Abstract
Effective treatments of pediatric lymphoma are currently available and innovative regimens are constantly on the horizon. However, the efficacy of treatment relies on accurate staging, early evaluation of the disease, post-therapy monitoring, and continued disease surveillance. In children, this sequence begins with a detailed and sensitive diagnostic exam accompanied by specific studies in order to avoid the many complications that are exacerbated by overtreatment. As in adults, a whole-body 18F-FDG–PET/CT exam extending from the orbitomeatal line to the proximal femur is recommended in children.
To accurately stage childhood lymphoma, 18F-FDG–PET is essential because it is a functional exam whereas purely morphological data lack sensitivity. Moreover, the spatial resolution of 18F-FDG–PET is superior to that of other nuclear imaging techniques such as gallium scintigraphy or bone scan, given the high intrinsic capability of tumor cells to take up FDG. During therapy, typically after two or three cycles of chemotherapy, repeat 18F-FDG–PET/CT can be used as an interim measure of treatment efficacy. FDG–PET/CT findings correlate with progression-free survival and are of higher specificity than conventional imaging. At the end of chemotherapy, FDG–PET/CT is more accurate than conventional imaging in excluding disease. During surveillance, i.e., in the absence of any suspected relapse, the use of FDG–PET/CT to detect recurrence has been suggested but the number of false-positives remains discouraging.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bar-Sever Z, Keidar Z, Ben-Barak A, Bar-Shalom R, Postovsky S, Guralnik L, Ben Arush MW, Israel O (2007) The incremental value of 18F-FDG PET/CT in paediatric malignancies. Eur J Nucl Med Mol Imaging 34:630–637
Furth C, Denecke T, Steffen I, Ruf J, Voelker T, Misch D, Vondran F, Plotkin M, Stöver B, Henze G, Lemke AJ, Amthauer H (2006) Correlative imaging strategies implementing CT, MRI, and PET for staging of childhood Hodgkin disease. J Pediatr Hematol Oncol 28:501–512
Shulkin BL, Goodin GS, McCarville MB, Kaste SC, Krasin MJ, Hudson MM, Metzger M (2009) Bone and [18F]fluorodeoxyglucose positron-emission tomography/computed tomography scanning for the assessment of osseous involvement in Hodgkin lymphoma in children and young adults. Leuk Lymphoma 50:1794–1802
Mody RJ, Bui C, Hutchinson RJ, Frey KA, Shulkin BL (2007) Comparison of (18)F Flurodeoxyglucose PET with Ga-67 scintigraphy and conventional imaging modalities in pediatric lymphoma. Leuk Lymphoma 48:699–707
Hines-Thomas M, Kaste SC, Hudson MM, Howard SC, Liu WA, Wu J, Kun LE, Shulkin BL, Krasin MJ, Metzger ML (2008) Comparison of gallium and PET scans at diagnosis and follow-up of pediatric patients with Hodgkin lymphoma. Pediatr Blood Cancer 51:198–203
Sammer MB, Shulkin BL, Alessio A, Parisi MT (2011) Role of limited whole-body PET/CT in pediatric lymphoma. AJR Am J Roentgenol 196(5):1047–1055
Cheng G, Chen W, Chamroonrat W, Torigian DA, Zhuang H, Alavi A (2011) Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients. Eur J Nucl Med Mol Imaging 38:1469–1476
Lopci E, Burnelli R, Guerra L, Cistaro A, Piccardo A, Zucchetta P, Derenzini E, Todesco A, Garaventa A, Schumacher F, Farruggia P, Buffardi S, Sala A, Casale F, Indolfi P, Biondi S, Pession A, Fanti S (2011) Post chemotherapy PET evaluation correlates with patient outcome in paediatric Hodgkin’s disease. Eur J Nucl Med Mol Imaging 38:1620–1627
Furth C, Steffen IG, Amthauer H, Ruf J, Misch D, Schönberger S, Kobe C, Denecke T, Stöver B, Hautzel H, Henze G, Hundsdoerfer P (2009) Early and late therapy response assessment with [18F]fluorodeoxyglucose positron emission tomography in pediatric Hodgkin’s lymphoma: analysis of a prospective multicenter trial. J Clin Oncol 27:4385–4391
Robertson VL, Anderson CS, Keller FG, Halkar R, Goodman M, Marcus RB, Esiashvili N (2011) Role of FDG-PET in the definition of involved-field radiation therapy and management for pediatric Hodgkin’s lymphoma. Int J Radiat Oncol Biol Phys 80:324–332
Metwally H, Courbon F, David I, Filleron T, Blouet A, Rives M, Izar F, Zerdoud S, Plat G, Vial J, Robert A, Laprie A (2011) Coregistration of prechemotherapy PET-CT for planning pediatric Hodgkin’s disease radiotherapy significantly diminishes interobserver variability of clinical target volume definition. Int J Radiat Oncol Biol Phys 80:793–799
Pommier P, Dussart S, Girinsky T, Chabaud S, Lagrange JL, Nguyen TD, Beckendorff V, D’Hombres A, Artignan X, Bondiau PY, Carrie C, Giammarile F (2011) Impact of 18F-fluoro-2-deoxyglucose positron emission tomography on treatment strategy and radiotherapy planning for stage I-II Hodgkin disease: a prospective multicenter study. Int J Radiat Oncol Biol Phys 79(3):823–828
Rhodes MM, Delbeke D, Whitlock JA, Martin W, Kuttesch JF, Frangoul HA, Shankar S (2006) Utility of FDG-PET/CT in follow-up of children treated for Hodgkin and non-Hodgkin lymphoma. J Pediatr Hematol Oncol 28:300–306
Edeline V, Bonardel G, Brisse H, Foehrenbach H, Pacquement H, Maszelin P, Gaillard JF, Michon J, Neuenschwander S (2007) Prospective study of 18F-FDG PET in pediatric mediastinal lymphoma: a single center experience. Leuk Lymphoma 48:823–826
Riad R, Omar W, Sidhom I, Zamzam M, Zaky I, Hafez M, Abdel-Dayem HM (2010) False-positive F-18 FDG uptake in PET/CT studies in pediatric patients with abdominal Burkitt’s lymphoma. Nucl Med Commun 31:232–238
Pagano M, Berta M, Postini AM et al (2011) Nonossifying fibroma: a possible pitfall in F18-FDG PET/CT imaging of Hodgkin’s disease. Radiol Case Rep 6(2):1–4
Goodin GS, Shulkin BL, Kaufman RA, Mc Carville MB (2006) PET/CT characterization of fibroosseous defects in children: 18F-FDG uptake can mimic metastatic disease. AJR Am J Roentgenol 187:1124–1128
Khademi S, Westphalen AC, Webb EM et al (2009) Frequency and etiology of solitary hot spots in the pelvis at whole-body positron emission tomography/computed tomography imaging. Clin Imaging 33(1):44–48
Zhu ZH, Cheng WY, Cheng X, Dang YH (2007) Characteristics of physiological uptake of uterus and ovaries on 18F-fluorodeoxyglucose positron emission tomography. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 29(1):124–129
Andrade JG, Guaragna MS, Soardi FC et al (2008) Clinical and genetic findings of five patients with WT1-related disorders. Arq Bras Endocrinol Metabol 52(8):1236–1243
Vrachliotis TG, Vaswani KK, Davies EA et al (2000) CT findings in posttransplantation lymphoproliferative disorder of renal transplants. AJR Am J Roentgenol 175(1):183–188
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Italia
About this chapter
Cite this chapter
Skanjeti, A., Guerra, L., Cistaro, A. (2014). 18F-FDG–PET/CT in Pediatric Lymphoma. In: Cistaro, A. (eds) Atlas of PET/CT in Pediatric Patients. Springer, Milano. https://doi.org/10.1007/978-88-470-5358-8_6
Download citation
DOI: https://doi.org/10.1007/978-88-470-5358-8_6
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-5357-1
Online ISBN: 978-88-470-5358-8
eBook Packages: MedicineMedicine (R0)