E1894. In the Era of Image Gently, How Careful Use of PET/CT Imaging Can Help Radiologists with Challenging Pediatric Conditions
  1. Parker Lovelace; Brooke Army Medical Center
  2. Justin Peacock; Brooke Army Medical Center; Uniformed Services University of the Health Sciences
PET/CT hybrid imaging has significantly enhanced cancer diagnosis and management in a wide-variety of patient populations, including adult and pediatric patients. Additionally, PET/CT imaging can help in the diagnosis and management of infectious and inflammatory conditions in adult and pediatric patients. Despite the utility of PET/CT in a variety of different pediatric conditions, PET/CT may not be selected due to concerns about radiation. In particular, practitioners are rightly concerned about the stochastic effects of radiation over the longer lifetime of a child. Using Image Gently® principles, including careful tailoring of the PET/CT study to the right patient, selecting appropriate imaging protocols, and reducing CT and radiotracer doses, PET/CT can safely provide important diagnostic and management information to referring clinicians and help solve challenging problems. In this presentation, we will demonstrate the value of PET/CT hybrid imaging in the diagnosis and management of both oncologic and non-oncologic pediatric conditions. We will also discuss ways to Image Gently® with PET/CT that will help radiologists comfortably refer pediatric patients for PET/CT imaging.

Educational Goals / Teaching Points
In this presentation, we will discuss indications for PET/CT imaging in pediatric patients. We will present case examples of PET/CT imaging in pediatric oncologic conditions, including new radiotracers for neuroendocrine tumors. Case examples of PET/CT imaging in pediatric infectious/inflammatory conditions will also be presented. Lastly, we will discuss mechanisms for reducing pediatric patient dose during PET/CT imaging.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Hybrid PET/CT imaging is particularly useful in pediatric malignancies that tend to have distant metastases, helping clinicians stage and appropriately manage disease. PET/CT imaging can help to diagnose, localize, and manage systemic pediatric infectious or inflammatory diseases, including monitoring treatment response. New PET radiotracers for pediatric neuroendocrine tumors, including neuroblastomas, pheochromocytomas, and paragangliomas, help diagnose the malignancy and also direct their treatment using new, targeted, molecular therapies. Advances in PET/CT imaging have led to decreased patient doses, including decreased CT and PET radiotracer doses. Applying these advances in radiologic practice can help to safely reduce pediatric patient doses for your patients.

Hybrid PET/CT imaging is a powerful diagnostic tool for oncologic and systemic infectious/inflammatory conditions. Using ImageGently® principles, PET/CT can be effectively and safely applied to pediatric patients, significantly improving a practice’s diagnostic capabilities.