In vivo metabolism of childhood posterior fossa tumors and primitive neuroectodermal tumors before and after treatment

V. A. Holthoff, K. Herholz, F. Berthold, B. Widemann, R. Schröder, I. Neubauer, W. D. Heiss

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Despite an increasing interest in the clinical application of positron emission tomography (PET) in tumors of the adult patient as a diagnostic and prognostic tool, only a few studies have been concerned with the usefulness of PET with [18F]2‐deoxy‐2‐fluoro‐D‐glucose (FDG) in childhood tumors. Methods. Fifteen children and young adults (0.5–26.0 years of age) with histologically confirmed brain tumors were studied with PET and FDG. Seven children with medulloblastoma (n = 5) or primitive neuroectodermal tumor (PNET) (n = 2) underwent repeated PET studies during their therapy. The other eight children with medulloblastoma (n = 5) or astrocytoma (n = 3) were studied only once before initiation of treatment. A close clinical follow‐up was performed in every case. Results. Comparison of local glucose metabolic rates obtained in the various tumor lesions revealed that the mean rates found in medulloblastomas (mean glucose metabolic rate, 42.8 ± 14.03 μmol/100g/min) were twice as high as the rates measured in either PNET (17.3 ± 4.5 μmol/100g/min) or infratentorial gliomas (21.8 ± 4.2 μmol/100g/min). The high metabolism of medulloblastomas enabled the observer to identify the tumor more easily and to clearly separate it from the surrounding unaffected brain tissue. In the seven patients with follow‐up PET studies during therapy, decreasing or increasing ratios of tumor‐to‐white matter metabolic rate were not only commensurate with neuroradiologically defined tumor reduction or growth, but also corresponded to the duration of initial clinical improvement. Conclusions. These preliminary results suggest that PET with FDG may be a useful tool to evaluate metabolic activity of pediatric brain tumors over time and to assess response to treatment.

Original languageEnglish (US)
Pages (from-to)1394-1403
Number of pages10
JournalCancer
Volume72
Issue number4
DOIs
StatePublished - Aug 15 1993

Keywords

  • children
  • emission computed tomography
  • glucose metabolism
  • primary brain tumors
  • tumor response

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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