Pediatric Imaging

FIGURE: MRI AND PET-MRI FUSION IMAGES OF PATIENTS WITH DIPG. Top row: Zr-89-bevacizumab PET (144 hrs p.i.) fused with T1-Gd weighted MRI per patient; middle row: T1-Gd weighted MRI; lower row: T2-weighted/FLAIR MR-images. Five tumors show variable uptake of Zr-89-bevacizumab (white arrows), with both PET negative and positive areas within each tumor. Two primary tumors are completely PET negative (Fig. 1C and 1E), while the T2 weighted images show tumor infiltration in the whole pons of both patients. In the middle row, the red arrows represent the areas of contrast enhancement within the tumor. In four out of five primary tumors, the PET-positive area corresponds with the contrast-enhancing area on MRI of the tumors (Fig. 1A, 1B, 1F and 1G). In Fig. 1C, the tumor shows an MRI contrast-enhancing area, while there is no Zr-89-bevacizumab uptake. Fig. 1D shows a PET positive tumor, while no Gd-enhancement is observed on MRI. Credit: Sophie Veldhuijzen van Zanten and Marc Jansen, VU University Medical Center, Amsterdam, The Netherlands.