Departments of Nuclear Medicine.
Pediatrics.
Clin Nucl Med. 2022 Jan 1;47(1):21-25. doi: 10.1097/RLU.0000000000003972.
This retrospective study aimed to determine the prognostic value of imaging parameters derived from midtherapy 18F-fluorodihydroxyphenylalanine (18F-DOPA) and 18F-FDG PET in pediatric patients with stage 3-4 neuroblastoma.
We enrolled 32 stage 3-4 pediatric neuroblastoma patients who underwent 18F-DOPA and 18F-FDG PET/CT scans before and after 3 chemotherapy cycles. We measured metabolic and volumetric parameters and applied a metabolic burden scoring system to evaluate the primary tumor extent and soft tissue metastases and that of bone/bone marrow involvement. The associations between these parameters and clinical outcomes were investigated.
Over a median follow-up period of 47 months (range, 3-137 months), 16 patients experienced disease progression, and 13 died. After adjustment for clinical factors, multivariate Cox proportional hazard models showed that interim tumor FDG/FDOPA SUVmax (hazard ratio [HR], 5.94; 95% confidence interval [CI], 1.10-34.98) and interim FDOPA whole-body metabolic burden scores (WBMB) (HR, 7.30; 95% CI, 1.50-35.50) were significant prognostic factors for overall survival (OS). Only interim FDOPA WBMB scores (HR, 7.05; 95% CI, 1.02-48.7) were predictive of progression-free survival. Based on median cutoff values, prognosis (OS and progression-free survival) was significantly associated with an interim FDOPA WBMB score ≥21.92 (all P < 0.05) and interim tumor FDG/FDOPA (SUVmax) score ≥0.57 with poor OS (P < 0.05).
Our results indicate that midtreatment FDG and FDOPA PET/CT could serve as prognostic markers in stage 3-4 neuroblastoma patients.
本回顾性研究旨在确定中治疗程 18F-氟代二羟苯丙氨酸（18F-DOPA）和 18F-氟脱氧葡萄糖（18F-FDG）PET 成像参数在 3-4 期神经母细胞瘤患儿中的预后价值。
我们纳入了 32 例接受 3 个化疗周期前后的 18F-DOPA 和 18F-FDG PET/CT 扫描的 3-4 期神经母细胞瘤患儿。我们测量了代谢和容积参数，并应用代谢负荷评分系统评估原发肿瘤范围和软组织转移以及骨/骨髓受累情况。研究了这些参数与临床结果之间的相关性。
在中位数为 47 个月（范围，3-137 个月）的随访期间，16 例患者出现疾病进展，13 例患者死亡。调整临床因素后，多变量 Cox 比例风险模型显示，中期肿瘤 FDG/FDOPA SUVmax（风险比 [HR]，5.94；95%置信区间 [CI]，1.10-34.98）和中期 F-DOPA 全身代谢负荷评分（WBMB）（HR，7.30；95%CI，1.50-35.50）是总生存（OS）的显著预后因素。只有中期 F-DOPA WBMB 评分（HR，7.05；95%CI，1.02-48.7）与无进展生存相关。基于中位数截断值，中期 F-DOPA WBMB 评分≥21.92（所有 P<0.05）和中期肿瘤 FDG/FDOPA（SUVmax）评分≥0.57 与较差的 OS（P<0.05）显著相关。
我们的结果表明，中治疗程 FDG 和 F-DOPA PET/CT 可作为 3-4 期神经母细胞瘤患者的预后标志物。
