Empfehlungen zur Durchführung der Ganz körper-¹⁸F-FDG-PET und -PET/CT bei Kindern mit onkologischen Erkrankungen

 

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Summary

The purpose of these guidelines is to offer the nuclear medicine and the appropriate interdisciplinary team a framework for performing and reporting positron emission tomography (PET) and the combination with computed tomography (PET/CT) in children with malignant diseases mainly using the radiopharmaceutical ¹⁸F-fluorodeoxy-glucose (FDG). These guidelines are based on the recent guidelines of the Paediatric Committee of the European Association of Nuclear Medicine (EANM) (57) and have been translated and adapted to the current conditions in Germany. The adaptation of CT-parameters using PET/CT in children is covered in a more detailed way than in the EANM guideline taking into account that in Germany already a good portion of PET examinations is performed using an integrated PET/CT-scanner. Furthermore, a CT-scan without adaption of the CT acquisition parameters would result in a not tolerably high radiation exposition of the child. There are excellent guidelines for FDG PET and PET/CT in oncology published by the German Society of Nuclear Medicine (Deutsche Gesellschaft für Nuklearmedizin, DGN) (42) and EANM (4). These guidelines aim at providing additional information on issues particularly relevant to PET and PET/CT imaging in children. These guidelines should be taken in the context of local and national current standards of quality and rules.

Zusammenfassung

Das Ziel dieser Leitlinie ist es, dem nuklearmedizinischen und ggf. interdisziplinären Team Hilfestellungen für die Indikationsstellung, Durchführung, Interpretation und Dokumentation der Positronenemissionstomographie (PET) und der Kombination mit der Computertomographie (PET/CT) bei Kindern mit malignen Erkrankungen zu geben. Im Wesentlichen wird auf die Anwendung von ¹⁸F-Fluordesoxyglukose eingegangen. Diesen Empfehlungen liegt die aktuelle Leitlinie des Paediatric Committee der EANM zugrunde (57), die ins Deutsche übertragen und an die aktuellen Gegebenheiten in Deutschland angepasst wurde. Das Thema Anpassung der CT-Parameter bei der PET/CT im Kindesalter wird ausführlicher behandelt als in der EANM-Leitlinie. Dies berücksichtigt, dass in Deutschland ein Großteil der PET-Untersuchungen an PET/CTGeräten durchgeführt wird, und ein unkritisches Übernehmen der Erwachsenenprotokolle für die CT-Komponente zu einer nicht zu tolerierenden Strahlenexposition der Kinder führt. Diese Empfehlungen verstehen sich als Ergänzung der Leitlinien für die FDG-PET und PET/CT in der Onkologie, wie sie von der Deutschen Gesellschaft für Nuklearmedizin (DGN) (42) und der European Association of Nuclear Medicine (EANM) (4) publiziert wurden. Die Ergänzungen betreffen ausschließlich die speziellen Anforderungen bei der Untersuchung von Kindern. Diese Empfehlungen müssen immer im Zusammenhang mit lokalen und aktuellen nationalen Qualitätsstandards und Vorschriften gesehen werden.

^* Stauss J, Franzius C, Pfluger T, Juergens KU, Biassoni L, Begent J, Kluge R, Amthauer H, Voelker T, Højgaard L, Barrington S, Hain S, Lynch T, Hahn K. Guideline for F-18-FDG PET and PET-CT imaging in paediatric oncology. Eur J Nucl Med Mol Imaging 2008; 35: 1581–1588.

^** Weiterführende Literatur (1, 2, 5, 10–12, 14, 17–20, 23–26, 28, 29, 31, 33–38, 40, 43, 47–51, 53, 54, 56, 58).

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