The Role of PET in Supratentorial and Infratentorial Pediatric Brain Tumors.

Angelina Cistaro,Domenico Albano,Riccardo Laudicella,Arnoldo Piccardo,Cinzia Romagnolo,Federica Stracuzzi,Natale Quartuccio,Giuseppe Formica,Daniele Antonio Pizzuto,Viviana Frantellizzi,Pierpaolo Alongi

doi:10.3390/curroncol28040226

Abstract

Objective: This review aims to provide a summary of the clinical indications and limitations of PET imaging with different radiotracers, including 18F-fluorodeoxyglucose (18F-FDG) and other radiopharmaceuticals, in pediatric neuro-oncology, discussing both supratentorial and infratentorial tumors, based on recent literature (from 2010 to present). Methods: A literature search of the PubMed/MEDLINE database was carried out searching for articles on the use of PET in pediatric brain tumors. The search was updated until December 2020 and limited to original studies published in English after 1 January 2010. Results: 18F-FDG PET continues to be successfully employed in different settings in pediatric neuro-oncology, including diagnosis, grading and delineation of the target for stereotactic biopsy, estimation of prognosis, evaluation of recurrence, treatment planning and assessment of treatment response. Nevertheless, non-18F-FDG tracers, especially amino acid analogues seem to show a better performance in each clinical setting. Conclusions: PET imaging adds important information in the diagnostic work-up of pediatric brain tumors. International or national multicentric studies are encouraged in order to collect larger amount of data.

Highlights

This review aims to provide a summary of the clinical indications and limitations of positron-emitting tomography (PET) imaging with different radiotracers (18F-FDG and other radiopharmaceuticals) in pediatric neuro-oncology, discussing both supratentorial and infratentorial tumors, based on recent literature
Few authors illustrated the usefulness of 18F-FDG-PET imaging in supratentorial tumors in the differential diagnosis of brain tumors in pediatric patients
Literature published in the last 10 years focusing on PET imaging in pediatric brain tumors appears fragmentary. 18F-FDG PET imaging appears useful in several clinical settings in pediatric neuro-oncology, and especially for grading, predicting malignant transformation and detecting the most representative bioptic site of tumor aggressiveness

Summary

Introduction

Primary CNS tumors are divided according to their tissue of origin into glial and non-glial tumors. Gliomas constitute the most frequent group of brain tumors in the pediatric population, with pilocytic astrocytoma and brain glioma representing the most common type, with an incidence of approximately 17% and 10%, respectively [1,2]. Another important distinction for pediatric brain tumors, which influences the surgical approach, is based on the location with respect to the tentorium (supra- and infratentorial) [3].

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Conclusion