Non-invasive prediction of an unfavorable histological variant in patients with neuroblastic tumors using the quantitative and semiquantitative assessment of ¹²³I-MIBG uptake

Abstract

¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) scintigraphy is widely used for the detection and staging of neuroblastoma. Risk-adapted treatment in patients with neuroblastic tumors is based on many clinical and genetic factors including histopathology. Purpose: non-invasive prediction of an unfavorable histological variant in patients with neuroblastic tumors using quantitative assessment of ¹²³I-MIBG uptake. This study was approved by the Independent Ethical Committee and the Academic Council of Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation. 96 patients were included in this retrospective study. ¹²³I-MIBG-scintigraphy including whole body planner images and SPECT/CT were performed for all patients before any type of treatment. Semiquantitative and quantitative assessment of ¹²³I-MIBG uptake were calculated and analyzed. Out of 96 patients: 54 with neuroblastoma (NB), 28 with ganglioneuroblastoma (GNB) and 14 with ganglioneuroma (GN). The average values of TLCRR and SUVmax for NB were 5.67 and 7.5, for GNB – 2.58 and 3.1 and for GN – 1.48 and 1.85, respectively. A centile analysis was carried out for all groups. SPECT/CT in combination with modern software allows semiquantitative and quantitative assessment of ¹²³I-MIBG uptake in neuroblastic tumor. The TLCRR and SUVmax can be used separately as well as in combination with NSE for prediction of histological variant.

Ganglioneuroma as the phenomenon of neuroblastoma maturation

“…В настоящее время нет публикаций с оценкой частоты накопления МЙБГ при ГН, которые включали бы большое количество данных. Однако в ряде научных публикаций было показано, что интенсивность накопления МЙБГ у пациентов с ГН ниже или существенно ниже, чем при ГНБ и НБ [33,34]. Этот факт позволяет предположить, что использование протокола однофотонной эмиссионной компьютерной томографии, совмещенной с компьютерной томографией, в дополнение к планарным изображениям в режиме «все тело» при сцинтиграфии с МЙБГ у пациентов с нейрогенной опухолью может уменьшить количество ложноотрицательных случаев.…”