Functional imaging in rhabdomyosarcoma

A special type of scanning shows promise for imaging rhabdomyosarcoma, in research funded by CCLG and undertaken by CCLG member Dr Bob Phillips and colleagues at the University of York.

What is the research about?

The team looked at whether there was evidence to show that a type of scan, known as ‘functional imaging’, could provide information useful in planning the treatment of rhabdomyosarcoma; a rare cancer of the muscles seen mostly in children and young people.

Why did you do the research?

Young people with rhabdomyosarcoma are given several treatments including chemotherapy, radiotherapy and surgery. To plan the best treatment we have to conduct a range of tests, some of which require a general anaesthetic. We wanted to find out if functional Imaging could replace some of the tests or provide extra useful information about a patient’s disease. The Children’s Cancer and Leukaemia Group funded our team to carry out this research.

What exactly is Functional Imaging?

Functional imaging can tell us about the activity of cancer cells as well as their location.  One type of functional imaging is PET. A PET scan uses a very small amount of a radioactive drug to show where cells are active in the body. It is often used with a CT scan that takes images of the body. When these two scans are done together the images can be put together and differences in activity of the cells highlighted in different colours. This type of scan is known as a PET-CT scan.

How did you do the research?

We looked at the evidence from around the world on functional imaging in Rhabdomyosarcoma in a type of research known as a systematic review. This involved searching databases of research and writing to researchers, looking at the quality of the evidence we found and combining the results together in an analysis.

What did your systematic review find?

We found eight relevant research studies. Our analysis of these studies showed that PET or PET-CT might give a more accurate picture of the stage of a patient’s cancer and the extent of its spread to other parts of the body. This means it could possibly replace some other tests, but there were not enough patients in these studies for us to be sure about this. The studies did not tell us whether this technique could assess a patient’s response to chemotherapy or provide information on when to stop treatment.

Although there are other types of functional imaging, we did not find any evidence for their use in evaluating groups of patients with rhabdomyosarcoma.

What use is this research?

It is useful to gain an accurate picture of existing research before conducting new studies. We now know that PET or PET-CT has potential and it is worth further investigation in larger trials. We hope that other types of functional imaging will also be tested in good quality research studies.

What happens now?

A new trial is currently being planned to test new treatments for rhabdomyosarcoma. We have recommended that PET-CT scanning is used in this trial as well as the usual tests. This will then give us a better idea of whether this type of imaging can replace or add to current tests to improve outcomes for young people with rhabdomyosarcoma.

Study reports

Functional imaging in the assessment of children and young people with rhabdomyosarcoma: a systematic review of clinical effectiveness

Summary report

 

Full report