Background: Amino acid tracer positron emission tomography–magnetic resonance imaging (PET-MRI) was shown to be superior to MRI alone for evaluating central nervous system (CNS) tumours in adults. This study aimed to investigate the utility of amino acid PET-MRI in children with CNS tumours.Methods: We reviewed the amino acid PET-MRI findings of children with suspected or confirmed CNS neoplasms managed in a territory-wide referral centre in Hong Kong from 2022 to 2025. Maximal standardized uptake values (SUVmax) were captured, and tumour-to-background SUVmax ratios (TBRmax) were measured with reference to adjacent or contralateral normal brain structures. Comparisons were made among patients with clinical high-grade and low-grade/non-neoplastic lesions.Results: Thirty-seven patients were included, with 63 PET-MRIs performed. PET-MRI was performed as part of initial diagnostics in 41% of the cases, for response assessment in 48%, and evaluation of residual/relapsed disease in 11%. High-grade lesions had a significantly higher SUVmax and TBRmax compared to low-grade/non-malignant lesions (median SUVmax 3.7 vs. 1.6,p= 0.00006; median TBRmax 2.06 vs. 0.91,p= 0.00002). Optimal SUVmax and TBRmax cut-offs by ROC analysis were 2.38 and 1.62, respectively. Similar performance was reproduced by focusing on the subset of patients with suspected CNS germ cell tumours (CNS-GCT). The impact of amino acid PET availability is considerable, as clinical management was modified in 65% of patients.Conclusions: Our study demonstrates the performance and clinical utility of amino acid PET-MRI in the management of children with CNS pathologies. Amino acid PET-MRI contributes to the diagnosis, monitoring, and treatment guidance of these patients, providing crucial information for decision-making.
背景：氨基酸示踪剂正电子发射断层扫描-磁共振成像（PET-MRI）在评估成人中枢神经系统肿瘤方面已显示出优于单独使用MRI的效果。本研究旨在探讨氨基酸PET-MRI在儿童中枢神经系统肿瘤中的应用价值。 方法：我们回顾了2022年至2025年间香港一家全港性转诊中心收治的疑似或确诊中枢神经系统肿瘤患儿的氨基酸PET-MRI检查结果。记录最大标准化摄取值（SUVmax），并参照邻近或对侧正常脑组织结构测量肿瘤与背景的SUVmax比值（TBRmax）。对临床高级别与低级别/非肿瘤性病变患者进行了比较。 结果：共纳入37例患者，完成63次PET-MRI检查。其中41%的检查用于初始诊断，48%用于疗效评估，11%用于残留/复发疾病评估。与低级别/非恶性病变相比，高级别病变的SUVmax和TBRmax显著更高（中位SUVmax 3.7 vs. 1.6，p=0.00006；中位TBRmax 2.06 vs. 0.91，p=0.00002）。ROC分析确定的最佳SUVmax和TBRmax截断值分别为2.38和1.62。在疑似中枢神经系统生殖细胞肿瘤亚组患者中也观察到相似的诊断效能。氨基酸PET的应用影响显著，65%患者的临床治疗方案因此调整。 结论：本研究证实了氨基酸PET-MRI在儿童中枢神经系统病变管理中的诊断效能和临床实用价值。该技术有助于这些患者的诊断、监测和治疗指导，为临床决策提供关键信息。
肿瘤(癌症)患者之家