TY - JOUR
T1 - Diagnosis, Treatment Response and Prognosis. The role of 18F-DOPA PET/CT in children affected by Neuroblastoma in comparison with 123I-mIBG scan. The first prospective study
AU - Piccardo, Arnoldo
AU - Morana, Giovanni
AU - Puntoni, Matteo
AU - Campora, Sara
AU - Stefania, Sorrentino
AU - Zucchetta, Pietro
AU - Ugolini, Martina
AU - Conte, Massimo
AU - Cistaro, Angelin
AU - Ferrarazzo, Giulia
AU - Pescetto, Marco
AU - Lattuada, Marco
AU - Bottoni, Gianluca
AU - Garaventa, Alberto
AU - Giovanella, Luca
AU - Lopci, Egesta
N1 - Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2019/9/20
Y1 - 2019/9/20
N2 - To evaluate the diagnostic role of 18F-DOPA PET/CT at the time of staging, in children with Neuroblastoma (NB) and to investigate its ability to assess treatment response. We also investigated the prognostic value of 18F-DOPA PET/CT at the same time-points. Methods: We enrolled children with NB at onset. Before and after induction chemotherapy, all patients underwent 18F-DOPA PET/CT and 123I-mIBG scan plus SPECT/CT. 18F-DOPA PET/CT results were compared with those of 123I-mIBG WBS. For each modality, patient-based (PBA) and lesion-based analyses (LBA) were performed and sensitivity was calculated. We applied scoring systems to 123I-mIBG scan and 18F-DOPA PET/CT (i.e.123I-mIBG whole body score (WBS) and whole-body metabolic burden (WBMB), respectively) and evaluated the association between these parameters, the principal NB risk-factors and outcome. Results: We enrolled 16 high- and 2 intermediate-risk NB patients. On PBA, the sensitivity of 123I-mIBG WBS and 18F-DOPA PET/CT in detecting primary tumours, soft tissue and bone/bone-marrow metastases was 83%, 50% and 92%, versus 94%, 92% and 100%, respectively. On LBA, the sensitivity of 18F-DOPA PET/CT in detecting soft tissue and bone/bone-marrow metastases was 86% and 99% - significantly higher than that of 123I-mIBG WBS: 41% and 93%. After therapy, on PBA, the sensitivity of 123I-mIBG WBS and 18F-DOPA PET/CT in detecting primary tumours, soft tissue and bone/bone-marrow metastases was 72%, 33% and 38%, versus 83%, 75% and 54%, respectively. On LBA, the sensitivity of 18F-DOPA PET/CT in detecting soft tissue and bone/bone-marrow metastases was 77% and 86% - significantly higher than that of 123I-mIBG WBS (28% and 69%). During follow-up, 8 cases of disease progression and 5 deaths occurred. On multivariate analysis, only post-therapeutic 18F-DOPA WBMB (>7.5) was associated to progression-free survival. Conclusion:18F-DOPA PET/CT is more sensitive than 123I-mIBG WBS in staging NB patients and evaluating disease persistence after chemotherapy. In a time-to-event analysis, post-therapeutic 18F-DOPA WBMB remained the only risk factor associated to disease progression.
AB - To evaluate the diagnostic role of 18F-DOPA PET/CT at the time of staging, in children with Neuroblastoma (NB) and to investigate its ability to assess treatment response. We also investigated the prognostic value of 18F-DOPA PET/CT at the same time-points. Methods: We enrolled children with NB at onset. Before and after induction chemotherapy, all patients underwent 18F-DOPA PET/CT and 123I-mIBG scan plus SPECT/CT. 18F-DOPA PET/CT results were compared with those of 123I-mIBG WBS. For each modality, patient-based (PBA) and lesion-based analyses (LBA) were performed and sensitivity was calculated. We applied scoring systems to 123I-mIBG scan and 18F-DOPA PET/CT (i.e.123I-mIBG whole body score (WBS) and whole-body metabolic burden (WBMB), respectively) and evaluated the association between these parameters, the principal NB risk-factors and outcome. Results: We enrolled 16 high- and 2 intermediate-risk NB patients. On PBA, the sensitivity of 123I-mIBG WBS and 18F-DOPA PET/CT in detecting primary tumours, soft tissue and bone/bone-marrow metastases was 83%, 50% and 92%, versus 94%, 92% and 100%, respectively. On LBA, the sensitivity of 18F-DOPA PET/CT in detecting soft tissue and bone/bone-marrow metastases was 86% and 99% - significantly higher than that of 123I-mIBG WBS: 41% and 93%. After therapy, on PBA, the sensitivity of 123I-mIBG WBS and 18F-DOPA PET/CT in detecting primary tumours, soft tissue and bone/bone-marrow metastases was 72%, 33% and 38%, versus 83%, 75% and 54%, respectively. On LBA, the sensitivity of 18F-DOPA PET/CT in detecting soft tissue and bone/bone-marrow metastases was 77% and 86% - significantly higher than that of 123I-mIBG WBS (28% and 69%). During follow-up, 8 cases of disease progression and 5 deaths occurred. On multivariate analysis, only post-therapeutic 18F-DOPA WBMB (>7.5) was associated to progression-free survival. Conclusion:18F-DOPA PET/CT is more sensitive than 123I-mIBG WBS in staging NB patients and evaluating disease persistence after chemotherapy. In a time-to-event analysis, post-therapeutic 18F-DOPA WBMB remained the only risk factor associated to disease progression.
U2 - 10.2967/jnumed.119.232553
DO - 10.2967/jnumed.119.232553
M3 - Article
C2 - 31541036
SN - 0161-5505
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
ER -