Marty Christopher McGraw MD, Abstract Co-Author: Nothing to Disclose

Cynthia L. Christoph MD, Presenter: Nothing to Disclose

Scarlett Schneider MD, Abstract Co-Author: Nothing to Disclose

Ricardo Restrepo MD, Abstract Co-Author: Nothing to Disclose

Martha Cecilia Ballesteros MD, Abstract Co-Author: Nothing to Disclose

Diana Marin MD, Abstract Co-Author: Nothing to Disclose

To discuss the indications and provide a step-by-step approach to performing pediatric Body PET/CT. Unique pediatric pitfalls and diseases will be demonstrated.

Over 100 studies, most with combined diagnostic quality CT and integrated PET, were performed on a GE Discovery ST 16-slice PET/CT scanner, with intravenous and oral contrast (Volumen), following intravenous injection of 200 uCi F-18 FDG/kilo. 120 kVp and weight adjusted mA are scan parameters which minimize radiation dose without sacrificing diagnostic information. The need for sedation and bladder drainage are tailored individually. Clear instructions to the family are necessary for optimum studies, especially the need to curtail physical activity including video games.

Lymphoma, various sarcomas (mostly rhabdomyosarcoma) and neuroblastoma were common FDG-avid tumors. Others included eosinophilic granuloma (EG), neurofibromatosis, testicular germ cell tumor, desmoid tumor, leukemia as secondary primary complicating osteosarcoma and Wilm’s tumor. One case of biopsed proven small round blue cell tumor involving the chest wall with metastases to muscle and pancreas. Results for other entities varied. One patient referred from an adult facility for evaluation of an anterior mediastinal mass showed a normal thymus, one patient suspected of lymphoma involving bowel and nodes had tuberculosis, and one patient quiescent Crohn's disease. Normal thymic, physeal plate, testicular, and bone marrow activity should not be confused for disease.

For FDG-avid tumors, PET is a valuable modality for assessment of the extent of disease. Results can lead to upstaging of tumor grade, localize biopsy sites, and be used to assess response to therapy; thereby limiting overtreatment and long term drug or radiotherapy toxicity.

Pediatric PET/CT is changing staging, therapy arm & duration in many childhood tumors, especially lymphoma, EG & sarcomas. Learn low-dose protocols & new indications & pitfalls.

McGraw, M, Christoph, C, Schneider, S, Restrepo, R, Ballesteros, M, Marin, D, Pediatric Body PET/CT: Indications, Technique, and Unique Pitfalls.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016732.html