Diagnostic value of 18F-FDG PET/CT in paediatric neuroblastoma. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Dhull, Varun S.; Sharma, Punit; Patel, Chetan; Kundu, Parveen; Agarwala, Sandeep; Bakhshi, Sameer; Bhatnagar, Veereshwar; Bal, Chandrasekhar; Kumar, Rakesh
• Is Part Of: Nuclear medicine communications. Volume 36:Issue 10(2015:Oct.)
• Publication Date: 2015-10
• Subjects: Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000347
• Languages: English
• ISSNs: 0143-3636

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose</title> <p>The aim of the study was to evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose (<sup>18</sup>F-FDG) PET/computed tomography (CT) in paediatric patients with neuroblastoma (NB) and compare the results with iodine-131 metaiodobenzylguanidine (<sup>131</sup>I-MIBG) scintigraphy.</p> </sec> <sec> <title>Methods</title> <p>Data on 40 paediatric patients (age, 5.5±5.6 years; male, 32; female, eight) with histopathologically proven NB who underwent <sup>18</sup>F-FDG PET/CT (staging, 21 patients; restaging/response monitoring, 19 patients) were retrospectively evaluated. <sup>131</sup>I-MIBG scintigraphy data were available for 28/40 patients (median interval, 15 days; staging, 20 patients; restaging/response monitoring, eight patients). <sup>131</sup>I-MIBG scintigraphy and <sup>18</sup>F-FDG PET/CT images were evaluated by two nuclear medicine physicians in consensus and in separate sessions. Histopathology (<italic>n</italic>=50 lesions) and/or clinical/imaging follow-up (<italic>n</italic>=90 lesions) data were taken as the reference standard.</p> </sec> <sec> <title>Results</title> <p>Patient-wise sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of <sup>18</sup>F-FDG PET/CT were 100, 50, 91.89, 100 and 92.50%, respectively. A total of 140 lesions (primary, 37; lymph node, 31; bone, 50; bone marrow, 15; and others, seven) were detected on PET/CT. In 28 patients undergoing both imaging studies, the sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of <sup>18</sup>F-FDG PET/CT were 100, 60, 92, 100 and 92.80%, respectively, and those of <sup>131</sup>I-MIBG were 95.65, 60, 91.67, 75 and 89.20%, respectively. In these 28 patients, PET/CT detected 107 lesions (primary, 25; lymph node, 22; bone/bone marrow, 56; and others, four) and <sup>131</sup>I-MIBG scintigraphy detected 74 lesions (primary, 24; lymph node, five; and bone/bone marrow, 45). On a patient-based comparison there was no significant difference between <sup>18</sup>F-FDG PET/CT and <sup>131</sup>I-MIBG (<italic>P</italic>=1.000), but <sup>18</sup>F-FDG PET/CT was superior to <sup>131</sup>I-MIBG on a lesion-based comparison (<italic>P</italic><0.0001). Although no difference was noted for primary lesions (<italic>P</italic>=1.000), PET/CT was superior to <sup>131</sup>I-MIBG scintigraphy for the detection of lymph nodal (<italic>P</italic>=0.001) and bone/bone marrow lesions (<italic>P</italic>=0.007).</p> </sec> <sec> <title>Conclusion</title> <p> <sup>18</sup>F-FDG PET/CT shows high accuracy in paediatric patients with NB and demonstrates more lesions as compared with <sup>131</sup>I-MIBG scintigraphy.</p> </sec> </abstract>