18F-FDG PET standard uptake values of the normal pons in children: establishing a reference value for diffuse intrinsic pontine glioma.

M.H.A. Jansen, R.W. Kloet, D.G. van Vuurden, S.E.M. Veldhuijzen van Zanten, B.I. Witte, S. Goldman, W.P. Vandertop, E.F.I. Comans, O.S. Hoekstra, R. Boellaard, G.J.L. Kaspers

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Background: Positron emission tomography (PET) scanning with [F-18]fluorodeoxyglucose (F-18-FDG) is a useful diagnostic and prediction tool in brain tumors, but its value in childhood diffuse intrinsic pontine glioma (DIPG) is still unclear. For interpretation of F-18-FDG PET results in DIPG, uptake values of the normal pons of children of increasing ages are mandatory. The aim of this study was to determine F-18-FDG standard uptake value ratios (SUVr) of the normal pons and to compare these to those of DIPG. Methods: We studied 36 subjects with a normal, non-affected pons (aged 5 to 23 years) and 6 patients with DIPG (aged 4 to 17 years) who underwent F-18-FDG PET scanning. Magnetic resonance imaging (MRI) was co-registered to define the regions of interest. SUVr and SUVrmax for the pons/cerebellum (SUVr(p/c)) and the pons/occipital lobe (SUVr(p/o)) were calculated. Independent-samples t tests and Mann-Whitney U tests were used to compare the mean SUVr and Pearson's test for correlations. Results: For the normal pons, mean SUVr(p/c) and SUVr(p/o) were 0.65 (+/- 0.054) and 0.51 (+/- 0.056), respectively. No significant correlations were found between the SUVr of the normal pons and sex, age, nor pontine volume. A modest but statistically significant correlation was found between SUVr and post-injection time acquisition timing. For DIPG, mean SUVr(p/c) and SUVr(p/o) were 0.74 (+/- 0.20) and 0.65 (+/- 0.30), respectively, while mean SUVr(p(max)/c) and SUVr(p(max)/o) were 1.95 (+/- 0.48) and 1.81 (+/- 0.20), respectively. Conclusion: The SUVr of the unaffected pons are strikingly constant between children, irrespective of sex and age, and can therefore be well used as a reference value for F-18-FDG PET studies in DIPG
Original languageEnglish
Article number8
Pages (from-to)8
JournalEJNMMI Research
Issue number1
Publication statusPublished - 2014

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