PET clinics最新文献

While ¹²³I-metaiodobenzylguanidine scintigraphy with single-photon emission computed tomography/computed tomography remains the gold standard for the initial diagnosis, staging, treatment response assessment, and surveillance of recurrence in neuroblastoma (NB), PET imaging has emerged as a promising alternative modality. PET provides superior spatial resolution, allowing earlier detection of small lesions and more accurate staging through quantitative analysis. The development of diverse PET radiotracers has further improved diagnostic precision and facilitated treatment planning. Although current clinical evidence for PET in NB is still limited, ongoing advances in tumor-specific PET tracers are likely to expand its role in future clinical practice.

PET/MR combines MR imaging's structural detail with PET's functional and molecular insights, offering a powerful tool for pediatric nervous disorders. It is particularly valuable in epilepsy for surgical planning and treatment guidance, with emerging applications in autoimmune, neuroinflammatory, and neurodevelopmental conditions. This review highlights recent advances and case examples demonstrating its clinical utility in nonmalignant pediatric nervous disorders.

Most published studies of fluorodeoxyglucose (FDG)-PET for infection and inflammation have focused on adults, and this experience-along with more limited pediatric FDG-PET/CT experience-has guided the use of FDG-PET/MR in children and young adults. In pediatric patients, FDG-PET/MR has been used for evaluation of fever of unknown origin, suspected osteomyelitis, endocarditis or cardiac device infection, vasculitis, and inflammatory bowel disease. Compared with FDG-PET/CT, FDG-PET/MR provides better soft tissue detail and lower radiation exposure. Although FDG-PET/MR is currently underused, these advantages support broader adoption of FDG-PET/MR for evaluating inflammatory and infectious conditions in younger patients.

Pediatric osteosarcoma and Ewing sarcoma are aggressive primary bone tumors requiring precise diagnosis and staging. 18F-FDG PET/computed tomography and PET/MRI are essential for staging, treatment monitoring, and clinical decision-making. PET/MRI provides enhanced soft-tissue contrast and reduced radiation exposure, making it well-suited for long-term surveillance in pediatric patients. Emerging molecular probes demonstrate potential for tumor-specific imaging, although their clinical utility has yet to be explored. This review aims to summarize the applications, limitations, and future directions of PET imaging in the precision diagnosis and management of pediatric osteosarcoma and Ewing sarcoma.

Congenital hyperinsulinism is the most common cause of persistent hypoglycemia in infants and is caused by mutations in genes encoding proteins regulating insulin secretion. Children with persistent hypoglycemia due to hyperinsulinism (HI) that do not respond to therapy with diazoxide may require surgical treatment. Approximately 50% of these children have a focal form of HI that can be cured by surgical resection. Rapid genetic analysis helps predict the likelihood of focal disease and is essential for choosing patients who will benefit from an 18F-l-dihydroxyphenylalanine PET scan for localization of a focal lesion.

This review highlights the growing role of hybrid PET/MR imaging in pediatric imaging, emphasizing its advantages in reducing radiation exposure and consolidating diagnostic procedures. It discusses applications across various pediatric conditions, including histiocytic disorders, tumors, genetic syndromes, and inflammatory diseases. PET/MR imaging enhances lesion detection, treatment monitoring, and prognosis, especially in sensitive populations like children, where minimizing radiation and sedation is critical. The article underscores its expanding utility beyond oncology, demonstrating its value in diagnosing, managing, and surveilling rare and complex pediatric diseases, thereby promising broader adoption in pediatric care.

Pediatric lymphoma (PL) is the third most common malignancy to affect children, seen in up to 15% of children, after leukemia and central nervous system tumors. SEER data from 1975 - 2019 has shown an increase in the incidence of childhood cancer including leukemia and lymphomas. Fortunately, there has been an increase if the 5-year overall survival of PL. 18F-Fluordeoxyglucose PET imaging plays an important role in the diagnosis, staging and response to therapy in pediatric lymphomas. This review will focus on the incorporation of PET/MR into the standard treatment of children with PL.

Neuroblastoma, a major cause of pediatric cancer deaths, often requires precise imaging for accurate diagnosis and treatment. While ¹²³I-metaiodobenzylguanidine scintigraphy is the current standard for targeting the human norepinephrine transporter (hNET), it has limitations such as low resolution, long scans, and higher radiation exposure. The new PET tracer ¹⁸F-meta-fluorobenzylguanidine retains hNET specificity but offers superior image quality, faster acquisition, and lower radiation dose. Clinical studies show improved lesion detection, especially for small or low-uptake metastases, and greater practicality in children. Integration with PET/MR and long axial field-of-view PET/computed tomography further enhances performance and reduces sedation needs.

This review highlights the fundamental differences between pediatric and adult PET/MR imaging, emphasizing patient preparation, age-appropriate techniques, weight-based radiopharmaceutical dosing, and protocol customization. Unique physiologic uptake patterns in children are examined, along with common pitfalls in interpretation. Differences in clinical indications and disease prevalence between pediatric and adult populations further influence PET/MR imaging application. Understanding these distinctions at every step-from preparation to image interpretation-is essential to ensure diagnostic accuracy and to minimize false-positive and false-negative findings specific to pediatric imaging.