{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:12:33Z","timestamp":1790154753947,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Accurate staging is critical in pediatric rhabdomyosarcoma (RMS), as bone marrow (BM) and nodal involvement strongly influence risk stratification and treatment. Current guidelines recommend invasive procedures, including bone marrow aspirate\/biopsy (BMAB) for all patients, and nodal histology in selected patients, despite their burden in children. This study evaluates the diagnostic performance of\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT for BM and nodal staging in pediatric RMS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective, multicenter study was conducted including patients less than 25\u00a0years with newly diagnosed RMS from Paris Kids Cancer centers who underwent baseline\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT. PET\/CT accuracy was assessed using BMAB as the reference standard. For nodal staging, histological confirmation was used when available; otherwise, an exploratory real\u2010world clinical assessment of lymph node status based on imaging and follow\u2010up was applied. Discordant cases underwent multidisciplinary review including MRI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 147 patients, 129 had both\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT and BMAB. PET\/CT correctly classified BM status in more than 99% of cases, with a negative predictive value of 99.1%. Nine PET\u2010positive\/BMAB\u2010negative cases were confirmed as true BM involvement on MRI, reflecting possible BMAB sampling bias. For nodal staging,\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT sensitivity and specificity were 85.2% and 85.7% versus histology (48 cases). Using real\u2010world clinical assessment (146 cases), sensitivity and specificity increased to 86.5% and 96.8%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT demonstrates excellent accuracy for BM staging and strong performance for nodal assessment in pediatric RMS. These findings support selective omission of invasive staging procedures in patients with negative\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT while reinforcing the complementary role of sentinel node biopsy in specific subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70709","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:55:28Z","timestamp":1790153728000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone Marrow and Lymph Node Involvement in Newly Diagnosed Pediatric Rhabdomyosarcoma: Can\n                    <sup>18<\/sup>\n                    F\u2010FDG PET\/CT Replace Bone Marrow and Lymph Node Biopsies? Analysis of the \u201cParis Kids Cancer\u201d Cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4690-2610","authenticated-orcid":false,"given":"Giovanni","family":"Spinaci","sequence":"first","affiliation":[{"name":"Pediatric Hematology and Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8831-9133","authenticated-orcid":false,"given":"Laurentiu","family":"Agrigoroaie","sequence":"additional","affiliation":[{"name":"Medical Imaging Department Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-139X","authenticated-orcid":false,"given":"Daniel","family":"Orbach","sequence":"additional","affiliation":[{"name":"SIREDO Oncology Center (Care Innovation and Research for Children, Adolescents and Young Adults With Cancer) Institut Curie PSL University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Moalla","sequence":"additional","affiliation":[{"name":"Radiology Department Gustave Roussy Villejuif  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Boutroux","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Immunology and Oncology, Centre de R\u00e9f\u00e9rence des Pathologies Plaquettaires (CRPP), Centre de R\u00e9f\u00e9rence des Cytop\u00e9nies Auto\u2010Immunes De L'enfant (CEREVANCE) Armand Trousseau Hospital AP\u2010HP Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9932-1944","authenticated-orcid":false,"given":"Federico","family":"Mercolini","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Winter","sequence":"additional","affiliation":[{"name":"SIREDO Oncology Center (Care Innovation and Research for Children, Adolescents and Young Adults With Cancer) Institut Curie PSL University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6682-5847","authenticated-orcid":false,"given":"Lucy","family":"Metayer","sequence":"additional","affiliation":[{"name":"Department of Children and Adolescent Oncology Gustave Roussy Cancer Center  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-2121","authenticated-orcid":false,"given":"Pierre","family":"Khneisser","sequence":"additional","affiliation":[{"name":"Department of Pathology Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2794-5875","authenticated-orcid":false,"given":"Herv\u00e9 J.","family":"Brisse","sequence":"additional","affiliation":[{"name":"Imaging Department, Institut Curie Universit\u00e9 Paris Sciences et Lettres  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-5207","authenticated-orcid":false,"given":"Veronique","family":"Minard\u2010Colin","sequence":"additional","affiliation":[{"name":"Department of Children and Adolescent Oncology Gustave Roussy Cancer Center  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4370-8223","authenticated-orcid":false,"given":"Nina","family":"Jehanno","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Curie Institute  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010018\u20100051\u20102"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02981"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29511"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.7207"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.6476"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3180307693"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102014\u2010006030"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcped.2025.100229"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010021\u201005081\u20100"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24430"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2021.07.006"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/rycan.240475"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31538"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2022.08.003"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010024\u201002864\u20108"},{"issue":"7","key":"e_1_2_11_17_1","first-page":"234","article-title":"The 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