Noninvasive Evaluation of Pediatric CNS Tumors

这个项目有几个部分涉及到成像的不同方面。1.MR序列：我们目前在诊断放射学研究实验室工作，对儿童脑肿瘤的多个MR序列进行纵向评估，以评估预后和预后因素。这些成像方式包括光谱学(单体素、CSI和多层多体素)、灌注研究(Demri、DSC-MRI)和扩散TENOR成像。2.将NMRS的结果与成人神经肿瘤学的“金标准”(即FDG-PET)进行比较，以确定每种检查结果之间的相关性。3.正在对涉及替代放射性同位素的新的核医学研究进行评估。我们已经开始了一项研究，涉及将接受Flt、FDG和NMRS评估的高级别胶质瘤或弥漫性脑干肿瘤的儿童患者。这项研究的目标特别是：确定18F-Flt PET成像在儿童恶性胶质瘤患者中的可行性，确定18F-Flt PET成像检测儿童恶性胶质瘤患者放射治疗的治疗变化的能力，确定18F-Flt PET成像在儿童恶性胶质瘤患者中的安全性和毒性，将18F-Flt PET成像在儿童恶性胶质瘤患者放射治疗前后的变化与结果(12个月PFS)进行相关性分析，以比较18F-Flt-PET与MR的表现，质子磁共振波谱(1H-MRSI)和18F-FDGPET在预测肿瘤反应、进展时间和总生存时间中的作用。

There are several sections of this project involving different aspects of imaging. 1. MR sequences: We are currently working in the Laboratory of Diagnostic Radiology Research evaluating multiple MR sequences on children with brain tumors, longitudinally, to assess outcome to tehrapy and prognostic factors. These imaging modalities include spectroscopy (single voxel, CSI and multislice multivoxel), perfusion studies (DEMRI, DSC-MRI) and diffusion tenor imaging. 2. Results from NMRS are being compared to the "gold standard" in adult neuro-oncology, i.e. FDG-PET, to determine the correlation between results of each modality. 3. New nuclear medicine studies involving alternate radioisotopes are being evaluated. We have opened a study involving pediatric patients with high grade gliomas or diffuse brainstem tumors who will be evaluated by FLT, FDG and NMRS.The objectives of this study specifically are: Determine the feasibility of 18F-FLT PET imaging in pediatric patients with malignant gliomas Determine the ability of 18F-FLT PET imaging to detect treatment changes in pediatric patients with malignant gliomas undergoing radiation therapy Determine the safety and toxicity profile of PET imaging using 18F-FLT in pediatric patients with malignant gliomas To correlate changes in 18F-FLT PET before and after radiation with outcome (12 month PFS) To compare the performance of 18F-FLT-PET to that of MR perfusion, proton magnetic resonance spectroscopy (1H-MRSI) and 18F-FDG PET in prediction of tumor response, time to progression and overall survival time.