Transcript Presentazione di PowerPoint

PET/CT AND PAEDIATRIC ONCOLOGY: A SINGLE CENTRE EXPERIENCE
A.
1
Cistaro ,
L.
2
Gastaldo ,
A. Brach del
3
Prever ,
V.
1
Arena ,
E.
1
Pelosi ,
M.
1
Mancini
1. Positron Emission Tomography IRMET S.p.A., Turin, Italy
2. Department of Paediatric Sciences, Regina Margherita Infant Hospital, Turin, Italy
3. Onco-Hematology Department, Regina Margherita Infant Hospital, Turin, Italy
AIM
To assess the role of FDG-PET/CT in paediatric patients.
MATERIAL AND METHODS
75 patients (age 2-20 years) have been analysed: 12 for metabolic characterisation of
lesions of unknown origin suspected for malignant disease, 11 for staging and 52 for restaging. Whole body PET/CT images were obtained 60 min after the administration of
18F-FDG (3.7 MBq/kg) with Discovery ST (GE Medical Systems). CT was performed
with adequate acquisition parameters for paediatrics.
RESULTS
no patient needed sedation during the procedure.
In patients analysed for suspected malignant tumour, PET-CT resulted positive in 7
pts (final diagnosis: 2 Autoimmune Lymphoproliferative Syndromes (ALPS) caused by
Fas mutation, 2 HL, 2 NHL, 1 ALL), and negative in 5 pts (2 lung aspergillosis, 1
spondilodiscitis, 1 eosinophilic granuloma, 1 lymphadenitis). In positive cases, PET-CT
resulted able to indicate the most active and accessible site guiding biopsy.
In patient analysed for tumour staging (7 HL and 4 NHL), in 4 cases PET/CT
confirmed previous clinical-radiological staging. In 7 cases improved previous staging
modifying clinical and therapeutical approach, finding occult tumour sites. SUV
measured on first PET/CT exam is important to evaluate chemotherapy effectiveness
and for patient’s follow-up.
We also analysed 52 patients for re-staging (13 Ewing’s sarcoma,12 osteosarcoma
analysed for suspected lung recurrence, 6 rhabdomyosarcoma, 5 NHL, 5 HL, 2
neuroblastoma, 1 Wilm’s tumour, 1 sarcoma of kidney, 3 pNET, 1 adrenal gland
carcinoma, 1 undifferentiated hepatic sarcoma, 1 synovial sarcoma, 1epithelioid
sarcoma). In 35/52 patients PET/CT correctly confirmed malignancy recurrence, 2
patients resulted false positives (lung flogosis in 2 osteosarcoma patients), 1 false
negative (small lung lesion in Ewing’s Sarcoma patient) and 14 true negatives.
CONCLUSIONS
in paediatric patients 18F-FDG-PET/CT seems to be useful in metabolic
characterisation of suspected tumour and it finds the more accessible active sites for
biopsy.
In our experience, in patients affected by lymphomas, PET/CT was able to improve
staging in 7/11 cases.
It seems also useful in re-staging.
Nevertheless, because of the high variety of tumour types and the low number of
patients analysed, it is necessary to perform further investigations to support these
results.
Re-staging in epatoblastoma.
Hepatic and peritoneal recurrence.
For contact: [email protected]
PET-CT resulted able to indicate the
most active and accessible site guiding
biopsy.
Finally diagnosis LNH.
Metabolic characterisation of bone e
tissue lesions in patient treated for
LLA.
Finally diagnosis Ewing’s sarcoma
Metabolic characterisation of bone lesion.
Finally diagnosis eosinophilic granuloma. PET/CT exam
allowed to avoid biopsy.