Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany.
Pediatr Radiol. 2021 Jun;51(7):1223-1230. doi: 10.1007/s00247-020-04960-2. Epub 2021 Feb 5.
The prognostic value of the International Society of Paediatric Oncology European Neuroblastoma Research Network (SIOPEN) skeletal score using iodine-metaiodobenzylguanidine (MIBG) has been confirmed for people with high-risk neuroblastoma. Whole-body MRI with diffusion-weighted imaging is used increasingly.
To compare the original SIOPEN score and its adaption by diffusion-weighted imaging in high-risk stage 4 neuroblastoma and to evaluate any consequences of score differences on overall survival.
This retrospective observational study included pediatric patients who underwent MIBG scintigraphy and whole-body MRI, including diffusion-weighted imaging, between 2010 and 2015. Semi-quantitative skeletal scores for each exam were calculated independently. A difference of two or more points was defined as clinically relevant and counted as M+ (more in diffusion-weighted imaging) or S+ (more in MIBG). In cases of a negative result in one of the studies, residual disease of 1 point was also rated as relevant. We tested correlation and differences on an exam basis and also grouped by different therapeutic conditions. Overall survival was used to evaluate prognostic relevance.
Seventeen children with 25 paired examinations were evaluated. Median MIBG scintigraphy score was 0 (interquartile range [IQR] 0-4, range 0-25) vs. a median whole-body MRI score of 1 (IQR 0-5.5, range 0-35) (P=0.018). A relevant difference between whole-body MRI and MIBG scintigraphy was noted in 14 of the 25 paired examinations (M+: n=9; S+: n=5). After treatment, the median survival of cases with M+ was 14 months (IQR 4-59, range 1-74 months), while S+ cases showed a median survival of 49 months (IQR 36-52, range 36-52 months) (P=0.413).
The SIOPEN scoring system is feasible for whole-body MRI but might result in slightly higher scores, probably because of MRI's superior spatial resolution. Further studies are necessary to validate any impact on prognosis.
碘代间位碘苄胍（MIBG）示踪的国际小儿肿瘤学会欧洲神经母细胞瘤研究网络（SIOPEN）骨骼评分对高危神经母细胞瘤患者具有明确的预后价值。全身 MRI 加弥散加权成像的应用日益增多。
比较高危 4 期神经母细胞瘤中原始 SIOPEN 评分和其弥散加权成像的适应性，并评估评分差异对总生存的任何影响。
这项回顾性观察性研究纳入了 2010 年至 2015 年间接受 MIBG 闪烁扫描和全身 MRI（包括弥散加权成像）检查的儿科患者。分别独立计算每个检查的半定量骨骼评分。将两个或更多评分差异定义为临床相关，并分别计为 M+（弥散加权成像中更多）或 S+（MIBG 中更多）。如果其中一项研究结果为阴性，则残留病灶为 1 分也被认为是相关的。我们在检查基础上以及按不同治疗条件进行分组测试相关性和差异。总生存用于评估预后相关性。
共评估了 17 名儿童的 25 对检查。MIBG 闪烁扫描评分中位数为 0（四分位距 [IQR] 0-4，范围 0-25），而全身 MRI 评分中位数为 1（IQR 0-5.5，范围 0-35）（P=0.018）。在 25 对配对检查中，有 14 对检查发现全身 MRI 与 MIBG 闪烁扫描之间存在相关差异（M+：n=9；S+：n=5）。治疗后，M+病例的中位生存时间为 14 个月（IQR 4-59，范围 1-74 个月），而 S+病例的中位生存时间为 49 个月（IQR 36-52，范围 36-52 个月）（P=0.413）。
SIOPEN 评分系统适用于全身 MRI，但可能导致评分略高，可能是因为 MRI 的空间分辨率更高。需要进一步研究来验证其对预后的任何影响。
