Doctors monitor the radiation dose given to children in imaging exams, generally using lower doses than that of adult patients, to get adequate exam results, said Wahl. "Especially as a follow-up examination, PET/CT appears to be the best imaging modality currently, as it provides both PET and CT information simultaneously in pediatric patients, in whom fewer examinations are preferable," he added. Wahl indicated that additional studies with specific childhood cancers are warranted.

PET is a powerful molecular imaging procedure that noninvasively demonstrates the function of organs and other tissues. When PET is used to image cancer, a radiopharmaceutical (such as FDG, which includes both a sugar and a radionuclide) is injected into a patient. Cancer cells metabolize sugar at higher rates than normal cells, and the radiopharmaceutical is drawn in higher amounts to cancerous areas. PET scans show where FDG is by tracking the gamma rays given off by the radionuclide tagging the drug and producing three-dimensional images of their distribution within the body. PET/CT offers precise fusion of metabolic PET images with high-quality anatomical CT images.


Besides Wahl, co-authors of "18F-FDG PET/CT in Evaluating Non-CNS Pediatric Malignancies" include Mitsuaki Tatsumi, nuclear medicine division, radiology department, and John H. Miller, pediatric radiology, radiology department, all from the Johns Hopkins Medical Institutions, Baltimore, Md.

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Co-authors of a related article note that the Johns Hopkins researchers "convincingly" show that PET/CT "may improve the evaluation and surveillance of pediatric malignancies." Written by Noah Federman and Stephen A. Feig, the invited perspective notes, "In Hodgkin's disease and pediatric sarcomas, PET/CT appears to be an important tool in the management of these diseases. However, the use of PET/CT in other pediatric malignancies has yet to be rigorously studied."

"PET/CT in Evaluating Pediatric Malignancies: A Clinician's Perspective" was co-written by Federman and Feig, both with Mattel Children's Hospital, David Geffen School of Medicine, University of California in Los Angeles.

Also in the Journal of Nuclear Medicine, German researchers determined that PET/CT was "significantly more accurate than PET alone for the detection and localization of lesions and improves staging of patients with Ewing tumor." The co-authors note, "There are inherent advantages of PET/CT over PET in lesion detection, determination of malignancy and, therefore, overall staging for patients with Ewing tumor." Ewing's tumor is a malignant bone tumor occurring in children and young adults.

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