124I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma
124I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma
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DOI：
10.2967/jnumed.120.243139
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发表时间：
2021-01-01
影响因子：
9.3
通讯作者：
Seo, Youngho
中科院分区：
文献类型：
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作者：
Aboian, Mariam S.;Huang, Shih-ying;Seo, Youngho
间碘苄胍（MIBG）扫描是神经母细胞瘤最敏感的非侵入性病变检测方式之一。与I-123-MIBG不同，I-124-MIBG允许高分辨率PET。我们评价了I-124-MIBG PET/CT的诊断性能，并与配对I-123-MIBG扫描进行了直接比较。研究方法：在I-131-MIBG治疗前，对7名患者进行标准I-123-MIBG成像（5.2 MBq/kg），包括全身（前后）平面成像、聚焦视野SPECT/CT和全身I-124-MIBG PET/CT（1.05 MBq/kg）。治疗后，7例患者中的2例还完成了I-124-MIBG PET/CT以及配对的I-123-MIBG平面成像和SPECT/CT。1例患者仅在治疗后接受了I-124-MIBG PET/CT。我们评估了所有8例患者，他们显示至少1个I-123-MIBG阳性病灶，共10次扫描。在8对中，I-123-MIBG和I-124-MIBG在彼此的1个月内进行。记录I-123-MIBG和I-124-MIBG扫描识别的病变位置、总病变数量和居里评分。最后，对于5例在I-124-MIBG给药后完成至少3次PET/CT扫描的患者，我们估计了I-124-MIBG的有效剂量。结果如下：I-123-MIBG全身平面扫描、聚焦视野SPECT/CT扫描和全身I-124-MIBG PET扫描分别发现了25、32和87个病灶。I-124-MIBG PET/CT与I-123-MIBG平面成像（P < 0.0001）和I-123-MIBG SPECT/CT（P < 0.0001）在病变检出方面存在统计学显著差异。在10名患者中，6名患者的I-124-MIBG PET/CT居里评分也高于I-123-MIBG平面成像和SPECT/CT。I-124-MIBG PET/CT表现出对全身病变的更好检测，包括胸部、脊柱、头颈部和四肢。患者特异性I-124-MIBG的估计有效剂量约为I-123-MIBG的10倍;然而，鉴于我们给予的I-124-MIBG活性极低（1.05 MBq/kg），尽管半衰期差异较大（100 vs 13.2 h），但有效剂量仅约为I-123-MIBG的2倍。结论：首次在人体中使用低剂量I-124-MIBG PET监测疾病负荷证明肿瘤检测能力上级于I-123-MIBG平面成像和SPECT/CT。
The metaiodobenzylguanidine (MIBG) scan is one of the most sensitive noninvasive lesion detection modalities for neuroblastoma. Unlike I-123-MIBG, I-124-MIBG allows high-resolution PET. We evaluated I-124-MIBG PET/CT for its diagnostic performance as directly compared with paired I-123-MIBG scans. Methods: Before I-131-MIBG therapy, standard I-123-MIBG imaging (5.2 MBq/kg) was performed on 7 patients, including whole-body (anterior-posterior) planar imaging, focused-field-of-view SPECT/CT, and whole-body I-124-MIBG PET/CT (1.05 MBq/kg). After therapy, 2 of 7 patients also completed I-124-MIBG PET/CT as well as paired I-123-MIBG planar imaging and SPECT/CT. One patient underwent I-124-MIBG PET/CT only after therapy. We evaluated all 8 patients who showed at least 1 I-123-MIBG-positive lesion with a total of 10 scans. In 8 pairs, I-123-MIBG and I-124-MIBG were performed within 1 mo of each other. The locations of identified lesions, the number of total lesions, and the curie scores were recorded for the I-123-MIBG and I-124-MIBG scans. Finally, for 5 patients who completed at least 3 PET/CT scans after administration of I-124-MIBG, we estimated the effective dose of I-124-MIBG. Results: I-123-MIBG whole-body planar scans, focused-field-of-view SPECT/CT scans, and whole-body I-124-MIBG PET scans found 25, 32, and 87 total lesions, respectively. There was a statistically significant difference in lesion detection for I-124-MIBG PET/CT versus I-123-MIBG planar imaging (P < 0.0001) and I-123-MIBG SPECT/CT (P < 0.0001). The curie scores were also higher for I-124-MIBG PET/CT than for I-123-MIBG planar imaging and SPECT/CT in 6 of 10 patients. I-124-MIBG PET/CT demonstrated better detection of lesions throughout the body, including the chest, spine, head and neck, and extremities. The effective dose estimated for patient-specific I-124-MIBG was approximately 10 times that of I-123-MIBG; however, given that we administered a very low activity of I-124-MIBG (1.05 MBq/kg), the effective dose was only approximately twice that of I-123-MIBG despite the large difference in half-lives (100 vs. 13.2 h). Conclusion: The first-in-humans use of low-dose I-124-MIBG PET for monitoring disease burden demonstrated tumor detection capability superior to that of I-123-MIBG planar imaging and SPECT/CT.