Bone marrow disease in rhabdomyosarcoma visualized by 2-[18F]fluorodeoxyglucose positron emission tomography/computed tomography

Pia Kröning; Sebastian Berg; Martin T Freitag; Reineke A Schoot; Alexandra Fischer; Alexander Puzik; T Feuchtinger; Charlotte Niemeyer; Philipp Tobias Meyer; Markus Uhl; Simone Hettmer

doi:10.1007/s00247-024-05933-5

Bone marrow disease in rhabdomyosarcoma visualized by 2-[¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography

Pediatr Radiol. 2024 Apr 26. doi: 10.1007/s00247-024-05933-5. Online ahead of print.

Authors

Affiliations

¹ Division of General Pediatrics, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
² Division of Pediatric Radiology, Department of Radiology, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
³ Department of Nuclear Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
⁴ Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
⁵ Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
⁶ Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany. simone.hettmer@uk-halle.de.
⁷ Universitätsmedizin Halle, Martin Luther University, Pediatrics 1, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany. simone.hettmer@uk-halle.de.

PMID: 38671145
DOI: 10.1007/s00247-024-05933-5

Abstract

Bone marrow metastases-noted in 6% of patients with rhabdomyosarcoma-have been linked to very poor outcomes. Bilateral bone marrow sampling from iliac crests has been the gold standard for bone marrow examination in rhabdomyosarcoma, but sampling errors due to patchy bone marrow involvement may limit its sensitivity. Here, we report the case of a 6-year-old boy with embryonal rhabdomyosarcoma of the skull base and multiple 2-[¹⁸F]fluoro-2-deoxy-D-glucose (2-[¹⁸F]FDG)-avid bone marrow metastases visualized by positron emission tomography and computed tomography (2-[¹⁸F]FDG PET/CT). His bone marrow aspirates were tumor-free. This case illustrates the diagnostic value of 2-[¹⁸F]FDG PET/CT in the detection of bone marrow metastases in rhabdomyosarcoma patients, which may re-shape the definition of bone marrow disease and, ultimately, alter disease staging and risk stratification.

Keywords: Bone marrow metastases; Flurodeoxyglucose F18; Pediatrics; Positron emission tomography computed tomography; Rhabdomyosarcoma.