Utilizing [¹⁸F]-FDG PET/CT Imaging for Enhanced Staging and Treatment Decisions in Pediatric Rhabdomyosarcoma

Area of Science:

• Oncology
• Nuclear Medicine
• Pediatric Imaging

Background:

• Accurate staging is crucial for pediatric rhabdomyosarcoma (RMS) treatment optimization.
• ¹⁸F-FDG PET/CT is increasingly used, but its clinical impact and prognostic value versus conventional imaging (CI) need further study.

Purpose of the Study:

• To evaluate the impact of ¹⁸F-FDG PET/CT on clinical management and its prognostic value in pediatric RMS.
• To compare the diagnostic performance of ¹⁸F-FDG PET/CT with conventional imaging (CT/MRI).

Main Methods:

• Retrospective single-center study of 56 pediatric RMS patients who underwent ¹⁸F-FDG PET/CT.
• Comparison of PET/CT findings with CI (CT/MRI).
• Correlation of imaging findings with clinical management and survival outcomes.

Main Results:

• PET/CT showed high concordance with CI for nodal staging (sensitivity 89.5%, specificity 94.6%).
• PET/CT identified skeletal metastases in 8.9% of patients and altered management in 16.1%, mainly affecting radiotherapy planning.
• Exploratory analysis indicated no statistically significant difference in event-free survival (EFS) or overall survival (OS) based on SUVmax levels.

Conclusions:

• ¹⁸F-FDG PET/CT is a valuable tool for pediatric RMS staging, especially for nodal and skeletal evaluation.
• The imaging modality demonstrated clinical utility by refining radiotherapy plans in a significant proportion of patients.
• SUVmax is not currently a validated prognostic biomarker in pediatric RMS; further multicenter studies are required.