Total-Body PET/CT Imaging after Proton Craniospinal Irradiation in Pediatric Patients: A Brief Report.
In three pediatric patients with medulloblastoma or pineoblastoma, rapid post-proton-CSI total-body PET/CT visualized irradiation-associated activity across the craniospinal axis and its time-dependent redistribution and decline throughout the body.
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In three pediatric patients with medulloblastoma or pineoblastoma, rapid post-proton-CSI total-body PET/CT visualized irradiation-associated activity across the craniospinal axis and its time-dependent redistribution and decline throughout the body.
Research significance
The study directly supports the feasibility of dynamic total-body imaging after proton craniospinal irradiation; it is an inference, not demonstrated here, that this approach could eventually aid treatment verification, workflow optimization, or assessment of proton-induced activity and washout.
Source abstract
PURPOSE: This study aims to report rapid off-line total-body PET/CT imaging on pediatric patients after proton craniospinal irradiation (CSI), which enabled visualization of the entire craniospinal axis together with whole-body redistribution of proton-induced activity. METHODS AND MATERIALS: Three pediatric patients with medulloblastoma or pineoblastoma underwent 60-minute dynamic single-bed total-body PET/CT scans shortly after proton CSI using a rapid near-room transfer workflow. PET data were reconstructed into consecutive 5-minute frames and cumulative acquisitions to characterize regional temporal changes and acquisition-duration-dependent image variability. RESULTS: PET visualized activity along the full craniospinal irradiation axis and in extra-field major blood vessels and blood-rich organs. Regional PET signal decreased by 92.0-94.8% in the cranial and spinal regions and by 89.4-91.9% in the cardiac blood pool, liver, and spleen from the 0-5-minute to the 55-60-minute frame, reflecting the combined effects of physical decay and biological washout. The first 5 minutes of PET data depicted the major whole-body distribution pattern, whereas acquisitions of approximately 20-30 minutes substantially reduced regional image variability. CONCLUSION: Rapid total-body PET/CT enabled single-bed visualization of the full craniospinal irradiation axis and quantitative characterization of whole-body temporal evolution after proton CSI.