18F-FDG PET/CT and 123I-Metaiodobenzylguanidine Imaging in High-Risk Neuroblastoma: Diagnostic Comparison and Survival Analysis
18F-FDG PET/CT and 123I-Metaiodobenzylguanidine Imaging in High-Risk Neuroblastoma: Diagnostic Comparison and Survival Analysis
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DOI：
10.2967/jnumed.110.083303
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发表时间：
2011-04-01
影响因子：
9.3
通讯作者：
Bomanji, Jamshed B.
中科院分区：
文献类型：
--
作者：
Papathanasiou, Nikolaos D.;Gaze, Mark N.;Bomanji, Jamshed B.
本研究的目的是前瞻性评价F-18-FDG PET/CT与I-123-间碘苄胍（I-123-MIBG）成像在高危神经母细胞瘤患者中的诊断性能和预后意义。研究方法：28例难治性或复发性高危神经母细胞瘤患者（16例男性和12例女性患者;年龄范围，2-45岁;中位年龄，7.5岁）在接受高剂量I-131-MIBG治疗前同时接受F-18-FDG PET/CT和I-123-MIBG成像评价。我们比较了两种方法在绘制肿瘤负荷，根据疾病的范围和强度的阳性病变确定在每个病人。对肿瘤负荷的软组织和骨-骨髓成分进行单独比较。进行生存分析以评估F-18-FDG和I-123-MIBG成像参数的预后意义。结果：28例患者中有24例（86%）的F-18-FDG PET/CT结果为阳性，而所有患者的I-123-MIBG成像结果均为阳性。F-18-FDG在28例患者中的4例（14%）中在标测肿瘤负荷方面上级，而I-123-MIBG在28例患者中的12例（43%）中更优。在其余12例（43%）患者中，两种模式之间没有发现重大差异。F-18-FDGPET/CT漏诊了5例骨髓疾病、4例软组织疾病和6例I-123-MIBG扫描阳性的颅骨受累。考克斯回归分析和Kaplan-Meier生存曲线显示，F-18-FDG上级优于I-123-MIBG的患者（4/28）生存率明显低于其他患者。肿瘤对F-18-FDG的亲合力（最大标准化摄取值）和F-18-FDG亲合力骨髓疾病的程度被确定为不良预后因素。结论：I-123-MIBG PET/CT对高危神经母细胞瘤病变范围的评价优于F-18-FDG PET/CT，具有上级的价值。然而，F-18-FDG PET/CT在这些患者中具有重要的预后意义。
The aim of our study was to evaluate prospectively the diagnostic performance and prognostic significance of F-18-FDG PET/CT in comparison with I-123-metaiodobenzylguanidine (I-123-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 F-18-FDG PET/CT and I-123-MIBG imaging before treatment with high-dose I-131-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 F-18-FDG and I-123-MIBG imaging parameters. Results: F-18-FDG PET/CT results were positive in 24 of 28 (86%) patients, whereas I-123-MIBG imaging results were positive in all patients. F-18-FDG was superior in mapping tumor load in 4 of 28 (14%) patients, whereas I-123-MIBG was better in 12 of 28 (43%) patients. In the remaining 12 (43%) patients, no major differences were noted between the 2 modalities. F-18-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 I-123-MIBG scans. Cox regression and Kaplan-Meier survival curves showed that the group of patients (4/28) in whom F-18-FDG was superior to I-123-MIBG had a significantly lower survival rate than the others. Tumoral avidity for F-18-FDG (maximum standardized uptake value) and extent of F-18-FDG-avid bone-bone marrow disease were identified as adverse prognostic factors. Conclusion: I-123-MIBG imaging is superior to F-18-FDG PET/CT in the assessment of disease extent in high-risk neuroblastoma. However, F-18-FDG PET/CT has significant prognostic implications in these patients.