Potential of non-FDG PET radiotracers for paediatric patients with solid tumours

Molecular imaging with positron emission tomography (PET) offers significant potential for improving diagnostic accuracy, staging and treatment monitoring in paediatric solid tumours, by using radiopharmaceuticals more specific than [18F]fluorodeoxyglucose ([18F]FDG). While non-[18F]FDG tracers have...

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Main Authors: Leonor Teles, Nelleke Tolboom, Sabine L.A. Plasschaert, Alex J. Poot, Arthur J.A.T. Braat, Max M. van Noesel
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:EJC Paediatric Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772610X24000631
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author Leonor Teles
Nelleke Tolboom
Sabine L.A. Plasschaert
Alex J. Poot
Arthur J.A.T. Braat
Max M. van Noesel
author_facet Leonor Teles
Nelleke Tolboom
Sabine L.A. Plasschaert
Alex J. Poot
Arthur J.A.T. Braat
Max M. van Noesel
author_sort Leonor Teles
collection DOAJ
description Molecular imaging with positron emission tomography (PET) offers significant potential for improving diagnostic accuracy, staging and treatment monitoring in paediatric solid tumours, by using radiopharmaceuticals more specific than [18F]fluorodeoxyglucose ([18F]FDG). While non-[18F]FDG tracers have already improved diagnostic abilities in adult solid cancers such as prostate and neuroendocrine tumours, their use in the paediatric population has been underexplored. This narrative review summarises clinical evidence regarding the use, advantages, and limitations of these more specific PET tracers in paediatric patients. In neuroblastoma, [18F]mFBG, [18F]F-DOPA, and SSTR-targeting peptides stand out as the most evolved and promising tracers for the clinical setting, with encouraging results regarding feasibility, safety and detection rates. SSTR-targeting peptides have also consistently outperformed other imaging methods (both conventional and functional) and carry the benefits of theragnostic applications. For brain tumours, amino acid-based tracers in general stand out due to their ability to surpass the blood-brain barrier/blood-tumour barrier (BBB/BTB) and their specific accumulation in malignant tissue. Other paediatric solid tumours, such as sarcoma and bone tumours, suffer from a clear lack of clinical evidence that should be addressed in the near future. The studies performed to date show high accuracy, evident prognostic value, and significant clinical impact of non-[18F]FDG tracers in paediatric patients with solid tumours. However, prospective studies with longer follow-up times are warranted to provide high-level evidence regarding the impact of these tracers on patient management and prognosis, to consolidate the encouraging results obtained so far. Further research and international collaboration will be essential to overcome current challenges related to low incidence of paediatric solid tumours, logistical barriers and concerns about radiation exposure.
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spelling doaj-art-c957bee80bbc48288e68cd4717e83cd22025-08-20T02:50:13ZengElsevierEJC Paediatric Oncology2772-610X2024-12-01410020310.1016/j.ejcped.2024.100203Potential of non-FDG PET radiotracers for paediatric patients with solid tumoursLeonor Teles0Nelleke Tolboom1Sabine L.A. Plasschaert2Alex J. Poot3Arthur J.A.T. Braat4Max M. van Noesel5Princess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands; Corresponding author.Princess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands; Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, Utrecht 3584 CX, the NetherlandsPrincess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the NetherlandsPrincess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands; Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, Utrecht 3584 CX, the NetherlandsPrincess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands; Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands; Department of Nuclear Medicine, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066 CX, the NetherlandsPrincess Maxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands; Division Imaging & Cancer, University Medical Center Utrecht, Utrecht 3584 CX, the NetherlandsMolecular imaging with positron emission tomography (PET) offers significant potential for improving diagnostic accuracy, staging and treatment monitoring in paediatric solid tumours, by using radiopharmaceuticals more specific than [18F]fluorodeoxyglucose ([18F]FDG). While non-[18F]FDG tracers have already improved diagnostic abilities in adult solid cancers such as prostate and neuroendocrine tumours, their use in the paediatric population has been underexplored. This narrative review summarises clinical evidence regarding the use, advantages, and limitations of these more specific PET tracers in paediatric patients. In neuroblastoma, [18F]mFBG, [18F]F-DOPA, and SSTR-targeting peptides stand out as the most evolved and promising tracers for the clinical setting, with encouraging results regarding feasibility, safety and detection rates. SSTR-targeting peptides have also consistently outperformed other imaging methods (both conventional and functional) and carry the benefits of theragnostic applications. For brain tumours, amino acid-based tracers in general stand out due to their ability to surpass the blood-brain barrier/blood-tumour barrier (BBB/BTB) and their specific accumulation in malignant tissue. Other paediatric solid tumours, such as sarcoma and bone tumours, suffer from a clear lack of clinical evidence that should be addressed in the near future. The studies performed to date show high accuracy, evident prognostic value, and significant clinical impact of non-[18F]FDG tracers in paediatric patients with solid tumours. However, prospective studies with longer follow-up times are warranted to provide high-level evidence regarding the impact of these tracers on patient management and prognosis, to consolidate the encouraging results obtained so far. Further research and international collaboration will be essential to overcome current challenges related to low incidence of paediatric solid tumours, logistical barriers and concerns about radiation exposure.http://www.sciencedirect.com/science/article/pii/S2772610X24000631Paediatric solid tumoursNuclear medicinePositron emission tomographyRadiotracersTheragnosticsRadioimmunotherapy
spellingShingle Leonor Teles
Nelleke Tolboom
Sabine L.A. Plasschaert
Alex J. Poot
Arthur J.A.T. Braat
Max M. van Noesel
Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
EJC Paediatric Oncology
Paediatric solid tumours
Nuclear medicine
Positron emission tomography
Radiotracers
Theragnostics
Radioimmunotherapy
title Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
title_full Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
title_fullStr Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
title_full_unstemmed Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
title_short Potential of non-FDG PET radiotracers for paediatric patients with solid tumours
title_sort potential of non fdg pet radiotracers for paediatric patients with solid tumours
topic Paediatric solid tumours
Nuclear medicine
Positron emission tomography
Radiotracers
Theragnostics
Radioimmunotherapy
url http://www.sciencedirect.com/science/article/pii/S2772610X24000631
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