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PET/MR in the Assessment of Pediatric Histiocytoses: A Comparison to PET/CT

Andrew C Sher1, Robert Orth, Kenneth McClain

  • 1From the *Department of Pediatric Radiology, Texas Children's Hospital, Houston; and †Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX.

Clinical Nuclear Medicine
|June 13, 2017
PubMed
Abstract

Insights

Positron emission tomography/magnetic resonance imaging (PET/MR) is a feasible imaging technique for pediatric histiocytosis, offering comparable image quality and lesion detection to PET/CT with reduced radiation exposure.

Area of Science:

  • Nuclear Medicine
  • Pediatric Radiology
  • Oncology Imaging

Background:

  • Histiocytic disorders in children require accurate diagnostic imaging.
  • Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) is commonly used but involves ionizing radiation.
  • Novel imaging techniques are being explored to improve diagnostic performance and reduce radiation burden.

Purpose of the Study:

  • To evaluate the feasibility and diagnostic performance of F-FDG PET/MR compared to F-FDG PET/CT in pediatric histiocytosis.
  • To assess image quality, lesion detection, and FDG quantification between the two modalities.

Main Methods:

  • Prospective recruitment of pediatric patients diagnosed with Langerhans cell histiocytosis or Rosai-Dorfman disease.
  • Performance of both F-FDG PET/CT and F-FDG PET/MR using a single-injection dual-imaging protocol in 9 pediatric patients.
  • Comparative analysis of image quality, lesion detection, and standardized uptake value (SUV) quantification between PET/MR and PET/CT.

Main Results:

  • All F-FDG PET/MR examinations demonstrated good or excellent image quality and were clinically acceptable.
  • Complete concordance in identifying active disease was observed between PET/MR and PET/CT on a per-patient basis.
  • PET/MR correctly identified 96% of lesions detected by PET/CT, with strongly correlated SUV quantification (Spearman's rho = 0.73, P < 0.001).

Conclusions:

  • F-FDG PET/MR is clinically feasible for imaging pediatric histiocytic disorders.
  • PET/MR offers comparable image quality and lesion detection to PET/CT.
  • PET/MR is a promising alternative to PET/CT in pediatric patients due to significant radiation dose savings.

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