Abstract
(1) Background: Standard magnetic resonance imaging (MRI) remains the gold standard for brain tumour imaging in paediatric and teenage and young adult (TYA) patients. Combining positron emission tomography (PET) with MRI offers an opportunity to improve diagnostic accuracy. (2) Method: Our single-centre experience of 18F-fluorocholine (FCho) and 18fluoro-L-phenylalanine (FDOPA) PET–MRI in paediatric/TYA neuro-oncology patients is presented. (3) Results: Hybrid PET–MRI shows promise in the evaluation of gliomas and germ cell tumours in (i) assessing early treatment response and (ii) discriminating tumour from treatment-related changes. (4) Conclusions: Combined PET–MRI shows promise for improved diagnostic and therapeutic assessment in paediatric and TYA brain tumours.
Highlights
Tumours of the Central Nervous System (CNS) are the most common form of solid tumour in children and teenage/young adult (TYA) populations, accounting for more than 25% of all types of cancers and 15% of malignancies in the teenage and young adult population (15–24 years)
We present (i) an overview of the current imaging techniques used in clinical practice, (ii) a series of clinical cases at our institution, highlighting the challenges and opportunities of hybrid positron emission tomography (PET)–magnetic resonance imaging (MRI), and (iii) we present recommendations for clinical use on paediatric and TYA neuro-oncology and some limitations
dynamic susceptibility-weighted contrast-enhanced MRI (DSC) perfusion is most commonly used in clinical practice [59] and numerous studies have demonstrated that rCBV is an early response marker in treated GBMs, pCASL is the favoured perfusion-weighted imaging (PWI) technique in paediatric neuro-oncology due to the lack of need for
Summary
Tumours of the Central Nervous System (CNS) are the most common form of solid tumour in children and teenage/young adult (TYA) populations, accounting for more than 25% of all types of cancers and 15% of malignancies in the teenage and young adult population (15–24 years). Each modality is reported as demonstrating increased diagnostic accuracy over standard MRI in neuro-oncology and combining PET with advanced MRI has the potential to further improve diagnostic accuracy and patient outcomes. There have been a number of reports exploring the potential of hybrid PET–MRI in neuro-oncology [13,14,15], but this has been limited to adult patients. We present (i) an overview of the current imaging techniques used in clinical practice, (ii) a series of clinical cases at our institution, highlighting the challenges and opportunities of hybrid PET–MRI, and (iii) we present recommendations for clinical use on paediatric and TYA neuro-oncology and some limitations
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