Pediatric Radiology

, 41:505

Oncological imaging: tumor surveillance in children

ALARA-CT

Abstract

As the need for accurate diagnostic imaging often continues throughout a cancer survivor’s life, imaging methods with the least toxicity must be used so as to provide needed information without contributing to long-term sequelae that might compound toxicities inherent with the primary disease and its treatment. In this regard, the costs, benefits and potential risks of post-therapy monitoring for disease recurrence warrant periodic review. Unfortunately, few analyses are available regarding the impact of surveillance imaging on the detection of disease recurrence, salvage rates of relapse disease and long-term survival outcomes for pediatric cancer survivors. This review will examine the role and limitations of surveillance imaging in pediatric oncology.

Keywords

Surveillance imaging Pediatric cancer Diagnostic imaging Disease relapse 

References

  1. 1.
    Mariotto AB, Rowland JH, Yabroff KR et al (2009) Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomarkers Prev 18:1033–1040PubMedCrossRefGoogle Scholar
  2. 2.
    Bhatia S, Yasui Y, Robison LL et al (2003) High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the Late Effects Study Group. J Clin Oncol 21:4386–4394PubMedCrossRefGoogle Scholar
  3. 3.
    Bhatti P, Veiga LH, Ronckers CX et al (2010) Risk of second primary thyroid cancer after radiotherapy for a childhood cancer in a large cohort study: an update from the childhood cancer survivor study. Radiat Res 174:741–752PubMedCrossRefGoogle Scholar
  4. 4.
    Inskip PD, Curtis RE (2007) New malignancies following childhood cancer in the United States, 1973–2002. Int J Cancer 121:2233–2240PubMedCrossRefGoogle Scholar
  5. 5.
    Reaman GH (2009) What, why, and when we image: considerations for diagnostic imaging and clinical research in the Children’s Oncology Group. Pediatr Radiol 39(Suppl 1):S42–S45PubMedCrossRefGoogle Scholar
  6. 6.
    Meadows AT, Friedman DL, Neglia JP et al (2009) Second neoplasms in survivors of childhood cancer: findings from the childhood cancer survivor study cohort. J Clin Oncol 27:2356–2362PubMedCrossRefGoogle Scholar
  7. 7.
    Bowers DC, Adhikari S, El-Khashab YM et al (2009) Survey of long-term follow-up programs in the United States for survivors of childhood brain tumors. Pediatr Blood Cancer 53:1295–1301PubMedCrossRefGoogle Scholar
  8. 8.
    Minn AY, Pollock BH, Garzarella L et al (2001) Surveillance neuroimaging to detect relapse in childhood brain tumors: a pediatric oncology group study. J Clin Oncol 19:4135–4140PubMedGoogle Scholar
  9. 9.
    Lee AI, Zuckerman DS, Van den Abbeele AD et al (2010) Surveillance imaging of Hodgkin lymphoma patients in first remission: a clinical and economic analysis. Cancer 116:3835–3842PubMedCrossRefGoogle Scholar
  10. 10.
    Postovsky S, Barzilai M, Meller I et al (2008) Does regular follow-up influence the survival of patients with sarcoma after recurrence? The Miri Shitrit pediatric oncology department experience. J Pediatr Hematol Oncol 30:189–195PubMedCrossRefGoogle Scholar
  11. 11.
    Kovanlikaya A, Karabay N, Cakmakci H et al (2003) Surveillance imaging and cost effectivity in pediatric brain tumors. Eur J Radiol 47:188–192PubMedCrossRefGoogle Scholar
  12. 12.
    Biasotti S, Garaventa A, Padovani P et al (2005) Role of active follow-up for early diagnosis of relapse after elective end of therapies. Pediatr Blood Cancer 45:781–786PubMedCrossRefGoogle Scholar
  13. 13.
    Owens CM, Brisse HJ, Olsen OE et al (2008) Bilateral disease and new trends in Wilms tumour. Pediatr Radiol 38:30–39PubMedCrossRefGoogle Scholar
  14. 14.
    Guadagnolo BA, Punglia RS, Kuntz KM et al (2006) Cost-effectiveness analysis of computerized tomography in the routine follow-up of patients after primary treatment for Hodgkin’s disease. J Clin Oncol 24:4116–4122PubMedCrossRefGoogle Scholar
  15. 15.
    Torrey MJ, Poen JC, Hoppe RT (1997) Detection of relapse in early-stage Hodgkin’s disease: role of routine follow-up studies. J Clin Oncol 15:1123–1130PubMedGoogle Scholar
  16. 16.
    Dryver ET, Jernstrom H, Tompkins K et al (2003) Follow-up of patients with Hodgkin’s disease following curative treatment: the routine CT scan is of little value. Br J Cancer 89:482–486PubMedCrossRefGoogle Scholar
  17. 17.
    Howell L, Mensah A, Brennan B et al (2005) Detection of recurrence in childhood solid tumors. Cancer 103:1274–1279PubMedCrossRefGoogle Scholar
  18. 18.
    Chong AL, Grant RM, Ahmed BA et al (2010) Imaging in pediatric patients: time to think again about surveillance. Pediatr Blood Cancer 55:407–413PubMedCrossRefGoogle Scholar
  19. 19.
    Nathan PC, Ness KK, Mahoney MC et al (2010) Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Ann Intern Med 153:442–451PubMedGoogle Scholar
  20. 20.
    Meadows AT (2003) Pediatric cancer survivors: Past history and future challenges. Curr Probl Cancer 27:112–126PubMedCrossRefGoogle Scholar
  21. 21.
    Hudson MM, Mulrooney DA, Bowers DC et al (2009) High-risk populations identified in childhood cancer survivor study investigations: implications for risk-based surveillance. J Clin Oncol 27:2405–2414PubMedCrossRefGoogle Scholar
  22. 22.
    Kaste SC (2008) Skeletal toxicities of treatment in children with cancer. Pediatr Blood Cancer 50(2 Suppl):469–473PubMedCrossRefGoogle Scholar
  23. 23.
    Karimova EJ, Rai SN, Ingle D et al (2006) MRI of knee osteonecrosis in children with leukemia and lymphoma: Part 2, clinical and imaging patterns. AJR 186:477–482PubMedCrossRefGoogle Scholar
  24. 24.
    LA Mattano J, Sather HN, Trigg ME et al (2000) Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the children’s cancer group. J Clin Oncol 18:3262–3272PubMedGoogle Scholar
  25. 25.
    Sala A, Mattano LA Jr, Barr RD (2007) Osteonecrosis in children and adolescents with cancer—an adverse effect of systemic therapy. Eur J Cancer 43:683–689PubMedCrossRefGoogle Scholar
  26. 26.
    Barr RD, Sala A (2008) Osteonecrosis in children and adolescents with cancer. Pediatr Blood Cancer 50(2 Suppl):483–485PubMedCrossRefGoogle Scholar
  27. 27.
    Children’s Oncology Group (2008) Long-term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. Available via www.survivorshipguidelines.org. Accessed 07 March 2011
  28. 28.
    Guppy AE, Tebbutt NC, Norman A et al (2003) The role of surveillance CT scans in patients with diffuse large B-cell non-Hodgkin’s lymphoma. Leuk Lymphoma 44:123–125PubMedCrossRefGoogle Scholar
  29. 29.
    Elis A, Blickstein D, Klein O et al (2002) Detection of relapse in non-Hodgkin’s lymphoma: role of routine follow-up studies. Am J Hematol 69:41–44PubMedCrossRefGoogle Scholar
  30. 30.
    de Graaf N, Hew JM, Fock JM et al (2002) Predictive value of clinical evaluation in the follow-up of children with a brain tumor. Med Pediatr Oncol 38:254–257PubMedCrossRefGoogle Scholar
  31. 31.
    Ron E (2003) Cancer risks from medical radiation. Health Phys 85:47–59PubMedCrossRefGoogle Scholar
  32. 32.
    Frush DP, Goske MJ, Hernanz-Schulman M (2008) Computed tomography and radiation exposure. N Engl J Med 358:851–853PubMedGoogle Scholar
  33. 33.
    Frush DP (2009) Radiation, CT, and children: the simple answer is … it’s complicated. Radiology 252:4–6PubMedCrossRefGoogle Scholar
  34. 34.
    Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296PubMedGoogle Scholar
  35. 35.
    Huda W (2004) Assessment of the problem: pediatric doses in screen-film and digital radiography. Pediatr Radiol 34(Suppl 3):S173–S182PubMedCrossRefGoogle Scholar
  36. 36.
    Huda W (2007) Radiation doses and risks in chest computed tomography examinations. Proc Am Thorac Soc 4:316–320PubMedCrossRefGoogle Scholar
  37. 37.
    Brody AS, Frush DP, Huda W et al (2007) Radiation risk to children from computed tomography. Pediatrics 120:677–682PubMedCrossRefGoogle Scholar
  38. 38.
    Girshin M, Shapiro V, Rhee A et al (2009) Increased risk of general anesthesia for high-risk patients undergoing magnetic resonance imaging. J Comput Assist Tomogr 33:312–315PubMedCrossRefGoogle Scholar
  39. 39.
    Kwee TC, Takahara T, Luijten PR et al (2010) ADC measurements of lymph nodes: inter- and intra-observer reproducibility study and an overview of the literature. Eur J Radiol 75:215–220PubMedCrossRefGoogle Scholar
  40. 40.
    Ley S, Ley-Zaporozhan J, Schenk JP (2009) Whole-body MRI in the pediatric patient. Eur J Radiol 70:442–451PubMedCrossRefGoogle Scholar
  41. 41.
    Darge K, Jaramillo D, Siegel MJ (2008) Whole-body MRI in children: current status and future applications. Eur J Radiol 68:289–298PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Radiological SciencesSt. Jude Children’s Research HospitalMemphisUSA

Personalised recommendations