February 15, 2022 – Imaging Endpoints supports many studies involving new treatments for childhood cancers, including recent new treatment approvals, and is a strong supporter of International Childhood Cancer Day which is being observed on February 15. Being diagnosed with cancer is invariably upsetting, but it is even worse when cancer affects a child. Yet, it is estimated that approximately 16,000 cases of pediatric cancer are diagnosed each year in the United States and -400,000 worldwide – with 40,000 on active clinical trials in the United States at any given time and 20% of children with cancer will not survive it, making cancer the most common cause of death in children less than 14 years of age and the leading cause of death by disease for children in the United States.
Although such numbers are alarming, there is reassuring news about childhood cancers. First, the death rate for pediatric cancer has steadily declined (by 65%) in the last four decades. Second, many of these childhood cancers can be treated effectively and even cured, where indeed more than 80% of childhood cancers are now curable.
Leukemia, Brain tumors and Lymphoma are the most common childhood malignancies. The role of imaging has grown tremendously in the management of children with cancer as imaging is no longer restricted to providing anatomic information about a tumor, but is now capable of being a reliable biomarker of the cancer from its detection to determining its aggressivity, staging, assessing response to therapy, and monitoring for the presence of recurrence. As such, imaging has become a true surrogate to outcome prediction.
It is challenging to prevent cancer occurrence in children. Therefore, the best approach to improve patient prognosis is to focus on a prompt, correct diagnosis followed by an effective therapy. Imaging plays a pivotal role in the early detection, diagnosis, and ultimately the monitoring of therapy. Although many imaging modalities are available to perform such tasks, specific modalities have been introduced based on the nature and anatomy of the tumors.
Pediatric Lymphoma is one of the most common pediatric cancers, that was described first by Thomas Hodgkin in 1832 as an abnormal lymph nodes appearance with/without spleen involvement. In the past, the confirmation of the diagnosis and response assessment to therapy was performed using the Cheson criteria by conventional imaging such as CT which was limited by its ability to provide functional insight into the tumor. More recently, functional metabolic imaging including FDG-PET (PET/CT or PET/MRI) has gained acceptance to identify nodal, solid organ, cortical bone and bone marrow disease, which are critically important to accurately stage the disease. Lugano criteria has been introduced to evaluate staging and treatment response in the setting of clinical trials. Even more recently, Lyric criteria was introduced as a modification to the Lugano criteria to address the issue of tumor flare resulting from immunomodulatory therapy.
The issue of radiation exposure in children, especially as a potential cause of secondary malignant neoplasm, has greatly influenced the type of imaging favored and most commonly used for childhood cancer. Task forces have been charged with establishing the optimal imaging modality, and a consensus is emerging on the role of whole-body MR Imaging given the lack of risks from ionizing radiation. Another advantage is MRI’s ability to provide a large field-of-view lending itself to serial examination. The variety of sequences and imaging planes that can be tailored to specific cancers or syndromes, also make MRI the ideal imaging modality for childhood malignancies. If MRI is not an option, consultation should take place among various specialties to recommend alternative imaging modalities among CT, ultrasound or molecular imaging (PET).
As the largest-oncology focused-iCRO, Imaging Endpoints has witnessed the devastating impact of Childhood Cancer and encourages families to seek regular checkups and appropriate treatment if symptoms develop. To learn more about how Imaging Endpoints is battling Cancers in Children to detect them accurately and save lives, please visit ImagingEndpoints.com.