{"title":"Gastrointestinal radionuclide imaging in pediatric age group.","authors":"Maria C Garganese, Milena Pizzoferro","doi":"10.23736/S1824-4785.24.03548-9","DOIUrl":"https://doi.org/10.23736/S1824-4785.24.03548-9","url":null,"abstract":"<p><p>Pediatric gastrointestinal imaging plays a crucial role in evaluating and managing digestive system disorders in children. This comprehensive review dives into the nuances of pediatric gastrointestinal imaging techniques, focusing on three specific modalities: gastric emptying scintigraphy (GES), intestinal transit scintigraphy (ITS), and gastrointestinal bleeding scintigraphy. GES involves real-time monitoring of stomach emptying using radiotracers and gamma camera technology. While challenges exist in standardizing protocols due to age-specific meal compositions, GES remains pivotal in diagnosing motility disorders, gastroesophageal reflux, and abdominal pain in children. ITS, utilizing [<sup>67</sup>Ga], provides insights into gastrointestinal motility disorders such as Hirschsprung disease. It aids in whole-gut transit evaluation, guiding surgical interventions and improving long-term clinical outcomes. Gastrointestinal bleeding scintigraphy, employing [<sup>99</sup>mTc], assists in diagnosing conditions like Meckel's diverticulum and occult bleeding, offering continuous monitoring to pinpoint the bleeding site along the entire gastrointestinal tract. SPECT-CT improves the accuracy and the standards of care. Each technique's protocol details, clinical indications, and diagnostic capabilities are thoroughly discussed, highlighting the importance of these non-invasive, functional imaging modalities in pediatric gastroenterology.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":"68 1","pages":"23-31"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pediatric nuclear medicine: continuing the evolution.","authors":"Pinar Ozgen Kiratli, Pietro Zucchetta","doi":"10.23736/S1824-4785.24.03562-3","DOIUrl":"https://doi.org/10.23736/S1824-4785.24.03562-3","url":null,"abstract":"","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":"68 1","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catia Olianti, Sandra Trapani, Aurelio Secinaro, Michala Holm Reichkendler
{"title":"Fever of unknown origin in pediatrics: role of nuclear medicine.","authors":"Catia Olianti, Sandra Trapani, Aurelio Secinaro, Michala Holm Reichkendler","doi":"10.23736/S1824-4785.24.03546-5","DOIUrl":"10.23736/S1824-4785.24.03546-5","url":null,"abstract":"<p><p>Fever of unknown origin (FUO) is a debated issue in numerous scientific studies in adult patients with a not jet-defined workflow in a clinical and diagnostic setting. Few works are published about pediatric patients even if FUO represents a challenging, not infrequent scenario in hospital and outpatient recovery. The fever might be the onset symptom of a transient mild infection or the beginning of a more difficult-to-diagnose and serious pathological condition. In the adult workflow <sup>18</sup>FDG PET-CT is nowadays playing a relevant role, considering the limited spread of conventional <sup>99m</sup>Tc-HMPAO-White Blood Cells scintigraphy. It represents a robust tool for diagnosing the eventual site of infection, but it is limited by procedural complexity and long duration, up to 24 hours. The WBC-scintigraphy is also not suitable for children, only for young adults or adolescents, considering the relevant blood sample entity and the procedural risk for sensitive subjects. The most assessed clinical and diagnostic know-how on Pediatric FUO are summarized and a synthetic flow-chard is presented to support the clinical management and to choose the best diagnostic pathway.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"48-57"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current approach to pediatric differentiated thyroid cancer.","authors":"Pinar Ozgen Kiratli, Bilge Volkan-Salanci","doi":"10.23736/S1824-4785.24.03551-9","DOIUrl":"10.23736/S1824-4785.24.03551-9","url":null,"abstract":"<p><p>Differentiated thyroid cancers (DTC) is a rare cancer in children and adolescents, having features of different clinical presentation, biological behavior, and treatment from adult population. Most of the patient management guidelines are based on literature on adult population and the literature on children and adolescents still limited. There are still unsettled issues regarding both patient management and the therapy. However, the current approach for treatment of DTC includes thyroidectomy, lymph node dissection in patients with nodal metastases and possible use of Iodine-131 radiotherapy. The incidence of DTC is low in pediatric population, and the characteristics of the disease vary among different age groups within this population. Therefore, the literature depends on small cohorts and heterogeneous retrospective studies. This paper aims to review the current literature and give an overview to the approach in the management of DTC in pediatric population. DTC in pediatric population, has an aggressive nature, however the patient's overall survival is excellent. A multidisciplinary approach in the management of pediatric DTC patients would yield fewer side effects and a better life quality.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"32-39"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Fiz, Tommaso Piticchio, Gianluca Bottoni, Stefania Sorrentino, Martina Fragola, Virginia Livellara, Pierpaolo Trimboli, Arnoldo Piccardo
{"title":"Incidence of subclinical and overt hypothyroidism in children treated with [131I]mIBG: a systematic review and meta-analysis.","authors":"Francesco Fiz, Tommaso Piticchio, Gianluca Bottoni, Stefania Sorrentino, Martina Fragola, Virginia Livellara, Pierpaolo Trimboli, Arnoldo Piccardo","doi":"10.23736/S1824-4785.24.03552-0","DOIUrl":"10.23736/S1824-4785.24.03552-0","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment with [<sup>131</sup>I]mIBG is commonly used in pediatric metastatic neuroblastoma (NB); however, unbound [<sup>131</sup>I]I might be taken up by the thyroid, causing hypothyroidism. To prevent this occurrence, thyroid blockade with iodine salts is commonly used; despite this precaution, thyroid dysfunction still occurs. This review and meta-analysis aim to clarify the mean frequency of hypothyroidism in children with NB treated with [<sup>131</sup>I]mIBG and to investigate the possible causes.</p><p><strong>Evidence acquisition: </strong>The literature was searched for English-language scientific manuscripts describing the incidence of TSH elevation and overt hypothyroidism in children with NB treated with [<sup>131</sup>I]mIBG. Preclinical studies, small-case series, and reviews were excluded. A proportion meta-analysis was conducted to test the influence of potentially relevant factors (type and duration of thyroid blockade, year of the study, sample size) on the incidence of TSH elevation/overt hypothyroidism.</p><p><strong>Evidence synthesis: </strong>Eleven studies were included. The pooled percentage of TSH elevation was 0.41 (95% CI: 0.27-0.55); the duration of the thyroid blockade (P=0.004) was inversely correlated with the incidence of TSH elevation. Moreover, a TSH increase was more common in patients treated with potassium iodide (KI) alone than in those managed with a multi-drug thyroid blockade (P<0.001). The pooled percentage of children requiring hormone replacement therapy was 0.33 (95% CI: 0.16-0.49). As in the case of TSH elevation, a longer duration of the thyroid blockade (P=0.006) and a multi-pronged approach (P<0.001) were associated with a lower incidence of overt hypothyroidism.</p><p><strong>Conclusions: </strong>Hypothyroidism appears to occur frequently in children treated with [<sup>131</sup>I]mIBG, which should be monitored closely after the radionuclide treatment to start hormone replacement therapy as soon as needed. The duration, as well as the type of thyroid blockade, seem to influence the incidence of hypothyroidism; however, more data from prospective evaluations are needed.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"40-47"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Update on FDG-PET in pediatric lymphoma.","authors":"Lars Kurch, Regine Kluge","doi":"10.23736/S1824-4785.24.03560-X","DOIUrl":"https://doi.org/10.23736/S1824-4785.24.03560-X","url":null,"abstract":"<p><p>Lymphoma represent the third most common malignant disease in childhood and adolescence. They are divided into pediatric Hodgkin lymphoma (P-HL) and pediatric non-Hodgkin lymphoma (P-NHL). In P-HL, excellent cure rates are achieved through combined modality treatment using chemotherapy and radiotherapy. For more than 20 years, FDG-PET has been an integral part of the treatment and guides its intensity through improved staging and precise assessment of chemotherapy response. In P-NHL, good cure rates are achieved with chemotherapy alone. At present FDG-PET plays only a subordinate role in the treatment setting. Its potential to contribute to treatment management is far from being fully utilised. In this article, the current status of FDG-PET in pediatric lymphoma is presented in detail. The core elements are the sections on staging and response assessment. In addition, challenges and pitfalls are discussed and future developments are outlined.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":"68 1","pages":"58-69"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nuclear medicine and pediatric nephro-urology: a long-lasting successful partnership.","authors":"Ana I Santos, Rita T Ferreira","doi":"10.23736/S1824-4785.24.03557-X","DOIUrl":"10.23736/S1824-4785.24.03557-X","url":null,"abstract":"<p><p>Congenital anomalies of the kidney and urinary tract, as well as urinary infections, are very frequent in children. After the clinical and laboratory evaluation, the first imaging procedure to be done is a renal and bladder ultrasound, but afterwards, a main contribution comes from nuclear medicine. Through minimally invasive and sedation-free procedures, nuclear medicine allows the evaluation of the functional anatomy of the urinary tract, and the quantification of renal function and drainage. If pediatric dosage cards provided by scientific societies are used, radiation exposure can also be low. In the pediatric conditions previously mentioned, nuclear medicine is used both for initial diagnosis and follow-up, mostly in cases of suspicion of ureteropelvic or ureterovesical junction syndromes, as well as vesicoureteral reflux or renal scars of febrile infectious episodes. Pediatric nephro-urology constitutes a significant workload of pediatric nuclear medicine departments. The following paragraphs are a revision of the renal radiopharmaceuticals, as well as the nuclear nephro-urology procedures - dynamic and static renal scintigraphy, and direct and indirect radionuclide cystography. A summary of the techniques, main indications, interpretation criteria and pitfalls will be provided. Some future directions for the field are also pointed out, among which the most relevant is the need for nuclear medicine professionals to use standardized protocols and integrate multidisciplinary teams with other pediatric and adult health professionals that manage these life-long pediatric pathologies, which are recognized as an important cause of adult chronic kidney disease.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"3-22"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Innovations in imaging modalities: a comparative review of MRI, long-axial field-of-view PET, and full-ring CZT-SPECT in detecting bone metastases.","authors":"Roberto Moretti, Guenda Meffe, Salvatore Annunziata, Amedeo Capotosti","doi":"10.23736/S1824-4785.23.03537-9","DOIUrl":"10.23736/S1824-4785.23.03537-9","url":null,"abstract":"<p><p>The accurate diagnosis of bone metastasis, a condition in which cancer cells have spread to the bone, is essential for optimal patient care and outcome. This review provides a detailed overview of the current medical imaging techniques used to detect and diagnose this critical condition focusing on three cardinal imaging modalities: positron emission tomography (PET), single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI). Each of these techniques has unique advantages: PET/CT combines functional imaging with anatomical imaging, allowing precise localization of metabolic abnormalities; the SPECT/CT offers a wider range of radiopharmaceuticals for visualizing specific receptors and metabolic pathways; MRI stands out for its unparalleled ability to produce high-resolution images of bone marrow structures. However, as this paper shows, each modality has its own limitations. The comprehensive analysis does not stop at the technical aspects, but ventures into the wider implications of these techniques in a clinical setting. By understanding the synergies and shortcomings of these modalities, healthcare professionals can make diagnostic and therapeutic decisions. Furthermore, at a time when medical technology is evolving at a breakneck pace, this review casts a speculative eye towards future advances in the field of bone metastasis imaging, bridging the current state with future possibilities. Such insights are essential for both clinicians and researchers navigating the complex landscape of bone metastasis diagnosis.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"259-270"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current update and future applications of bone metastasis imaging: what's next?","authors":"Emmanouil Panagiotidis, Jules Zhang-Yin","doi":"10.23736/S1824-4785.23.03539-2","DOIUrl":"10.23736/S1824-4785.23.03539-2","url":null,"abstract":"","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"247-248"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Poon, Christopher Tang, Sanjay Vijayanathan, Davina Mak
{"title":"The use of MRI for the imaging of metastatic bone lesions.","authors":"Daniel Poon, Christopher Tang, Sanjay Vijayanathan, Davina Mak","doi":"10.23736/S1824-4785.23.03538-0","DOIUrl":"10.23736/S1824-4785.23.03538-0","url":null,"abstract":"<p><p>Skeletal metastatic disease accounts for significant overall morbidity in cancer patients. Accurate and accessible imaging forms an integral part of the investigation for patients with suspected or known skeletal metastatic disease; it is considered indispensable in making appropriate oncological treatment decisions. Magnetic resonance imaging (MRI) is a contemporary imaging modality that provides excellent spatial and contrast resolution for bone and soft tissues. Therefore, it is particularly useful for imaging patients suffering from metastatic skeletal disease. This review provides a fundamental overview of the physics and image generation of MRI. The most commonly used MRI sequences in the investigation of metastatic skeletal disease are also discussed. Additionally, a review of the pathophysiological basis of metastatic bone disease is presented, along with an introduction to the interpretation of MRI sequences obtained for metastatic bone disease. Finally, the strengths and drawbacks of MRI are considered in comparison to alternative imaging modalities for the investigation of this common and important oncological complication.</p>","PeriodicalId":49135,"journal":{"name":"the Quarterly Journal of Nuclear Medicine and Molecular Imaging","volume":"67 4","pages":"271-279"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}