The rapid increase in incidence of diagnosed malignant diseases in children over the last decades, combined with innovations in molecular oncology, neuroimaging, and hybrid imaging, has encouraged researchers and physicians to make a special effort in optimizing technological resources to approach pediatric patients using high-resolution imaging devices with concern about radiation exposure. In this context, a truly hybrid imaging tool, such as simultaneous positron emission tomography/magnetic resonance (PET/MR), presents the appealing advantage to combine serial image technology (MR) and a volumetric (PET) method, at the same time under the same conditions, to define and to assess a pathophysiological pattern for each disease in every single patient aiming to customize therapeutic strategy, therefore improving survival rate. Furthermore, a simultaneous approach enables to overcome some of the limitations of current PET/computed tomography (CT) scan, such as misregistration of attenuation (CT) and emission (PET) images due to spatial and temporal mismatch between CT and PET acquisitions, thus reducing artifactual false-positive result percentage. In addition, the possibility of matching two powerful modalities such as MR and PET opens the way for new challenging clinical applications for disease characterization that are currently under investigation, e.g., multiorgan disorders. In this chapter we will focus on the potential clinical role of PET/MR in pediatric diseases.
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