Patient factors affecting 18F FDG uptake in children
Related Experiment Video
Updated: Jul 4, 2025
Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
Pradipta Debnath1, Andrew T Trout2
1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Kasota Building MLC 5031, Cincinnati, OH 45229, United States of America.
Insights
Physiologic uptake of Fluorodeoxyglucose (FDG) in children undergoing PET/CT is associated with age and weight. Increasing injected dose per kilogram may not improve liver signal-to-noise ratio in young children.
Area of Science:
- Nuclear Medicine
- Pediatric Imaging
- Radiopharmaceuticals
Background:
- 18F FDG PET/CT is a crucial diagnostic tool in pediatric oncology.
- Optimizing image quality in children is essential for accurate diagnosis and treatment monitoring.
- Understanding physiologic FDG uptake patterns in pediatric patients is key to image quality improvement.
Purpose of the Study:
- To characterize the physiologic uptake of 18F FDG in children undergoing PET/CT.
- To identify factors influencing FDG uptake and image quality in pediatric patients.
- To inform strategies for optimizing FDG PET/CT image quality in pediatric populations.
Main Methods:
- Retrospective analysis of 193 18F FDG PET/CT scans from 139 pediatric patients.
- Measurement of liver and thigh muscle counts and SUVmean-bw using 3D spherical ROIs.
- Assessment of associations between counts, SUVs, liver SNR, and patient predictors (age, weight, injected activity) via correlation and regression analyses.
Main Results:
- Liver uptake (counts and SUVmean-bw) strongly correlated with patient weight, age, and total injected activity.
- Thigh muscle uptake was associated with injected activity per kilogram.
- Multivariable analysis identified body weight and age as significant independent predictors of liver uptake.
- Liver SNR showed moderate association with predictors, but not significantly with injected activity per kilogram.
Conclusions:
- Liver 18F FDG uptake in children is significantly associated with age and body weight.
- Increasing injected 18F FDG dose per kilogram may not enhance liver image quality (SNR) in young children.
- These findings provide insights for optimizing pediatric FDG PET/CT protocols.
Purpose:
To characterize physiologic uptake of 18F FDG in children undergoing PET/CT as a step to informing efforts to optimize FDG PET image quality in children.
Methods:
This retrospective study included 193 clinically indicated 18F FDG PET/CT examinations from 139 patients. 3D spherical regions of interest (ROIs) in the liver and in the thigh muscle (an area of uniform low-level uptake) were used to measure counts and mean standardized uptake value by body weight (SUVmean-bw). Counts, SUVs, and liver signal to noise ratio (SNR) were assessed for associations with patient-specific predictor variables using Pearson correlation and multivariable linear regression.
Results:
Mean patient age was 11.0 ± 5.4 (SD) years, mean liver SUVmean-bw was 1.77 ± 0.60 and mean liver counts was 5387 ± 1875 Bq/mL. On univariable analysis liver SUVmean-bw and liver counts were strongly correlated with weight (r = 0.87, p < 0.0001), age (r = 0.75, p < 0.0001) and total injected activity (r = 0.85, p < 0.0001). Mean thigh counts were significantly associated only with injected activity/kilogram (r = 0.37, p < 0.0001). On multivariable analysis, body weight and age (which is collinear with body weight) were the only significant independent predictors (p < 0.0001). Liver SNR was moderately associated with all predictors apart from injected activity per kilogram (r = 0.09, p = 0.23).
Conclusion:
Liver counts on 18F FDG PET/CT have a significant positive association with age and body weight. However, liver SNR has no significant association with injected activity per kilogram suggesting that increasing dose per kilogram may not improve image quality in young children.
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