Abstract
In the last decade, several radiopharmaceuticals have been developed and investigated for imaging in vivo of pediatric brain tumors with the aim of exploring peculiar metabolic processes as glucose consumption, amino-acid metabolism, and protein synthesis with nuclear medicine techniques. Although the clinical shreds of evidence are limited, preliminary results are encouraging. In this review, we performed web-based and desktop research summarizing the most relevant findings of the literature published to date on this topic. Particular attention was given to the wide spectrum of nuclear medicine advances and trends in pediatric neurooncology and neurosurgery. Furthermore, the role of somatostatin receptor imaging through single-photon emission computed tomography (SPECT) and positron emission tomography (PET) probes, with reference to their potential therapeutic implications, was examined in the peculiar context. Preliminary results show that functional imaging in pediatric brain tumors might lead to significant improvements in terms of diagnostic accuracy and it could be of help in the management of the disease.
Highlights
Pediatric brain tumors (PBT) include different tumor entities of varying malignancy
The aim of this review is to provide a comprehensive overview of the usefulness and limitations of nuclear medicine in the evaluation of PBT
Figure depicts a application of somatostatin receptor imaging (SRI) with [ In] pentetreotide or [ Ga] DOTA-peptides rare case of pineoblastoma
Summary
Pediatric brain tumors (PBT) include different tumor entities of varying malignancy. The incidence rate of childhood and adolescent primary malignant and nonmalignant brain and other central nervous system tumors in the United States is approximately 5.67 per 100,000 person-years [1]. Cancers 2019, 11, 1853 show several non-specific findings, such as hyperintensity on T2-weighted images and fluid-attenuated inversion recovery (FLAIR), which might limit the diagnostic accuracy [6,7] These limitations are relevant especially when surgery is associated with adjuvant therapy. In the management of the care of the patients, MI plays a relevant role in determining the extent or severity of the disease (by a correct staging with accurate detection of distant metastases) and the selection of the most appropriate therapy for the molecular properties of the disease. PET-MRI with 18 F-choline was able to correctly characterize intracranial non-germinomatous germ cell tumors and monitor the response to chemotherapy. Somatostatin receptor imaging with 111 In-pentetreotide was able to detect residual disease or relapse in selected pediatric brain tumors.
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