Fu Zheng, Ren Jiazhong, Zhou Jing, Shen Junkang
Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Imaging Center, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong, China.
Front Oncol. 2022 Dec 15;12:1031078. doi: 10.3389/fonc.2022.1031078. eCollection 2022.
This study aims to compare the diagnostic value of F-fluorodeoxyglucose (18-FDG) positron emission tomography (PET)/computed tomography (CT) (F-FDG PET/CT) scan and bone marrow biopsy (BMB) for evaluating bone marrow infiltration (BMI) in newly diagnosed pediatric neuroblastoma (NB) and ganglioneuroblastoma (GNB).
We retrospectively reviewed 51 patients with newly diagnosed NB and GNB between June 1, 2019 and May 31, 2022. Each patient had undergone F-FDG PET/CT and BMB within 1 week and received no treatment. Clinical data were collected and statistically analyzed, including age, sex, pathologic type, and laboratory parameters. F-FDG PET/CT and BMB revealed the result of bone lesions.
A concordance analysis showed that, in this study population, F-FDG PET/CT and BMB were in moderate agreement (Cohen's Kappa = 0.444; = 0.001), with an absolute agreement consistency of 72.5% (37 of 51). The analysis of the receiver operating characteristic (ROC) curve determined that the areas under the ROC curve (AUCs) of SUV and SUV/HE-SUVmax were 0.971 (95% CI: 0.911-1.000; < 0.001) and 0.917 (95% CI: 0.715-1.000; < 0.001) to predict bone-bone marrow involvement (BMI), respectively.
F-FDG PET/CT detects BMI with good diagnostic accuracy and can reduce unnecessary invasive inspections in newly diagnosed pediatric NB and GNB, especially patterns C and D. The analysis of the semi-quantitative uptake of F-FDG, including SUV and SUV/HE-SUVmax, enables an effective differentiation between patterns A and B.
本研究旨在比较氟脱氧葡萄糖（18-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）（F-FDG PET/CT）和骨髓活检（BMB）对新诊断的儿童神经母细胞瘤（NB）和神经节神经母细胞瘤（GNB）骨髓浸润（BMI）的诊断价值。
我们回顾性分析了2019年6月1日至2022年5月31日期间51例新诊断的NB和GNB患者。每位患者在1周内接受了F-FDG PET/CT和BMB检查，且未接受过治疗。收集临床数据并进行统计分析，包括年龄、性别、病理类型和实验室参数。F-FDG PET/CT和BMB显示了骨病变的结果。
一致性分析表明，在本研究人群中，F-FDG PET/CT和BMB具有中等一致性（Cohen's Kappa = 0.444；P = 0.001），绝对一致性为72.5%（51例中的37例）。受试者工作特征（ROC）曲线分析确定，SUV和SUV/HE-SUVmax的ROC曲线下面积（AUC）分别为0.971（95%CI：0.911-1.000；P < 0.001）和0.917（95%CI：0.715-1.000；P < 0.001），用于预测骨-骨髓受累（BMI）。
F-FDG PET/CT检测BMI具有良好的诊断准确性，可减少新诊断的儿童NB和GNB中不必要的侵入性检查，尤其是C型和D型。对F-FDG半定量摄取的分析，包括SUV和SUV/HE-SUVmax，能够有效区分A型和B型。
