Co-authors of a related article note that the Johns Hopkins researchers "convincingly" show that PET/CT "may improve the evaluation and surveillance of pediatric malignancies." Written by Noah Federman and Stephen A. Feig, the invited perspective notes, "In Hodgkin's disease and pediatric sarcomas, PET/CT appears to be an important tool in the management of these diseases. However, the use of PET/CT in other pediatric malignancies has yet to be rigorously studied."

"PET/CT in Evaluating Pediatric Malignancies: A Clinician's Perspective" was co-written by Federman and Feig, both with Mattel Children's Hospital, David Geffen School of Medicine, University of California in Los Angeles.

Also in the Journal of Nuclear Medicine, German researchers determined that PET/CT was "significantly more accurate than PET alone for the detection and localization of lesions and improves staging of patients with Ewing tumor." The co-authors note, "There are inherent advantages of PET/CT over PET in lesion detection, determination of malignancy and, therefore, overall staging for patients with Ewing tumor." Ewing's tumor is a malignant bone tumor occurring in children and young adults.
-end-
Authors of "Significant Benefit of Multimodal Imaging: PET/CT Compared With PET Alone in Staging and Follow-up of Patients With Ewing Tumors" include Hans U. Gerth, Otmar Schober and Christiane Franzius, nuclear medicine department, Kai U. Juergens, clinical radiology department, Uta Dirksen, pediatric hematology and oncology department, Joachim Gerss, medical informatics and biomathematics department, all at the University Hospital Munster, Munster, Germany.

Credentialed press: To obtain a copy of these articles--and online access to the Journal of Nuclear Medicine-- please contact Maryann Verrillo by phone at (703) 652-6773 or send an e-mail to mverrillo@snm.org. Current and past issues of the Journal of Nuclear Medicine can be found online at http://jnm.snmjournals.org. Print copies can be obtained by contacting the SNM Service Center, 1850 Samuel Morse Drive, Reston, VA 20190-5316; phone (800) 513-6853; e-mail servicecenter@snm.org; fax (703) 708-9015. A subscription to the journal is an SNM member benefit.

About SNM--Advancing Molecular Imaging and Therapy

SNM is an international scientific and professional organization of more than 16,000 members dedicated to promoting the science, technology and practical applications of molecular and nuclear imaging to diagnose, manage and treat diseases in women, men and children. Founded more than 50 years ago, SNM continues to provide essential resources for health care practitioners and patients; publish the most prominent peer-reviewed journal in the field (Journal of Nuclear Medicine); host the premier annual meeting for medical imaging; sponsor research grants, fellowships and awards; and train physicians, technologists, scientists, physicists, chemists and radiopharmacists in state-of-the-art imaging procedures and advances. SNM members have introduced--and continue to explore--biological and technological innovations in medicine that noninvasively investigate the molecular basis of diseases, benefiting countless generations of patients. SNM is based in Reston, Va.; additional information can be found online at http://www.snm.org.

Society of Nuclear Medicine

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
More Cancer News and Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...