Moothedath Abdul Wajid, Chopra Kanwaljeet Kaur, Seth Rachna, Meena Jagdish Prasad, Gupta Aditya Kumar, Kumar Rakesh, Jana Manisha, ArunRaj Sreedharan Thankarajan
Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India.
Department Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Nucl Med. 2022 Apr-Jun;37(2):142-146. doi: 10.4103/ijnm.ijnm_145_21. Epub 2022 Jul 8.
Retinoblastoma (RB) is the most common primary intraocular malignancy of childhood. Magnetic resonance imaging (MRI) of the orbit and brain is the preferred imaging modality to diagnose and define extent of disease as well as to assess response to therapy. Sometimes, it may be difficult to differentiate the presence of active residual disease from therapy-related changes based on posttreatment completion MRI.
RB patients who completed treatment between January 2017 and October 2019 were retrospectively analyzed. We evaluated the utility of F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) to predict active disease in RB patients who continued to have residual disease on MRI at completion of treatment.
Out of the 89 patients who completed treatment, dilemma regarding remission status was present in 11 children. All 11 patients underwent FDG-PET-CT. None of them had evidence of metabolically active disease in the orbit, optic nerve, brain, or rest of the body. After a median follow-up of 24 months, no children developed any evidence of disease progression in the form of local or distant relapse.
Our results showed that in MRI doubtful cases, a nonavid FDG-PET is reassuring in avoiding further therapy as long as close follow-up can be ensured. FDG-PET-CT may emerge as a useful functional modality to predict disease activity in RB.
视网膜母细胞瘤（RB）是儿童最常见的原发性眼内恶性肿瘤。眼眶和脑部的磁共振成像（MRI）是诊断和确定疾病范围以及评估治疗反应的首选成像方式。有时，根据治疗结束后的MRI很难区分活动性残留疾病与治疗相关变化。
回顾性分析2017年1月至2019年10月期间完成治疗的RB患者。我们评估了F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET-CT）在预测治疗结束时MRI仍有残留疾病的RB患者活动性疾病方面的效用。
在89例完成治疗的患者中，11例儿童存在缓解状态的困境。所有11例患者均接受了FDG-PET-CT检查。他们中没有一人在眼眶、视神经、脑部或身体其他部位有代谢活跃疾病的证据。中位随访24个月后，没有儿童出现局部或远处复发形式的疾病进展迹象。
我们的结果表明，在MRI可疑的病例中，只要能确保密切随访，非摄取性FDG-PET可放心地避免进一步治疗。FDG-PET-CT可能成为预测RB疾病活动的一种有用的功能检查方法。
