18F-FDG PET/CT and 123I-Metaiodobenzylguanidine Imaging in High-Risk Neuroblastoma: Diagnostic Comparison and Survival Analysis

Journal of Nuclear Medicine

Jamshed B. Bomanji¹  Ahmad Almuhaideb¹  Mark N. Gaze¹  Nikolaos D. Papathanasiou¹  Wendy Waddington¹  Kevin Sullivan¹  Matthew Aldridge¹ 

关键词: neuroblastoma;    positron emission tomography;    ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG);    ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG);   

DOI  :  10.2967/jnumed.110.083303

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The aim of our study was to evaluate prospectively the diagnostic performance and prognostic significance of 18F-FDG PET/CT in comparison with 123I-metaiodobenzylguanidine (123I-MIBG) imaging in patients with high-risk neuroblastoma. Methods: Twenty-eight patients with refractory or relapsed high-risk neuroblastoma (16 male and 12 female patients; age range, 2–45 y; median age, 7.5 y) were simultaneously evaluated with 18F-FDG PET/CT and 123I-MIBG imaging before treatment with high-dose 131I-MIBG. We compared the 2 methods in mapping tumor load, according to the extent of disease and intensity of positive lesions identified in each patient. Separate comparisons were performed for the soft-tissue and bone–bone marrow components of tumor burden. Survival analysis was performed to assess the prognostic significance of 18F-FDG and 123I-MIBG imaging parameters. Results: 18F-FDG PET/CT results were positive in 24 of 28 (86%) patients, whereas 123I-MIBG imaging results were positive in all patients. 18F-FDG was superior in mapping tumor load in 4 of 28 (14%) patients, whereas 123I-MIBG was better in 12 of 28 (43%) patients. In the remaining 12 (43%) patients, no major differences were noted between the 2 modalities. 18F-FDG PET/CT missed 5 cases of bone–bone marrow disease, 4 cases of soft-tissue disease, and 6 cases of skull involvement that were positive on 123I-MIBG scans. Cox regression and Kaplan–Meier survival curves showed that the group of patients (4/28) in whom 18F-FDG was superior to 123I-MIBG had a significantly lower survival rate than the others. Tumoral avidity for 18F-FDG (maximum standardized uptake value) and extent of 18F-FDG–avid bone–bone marrow disease were identified as adverse prognostic factors. Conclusion: 123I-MIBG imaging is superior to 18F-FDG PET/CT in the assessment of disease extent in high-risk neuroblastoma. However, 18F-FDG PET/CT has significant prognostic implications in these patients.

【 授权许可】

Unknown