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首页> 外文期刊>Indian Journal of Nuclear Medicine >Role of positron emission tomography-computed tomography in staging and early chemotherapy response evaluation in children with neuroblastoma
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Role of positron emission tomography-computed tomography in staging and early chemotherapy response evaluation in children with neuroblastoma

机译：正电子发射断层扫描计算机断层扫描在神经母细胞瘤儿童分期和早期化疗反应评估中的作用

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Background:To evaluate the role of positron emission tomography-computed tomography (PET-CT) in staging and determining early treatment response to chemotherapy in children with neuroblastoma (NB) and its correlation with the final outcome.Patients and Methods:Seventeen patients of NB with mean age of 51.5 months (age range 2-132 months; 14 males, 3 females) underwent serial 18F-flourodeoxygl ucose (FDG) PET-CT imaging. All 17 patients were for staging before any treatment. Twelve of 17 patients underwent I-131 meta-iodobezylguanidine (MIBG) scan and bone scan. MIBG uptake was seen in the primary lesion in 11/12 patients. MIBG uptake in bones was seen in 3/12 patients. All bone lesions were concordant on MIBG and bone scan. Early response to chemotherapy was evaluated after two cycles using PET-CT. A 30% reduction in longest diameter was taken as cut-off value for response on CT based on the response evaluation criteria in solid tumors criteria. Response on PET-CT was assessed using percentage improvement in lesion to background SUV ratio, taking a value of 50% as cut-off. Final outcome based on follow-up ranging from 6 to 43 months (mean 18.8 months) served as reference.Results:All 17 patients showed increased FDG uptake at the primary site. Seven of the 17 patients (41.2%) showed metastasis. Lymph nodes were the most common site of metastatic disease followed by bone, bone marrow, lung and meninges. For response evaluation, change in the size of the primary tumor was noted in 11/17 (64.7%) patients on CT. Treatment response was noted in 12/17 patients (70.6%) on PET-CT. Eleven out of 17 (65%) patients showed response in both CT and PET-CT. Five out of 17 patients showed no response in both. Discordant findings on CT and PET were noted in one (5.9%) patient where PET showed response but no response was seen on CT. Two patients with initial response but with distant metastases expired during follow-up.Conclusion:PET-CT has potential in the initial staging of NB. PET-CT also appears to be a good modality for response assessment in patients with moderate and high FDG uptake on the baseline scan. However, no significant beneficial effect was seen in patients with low baseline FDG uptake.
机译：背景：评价正电子发射断层扫描计算机断层扫描（PET-CT）在分期和确定神经母细胞瘤（NB）患儿对化疗的早期治疗反应中的作用及其与最终结局的关系。患者与方法：17例NB平均年龄51.5个月（年龄2-132个月;男14例，女3例）进行了18F-氟脱氧葡糖（FDG）PET-CT连续成像。所有17例患者在接受任何治疗前均需分期。 17名患者中有12名接受了I-131异碘联苄胍（MIBG）扫描和骨扫描。在11/12的患者中，原发灶可见MIBG摄取。在3/12的患者中发现骨骼中的MIBG摄取。 MIBG和骨扫描显示所有骨病变均一致。在两个周期后使用PET-CT评估了对化疗的早期反应。根据实体瘤标准中的响应评估标准，最长直径减少30％作为CT响应的临界值。使用病变与背景SUV比率的百分比提高来评估对PET-CT的反应，以50％为截止值。随访6至43个月（平均18.8个月）作为最终结果作为参考。结果：所有17例患者的原发部位FDG摄取均增加。 17例患者中有7例（41.2％）出现转移。淋巴结是转移性疾病最常见的部位，其次是骨，骨髓，肺和脑膜。为了进行反应评估，在CT上发现11/17（64.7％）患者的原发肿瘤大小发生了变化。在PET-CT上有12/17例患者（70.6％）注意到治疗反应。 17例患者中有11例（65％）在CT和PET-CT中均显示出反应。 17例患者中有5例均无反应。一名（5.9％）的患者在CT和PET上发现不一致的结果，其中PET表现出反应，但CT上没有反应。两名有初始反应但有远处转移的患者在随访期间死亡。结论：PET-CT在NB的初始分期中具有潜力。对于基线扫描中FDG摄取量中等和较高的患者，PET-CT似乎也是一种评估反应的好方法。但是，对于低基线FDG摄入量的患者，未见明显的有益作用。

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