Piccardo Arnoldo, Treglia Giorgio, Fiz Francesco, Bar-Sever Zvi, Bottoni Gianluca, Biassoni Lorenzo, Borgwardt Lise, de Keizer Bart, Jehanno Nina, Lopci Egesta, Kurch Lars, Massollo Michela, Nadel Helen, Roca Bielsa Isabel, Shulkin Barry, Vali Reza, De Palma Diego, Cecchin Diego, Santos Ana Isabel, Zucchetta Pietro
Department of Nuclear Medicine, E.O. "Ospedali Galliera", Mura Delle Cappuccine 14, 16128, Genoa, Italy.
Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Eur J Nucl Med Mol Imaging. 2024 Feb;51(3):756-767. doi: 10.1007/s00259-023-06486-9. Epub 2023 Nov 14.
Molecular imaging is pivotal in staging and response assessment of children with neuroblastoma (NB). [I]-metaiodobenzylguanidine (mIBG) is the standard imaging method; however, it is characterised by low spatial resolution, time-consuming acquisition procedures and difficult interpretation. Many PET catecholaminergic radiotracers have been proposed as a replacement for [I]-mIBG, however they have not yet made it into clinical practice. We aimed to review the available literature comparing head-to-head [I]-mIBG with the most common PET catecholaminergic radiopharmaceuticals.
We searched the PubMed database for studies performing a head-to-head comparison between [I]-mIBG and PET radiopharmaceuticals including meta-hydroxyephedrine ([C]C-HED), F-18F-3,4-dihydroxyphenylalanine ([F]DOPA) [I]mIBG and Meta-[18F]fluorobenzylguanidine ([F]mFBG). Review articles, preclinical studies, small case series (< 5 subjects), case reports, and articles not in English were excluded. From each study, the following characteristics were extracted: bibliographic information, technical parameters, and the sensitivity of the procedure according to a patient-based analysis (PBA) and a lesion-based analysis (LBA).
Ten studies were selected: two regarding [C]C-HED, four [F]DOPA, one [I]mIBG, and three [F]mFBG. These studies included 181 patients (range 5-46). For the PBA, the superiority of the PET method was reported in two out of ten studies (both using [F]DOPA). For LBA, PET detected significantly more lesions than scintigraphy in seven out of ten studies.
PET/CT using catecholaminergic tracers shows superior diagnostic performance than mIBG scintigraphy. However, it is still unknown if such superiority can influence clinical decision-making. Nonetheless, the PET examination appears promising for clinical practice as it offers faster image acquisition, less need for sedation, and a single-day examination.
分子成像在神经母细胞瘤（NB）患儿的分期及疗效评估中起着关键作用。[I] - 间碘苄胍（mIBG）是标准的成像方法；然而，其特点是空间分辨率低、采集过程耗时且解读困难。许多PET儿茶酚胺能放射性示踪剂已被提议作为[I] - mIBG的替代物，但它们尚未进入临床实践。我们旨在回顾将[I] - mIBG与最常见的PET儿茶酚胺能放射性药物进行直接对比的现有文献。
我们在PubMed数据库中搜索了对[I] - mIBG与PET放射性药物进行直接对比的研究，包括间羟基麻黄碱（[C]C - HED）、F - 18F - 3,4 - 二羟基苯丙氨酸（[F]DOPA）、[I]mIBG和间位 - [18F]氟苄胍（[F]mFBG）。排除综述文章、临床前研究、小病例系列（<5例受试者）、病例报告以及非英文文章。从每项研究中提取以下特征：文献信息、技术参数以及根据基于患者的分析（PBA）和基于病灶的分析（LBA）得出的该检查方法的敏感性。
共选择了10项研究：2项关于[C]C - HED，4项关于[F]DOPA，1项关于[I]mIBG，3项关于[F]mFBG。这些研究纳入了181例患者（范围为5 - 46例）。对于PBA，在10项研究中有2项报告了PET方法的优越性（均使用[F]DOPA）。对于LBA，在10项研究中有7项显示PET检测到的病灶明显多于闪烁显像。
使用儿茶酚胺能示踪剂的PET/CT显示出比mIBG闪烁显像更优越的诊断性能。然而，这种优越性是否能影响临床决策仍不清楚。尽管如此，PET检查因其图像采集速度更快、镇静需求更少且可在一天内完成检查，在临床实践中似乎很有前景。
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