Imaging insights of FDG-PET from neonates to infants

In pediatric oncology, 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is valuable as a tool for noninvasive imaging and monitoring. While many reports have reviewed the use of PET and PET/CT in pediatrics, considerable variations in age, body size, and metabolism are seen during different stages of childhood development. Neonates (from birth to one month old) and infants (from 1 month to 1 year) present unique challenges for FDG-PET/CT examination due to their small body size, the immaturity of organs, the need for specialized patient preparation, and support requirements during scanning. In addition, differences in metabolic activity can lead to distinct differences in patterns of physiological FDG uptake on PET/CT imaging between neonates and infants. These factors differ significantly from those encountered in older children, who may be treated similarly to adults during imaging procedures. This review, based on both the literature and clinical experience, explores the specific characteristics, challenges, and considerations for FDG-PET/CT imaging from neonates to infants, with a focus on optimizing imaging protocols and interpreting physiological variations in this growth period.