Journal of Shanghai Jiao Tong University (Medical Science) >

2026 , Vol. 46 >Issue 4: 496 - 501

DOI: https://doi.org/10.3969/j.issn.1674-8115.2026.04.009

Clinical research

Physiological distribution characteristics and influencing factors of hepatic background and mediastinal blood pool on 18F-FDG PET/CT in children and adolescents of different ages

  • Wang Shaoyan ,
  • Li Chao ,
  • Huang Shuo ,
  • Wu Shuqi ,
  • Chen Suyun
Expand
  • Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Chen Suyun, E-mail: nuyus@outlook.com.

Received date: 2025-07-14

  Accepted date: 2025-11-10

  Online published: 2026-04-10

Fold

Abstract

Objective ·To investigate the physiological distribution characteristics of fluorine-18 fluorodeoxyglucose(18F-FDG) in the liver background and mediastinal blood pool on positron emission tomography/computed tomography (PET/CT) in children and adolescents, and to analyze the influencing factors. Methods ·A total of 271 pediatric patients (<18 years) with pathologically confirmed or suspected malignant tumors were retrospectively analyzed. Patients were divided into four age groups: ≤2 years, 3‒5 years, 6‒10 years, and ≥11 years. The maximum standardized uptake value and mean standardized uptake value (SUVmax and SUVmean) of the liver and mediastinal blood pool were measured. Their associations with age, weight, height, body mass index (BMI), gender, liver function, and chemotherapy status were assessed. Results ·The SUVmax and SUVmean of the liver were 1.89±0.62 and 1.36±0.44, respectively.The mediastinal blood pool SUVmax and SUVmean were 1.11±0.37 and 0.98±0.32. Pearson correlation analysis showed that SUVmax and SUVmean values of the liver and mediastinal blood pool were significantly positively correlated (r=0.78‒0.86, P<0.001). All SUV parameters were positively correlated with age, weight, height, and BMI (r=0.47‒0.73, P<0.05), but showed no significant correlation with gender (r=0.02‒0.04, P>0.05). 18F-FDG uptake in both the liver and mediastinal blood pool increased significantly with age. Hepatic SUVmax increased from 1.41±0.32 in the ≤2-year group to 2.57±0.60 in the ≥11-year group (P<0.001), while mediastinal SUVmax increased from 0.91±0.27 to 1.42±0.41 (P<0.001). Children with abnormal liver function had lower hepatic uptake compared to those with normal liver function (1.71±0.61 vs 1.93±0.61, P=0.034), while no significant difference was observed before and after chemotherapy. Multivariate regression analysis identified weight and age as independent influencing factors for hepatic SUV values (P<0.001), and body weight had the greatest impact on mediastinal blood pool SUV values (P<0.001). Conclusion ·Hepatic background and mediastinal blood pool 18F-FDG uptake increases with age and weight in children and adolescents, with SUV values typically below 2 in children under 5 years old. The SUV values of the liver and mediastinal blood pool show good consistency and reproducibility as non-target reference parameters for therapeutic response evaluation in pediatric PET/CT, which may improve the accuracy and standardization of image interpretation.

Key words： children and adolescents; positron emission tomography; computed tomography; 18F-FDG; liver background; mediastinal blood pool; standardized uptake value (SUV)

Cite this article

Wang Shaoyan , Li Chao , Huang Shuo , Wu Shuqi , Chen Suyun . Physiological distribution characteristics and influencing factors of hepatic background and mediastinal blood pool on 18F-FDG PET/CT in children and adolescents of different ages[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026 , 46(4) : 496 -501 . DOI: 10.3969/j.issn.1674-8115.2026.04.009

References

[1] Kluge R, Kurch L, Georgi T, et al. Current role of FDG-PET in pediatric Hodgkin's lymphoma[J]. Semin Nucl Med, 2017, 47(3): 242-257.
[2] Baum S H, Frühwald M, Rahbar K, et al. Contribution of PET/CT to prediction of outcome in children and young adults with rhabdomyosarcoma[J]. J Nucl Med, 2011, 52(10): 1535-1540.
[3] Lee J W, Cho A, Yun M J, et al. Prognostic value of pretreatment FDG PET in pediatric neuroblastoma[J]. Eur J Radiol, 2015, 84(12): 2633-2639.
[4] Boktor R R, Omar W S, Mousa E, et al. A preliminary report on the impact of 18F-FDG PET/CT in the management of paediatric head and neck cancer[J]. Nucl Med Commun, 2012, 33(1): 21-28.
[5] Kubota K, Watanabe H, Murata Y, et al. Effects of blood glucose level on FDG uptake by liver: a FDG-PET/CT study[J]. Nucl Med Biol, 2011, 38(3): 347-351.
[6] Shiono S, Abiko M, Okazaki T, et al. Positron emission tomography for predicting recurrence in stage I lung adenocarcinoma: standardized uptake value corrected by mean liver standardized uptake value[J]. Eur J Cardiothorac Surg, 2011, 40(5): 1165-1169.
[7] Ozcan Kara P, Kara T, Kara Gedik G, et al. The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesions[J]. Nucl Med Commun, 2011, 32(2): 106-112.
[8] Wahl R L, Jacene H, Kasamon Y, et al. From RECIST to PERCIST: evolving Considerations for PET response criteria in solid tumors[J]. J Nucl Med, 2009, 50(Suppl 1): 122S-150S.
[9] Okuyama C, Matsushima S, Nishimura M, et al. Increased 18F-FDG accumulation in the tonsils after chemotherapy for pediatric lymphoma: a common physiological phenomenon[J]. Ann Nucl Med, 2019, 33(5): 368-373.
[10] Kumbhar S S, Qi J. Normal FDG uptake in the adenoids and palatine tonsils in children on PET/MRI[J]. Pediatr Radiol, 2020, 50(7): 958-965.
[11] Vali R, Bakari A A, Marie E, et al. FDG uptake in cervical lymph nodes in children without head and neck cancer[J]. Pediatr Radiol, 2017, 47(7): 860-867.
[12] Taralli S, Leccisotti L, Mattoli M V, et al. Physiological activity of spinal cord in children: an 18F-FDG PET-CT study[J]. Spine, 2015, 40(11): E647-E652.
[13] Brink I, Reinhardt M J, Hoegerle S, et al. Increased metabolic activity in the thymus gland studied with 18F-FDG PET: age dependency and frequency after chemotherapy[J]. J Nucl Med, 2001, 42(4): 591-595.
[14] Meier J M, Alavi A, Iruvuri S, et al. Assessment of age-related changes in abdominal organ structure and function with computed tomography and positron emission tomography[J]. Semin Nucl Med, 2007, 37(3): 154-172.
[15] Sedig L K, Bailey J J, Wong K K, et al. Do Deauville scores improve the clinical utility of end-of-therapy FDG PET scans for pediatric Hodgkin lymphoma?[J]. AJR Am J Roentgenol, 2019, 212(2): 456-460.
[16] Jorgov L, Montravers F, Balogova S, et al. Paediatric and adolescent Hodgkin lymphoma: information derived from diffuse organ uptake of 18 F-fluorodeoxyglucose on pre-treatment and on interim PET/CT[J]. Eur J Nucl Med Mol Imaging, 2016, 43(7): 1220-1230.
[17] Beath S V. Hepatic function and physiology in the newborn[J]. Semin Neonatol, 2003, 8(5): 337-346.
[18] Suchy F L, Sokol R J, Balistreri W F, et al. Functional development of liver[M]//Suchy F J. Liver disease in children.4th ed. Cambridge: Cambridge University Press,2014: 10-23.
[19] Iozzo P, Geisler F, Oikonen V, et al. Insulin stimulates liver glucose uptake in humans: an 18F-FDG PET Study[J]. J Nucl Med, 2003, 44(5): 682-689.
[20] Sprinz C, Zanon M, Altmayer S, et al. Effects of blood glucose level on 18F fluorodeoxyglucose (18F-FDG) uptake for PET/CT in normal organs: an analysis on 5623 patients[J]. Sci Rep, 2018, 8(1): 2126.
[21] Webb R L, Landau E, Klein D, et al. Effects of varying serum glucose levels on 18F-FDG biodistribution[J]. Nucl Med Commun, 2015, 36(7): 717-721.
[22] Peters A M, Keramida G, Pencharz D. Assessment of alteration in liver 18F-FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score[J]. Eur J Nucl Med Mol Imaging, 2018, 45(12): 2231-2232.
[23] Viglianti B L, Wong K K, Wimer S M, et al. Effect of hyperglycemia on brain and liver 18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging[J]. Biomedecine Pharmacother, 2017, 88: 1038-1045.
[24] Eskian M, Alavi A, Khorasanizadeh M, et al. Effect of blood glucose level on standardized uptake value (SUV) in 18F-FDG PET-scan: a systematic review and meta-analysis of 20, 807 individual SUV measurements[J]. Eur J Nucl Med Mol Imaging, 2019, 46(1): 224-237.
Options
Outlines

/

〈 〉