Department of Clinical Radiology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.
Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.
Ann Nucl Med. 2021 May;35(5):549-556. doi: 10.1007/s12149-021-01595-7. Epub 2021 Feb 14.
I metaiodobenzylguanidine (MIBG) scintigraphy is a useful tool for the diagnosis of neuroblastoma (NB). MIBG uptake is correlated with norepinephrine transporter expression; hence, it is expected that high-MIBG tumors would be more highly differentiated and have a better prognosis than those with lower expression. We have introduced a method of assessing MIBG accumulation semi-quantitatively using SPECT/CT fusion images. The purpose of this study was to evaluate the relationship of I MIBG uptake measured by semi-quantitative values of SPECT/CT and early relapse of NB.
We studied the cases of 11 patients (5 males and 6 females, age 5-65 months, median age 20 months) with histopathologically proven NB between April 2010 and March 2015. The early-relapse group was defined as patients who had relapsed within 3 years after the first I MIBG SPECT/CT exam. Other patients were classified as the delay-relapse group. Uptake of MIBG was evaluated using the count ratio of tumor and muscles. T/Mmax and T/Mmean were defined as follows: T/Mmax = max count of tumor/max count of muscle, T/Mmean = mean count of tumor/mean count of muscle.
The average T/Mmean values of the early-relapse group and delay-relapse group were 2.65 ± 0.58 and 7.66 ± 2.68, respectively. The T/Mmean values of the early-relapse group were significantly lower than those of delay-relapse group (p < 0.05). The average T/Mmax of the early-relapse group and delay-relapse group were 8.86 ± 3.22 and 16.20 ± 1.97, respectively. There was no significant difference in T/Mmax values between the two groups.
Low I MIBG uptake using semi-quantitative SPECT/CT analysis was correlated with early relapse of NB.
碘代苄胍（MIBG）闪烁扫描术是诊断神经母细胞瘤（NB）的有用工具。MIBG 的摄取与去甲肾上腺素转运体的表达相关；因此，高摄取 MIBG 的肿瘤比低表达的肿瘤更具分化性和更好的预后。我们引入了一种使用 SPECT/CT 融合图像半定量评估 MIBG 积聚的方法。本研究的目的是评估 SPECT/CT 半定量值测量的 I MIBG 摄取与 NB 早期复发的关系。
我们研究了 2010 年 4 月至 2015 年 3 月期间病理证实的 11 例 NB 患者（5 男 6 女，年龄 5-65 个月，中位年龄 20 个月）。早期复发组定义为首次 I MIBG SPECT/CT 检查后 3 年内复发的患者。其他患者被归类为延迟复发组。MIBG 的摄取使用肿瘤和肌肉的计数比进行评估。T/Mmax 和 T/Mmean 的定义如下：T/Mmax=肿瘤最大计数/肌肉最大计数，T/Mmean=肿瘤平均计数/肌肉平均计数。
早期复发组和延迟复发组的平均 T/Mmean 值分别为 2.65±0.58 和 7.66±2.68。早期复发组的 T/Mmean 值明显低于延迟复发组（p<0.05）。早期复发组和延迟复发组的平均 T/Mmax 值分别为 8.86±3.22 和 16.20±1.97。两组间 T/Mmax 值无显著差异。
SPECT/CT 分析的 I MIBG 摄取低与 NB 的早期复发相关。
