Nucl Med Mol Imaging.  2017 Jun;51(2):154-160. 10.1007/s13139-016-0451-8.

Clinical Significance of Pretreatment FDG PET/CT in MIBG-Avid Pediatric Neuroblastoma

Affiliations
  • 1Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. larrycheon@gmail.com
  • 2Department of Molecular Medicine and Biopharmaceutical Science, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
  • 3Fellowship of Koh Chang Soon Program, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Nuclear Medicine, Multan Institute of Nuclear Medicine and Radiotherapy, Nishtar Medical College and Hospital, Multan, Pakistan.
  • 5Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 6Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehangro, Jongro-gu, Seoul 110-744, Korea.
  • 7Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 8Department of Radiological Science, University of California at Irvine, Irvine, CA, USA.

Abstract

PURPOSE
¹â¸F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is well known to have clinical significance in the initial staging and response evaluation of the many kinds of neoplasms. However, its role in the pediatric neuroblastoma is not clearly defined. In the present study, the clinical significance of FDG-PET/computed tomography (CT) in ¹²³I- or ¹³¹I-metaiodobenzylguanidine (MIBG)-avid pediatric neuroblastoma was investigated.
METHODS
Twenty patients with neuroblastoma who undertook pretreatment FDG PET/CT at our institute between 2008 and 2015 and showed MIBG avidity were retrospectively enrolled in the present study. Clinical information"”including histopathology, and serum markers"”and several PET parameters"”including SUVmax of the primary lesion (Psuv), target-to-background ratio (TBR), metabolic tumor volume (MTV), and coefficient of variation (CV)"”were analyzed. The prognostic effect of PET parameters was evaluated in terms of progression-free survival (PFS).
RESULTS
Total 20 patients (4.5 ± 3.5 years) were divided as two groups by disease progression. Six patients (30.0 %) experienced disease progression and one patient (5.0 %) died during follow-up period. There were not statistically significant in age, stage, MYCN status, primary tumor size, serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE), and ferritin level between two groups with progression or no progression. However, Psuv (p = 0.017), TBR (p = 0.09), MTV (p = 0.02), and CV (p = 0.036) showed significant differences between two groups. In univariate analysis, PFS was significantly associated with Psuv (p = 0.021) and TBR (p = 0.023).
CONCLUSIONS
FDG-PET parameters were significantly related with progression of neuroblastoma. FDG-PET/CT may have the potential as a valuable modality for evaluating prognosis in the patients with MIBG-avid pediatric neuroblastoma.

Keyword

Neuroblastoma; Pediatrics; F-18 FDG positron-emission tomography; Prognosis

MeSH Terms

3-Iodobenzylguanidine
Disease Progression
Disease-Free Survival
Ferritins
Follow-Up Studies
Humans
L-Lactate Dehydrogenase
Neuroblastoma*
Pediatrics
Phosphopyruvate Hydratase
Positron-Emission Tomography and Computed Tomography*
Prognosis
Retrospective Studies
Tumor Burden
3-Iodobenzylguanidine
Ferritins
L-Lactate Dehydrogenase
Phosphopyruvate Hydratase
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