Wang Han, Zuo Di, Zheng Fei, Sun Yingying, Liu Yuxuan, Yang Hao, Wang Jingfu, Sun Xiaorong
Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, China.
Department of Nuclear Medicine, Sichuan Provincial People's Hospital East Sichuan Hospital & Dazhou First People's Hospital, Dazhou, China.
Front Med (Lausanne). 2025 Jul 3;12:1596272. doi: 10.3389/fmed.2025.1596272. eCollection 2025.
To evaluate the value of F-AlF-NOTATATE PET/CT in restaging high-risk neuroblastoma (NB) after chemotherapy and its advantages over anatomical imaging.
We retrospectively collected data from high-risk patients with NB who were restaged after chemotherapy using F-AlF-NOTATATE PET/CT between June 2021 and June 2022. The histopathological, clinical, and radiographic follow-up results were used as reference standards for the final diagnosis. Patient- and lesion-based analyses were performed. The chi-square test was used to compare the efficacy between F-AlF-NOTATATE PET/CT and anatomical imaging for the detection of residual lesions. One-way ANOVA was used to compare the difference between the maximum standard uptake (SUVmax) values of false-positive and true-positive residual lesions in the surgical subgroups.
Exactly 159 high-risk patients with NB underwent F-AlF-NOTATATE PET/CT restaging. Exactly 134 patients had 634 residual lesions, and the true-positive rate was 88.5%. Among the residual NB lesions, distant and regional lymph node metastases accounted for 86 and 16%, respectively. In the lesion-based analysis, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of F-AlF-NOTATATE PET/CT were significantly higher than those of anatomical imaging. In the patient-based analysis, the specificity, PPV, and accuracy of F-AlF-NOTATATE PET/CT were also significantly higher. In the surgical subgroup, the SUVmax of false-positive lesions was significantly lower than that of NB.
The efficacy of F-AlF-NOTATATE PET/CT in restaging high-risk NB after chemotherapy is significantly superior to anatomical imaging. Although, the SUVmax may help identify false-positive lesions, it cannot distinguish benign transformation after NB treatment.
评估F-AlF-NOTATATE PET/CT在化疗后高危神经母细胞瘤（NB）再分期中的价值及其相对于解剖成像的优势。
我们回顾性收集了2021年6月至2022年6月期间使用F-AlF-NOTATATE PET/CT对化疗后高危NB患者进行再分期的数据。组织病理学、临床和影像学随访结果用作最终诊断的参考标准。进行了基于患者和病变的分析。采用卡方检验比较F-AlF-NOTATATE PET/CT与解剖成像在检测残留病变方面的疗效。采用单因素方差分析比较手术亚组中假阳性和真阳性残留病变的最大标准摄取值（SUVmax）之间的差异。
共有159例高危NB患者接受了F-AlF-NOTATATE PET/CT再分期。其中134例患者有634个残留病变，真阳性率为88.5%。在残留的NB病变中，远处和区域淋巴结转移分别占86%和16%。在基于病变的分析中，F-AlF-NOTATATE PET/CT的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性均显著高于解剖成像。在基于患者的分析中，F-AlF-NOTATATE PET/CT的特异性、PPV和准确性也显著更高。在手术亚组中，假阳性病变的SUVmax显著低于NB。
F-AlF-NOTATATE PET/CT在化疗后高危NB再分期中的疗效显著优于解剖成像。尽管SUVmax可能有助于识别假阳性病变，但它无法区分NB治疗后的良性转化。
