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Prognostic value of 18F-DOPA PET/CT at the time of recurrence in patients affected by neuroblastoma

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Abstract

Purpose

The aim of this study was to investigate the relationship between 123I-metaiodobenzylguanidine (MIBG) scan semi-quantification and a new 18F-DOPA positron emission tomography (PET)/CT score in patients with suspected or documented neuroblastoma (NB) relapse and to assess the association between these two parameters and progression-free survival (PFS)/overall survival (OS).

Methods

We analysed 24 NB patients who had undergone 123I-MIBG and 18F-DOPA PET/CT scans at the time of suspected relapse, after applying a proper scoring system for each scan. In time-to-event analyses, the score distributions were regarded as continuous and were categorized in tertiles and medians. We used Kaplan-Meier curves and Cox proportional hazard models for PFS and OS in order to estimate the independent prognostic impact of 123I-MIBG and 18F-DOPA PET/CT scans.

Results

The 123I-MIBG and 18F-DOPA scores were highly and positively correlated (Spearman’s rho = 0.8, p < 0.001). Over a median follow-up of 14 months (range 6–82), 12 cases of disease progression and 6 deaths occurred. Multivariate Cox models showed a higher risk of disease progression [hazard ratio (HR) 17.0, 95 % confidence interval (CI) 2.7–109] in NB patients with 123I-MIBG score > 3 (3rd tertile) and an even higher risk (HR:37.2, 95 % CI 2.4–574) in those with 18F-DOPA whole-body metabolic burden (WBMB) >7.5 (median), after adjustment for all main clinical/pathological factors considered. Kaplan-Meier analyses showed a significant association with OS (log-rank p = 0.01 and p = 0.03 for 123I-MIBG and 18F-DOPA WBMB, respectively).

Conclusion

Our results confirm the good agreement between 18F-DOPA PET/CT and 123I-MIBG scan in patients affected by NB relapse. In time-to-event analyses, 123I-MIBG scan and 18F-DOPA PET/CT scores were independently and significantly associated with disease progression.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Galliera Hospital, Genoa, Italy

    Arnoldo Piccardo, Mehrdad Naseri & Giampiero Villavecchia

  2. Clinical Trial Research Unit, Galliera Hospital, Genoa, Italy

    Matteo Puntoni

  3. Nuclear Medicine Unit, Sant’Orsola-Malpighi Hospital, Bologna, Italy

    Egesta Lopci & Stefano Fanti

  4. Department of Hematology-Oncology, G. Gaslini Children’s Hospital, Genoa, Italy

    Massimo Conte, Stefania Sorrentino & Alberto Garaventa

  5. Internal Medicine, Galliera Hospital, Genoa, Italy

    Luca Foppiani

  6. Department of Pathology and Radiology, G. Gaslini Children’s Hospital, Genoa, Italy

    Giovanni Morana

  7. PET Centre, IRMET, Turin, Italy

    Angelina Cistaro

  8. Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128, Genoa, Italy

    Arnoldo Piccardo

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  1. Arnoldo Piccardo
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Correspondence to Arnoldo Piccardo.

Additional information

Stefano Fanti and Alberto Garaventa share senior co-authorship.

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Piccardo, A., Puntoni, M., Lopci, E. et al. Prognostic value of 18F-DOPA PET/CT at the time of recurrence in patients affected by neuroblastoma. Eur J Nucl Med Mol Imaging 41, 1046–1056 (2014). https://doi.org/10.1007/s00259-014-2691-0

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  • DOI: https://doi.org/10.1007/s00259-014-2691-0

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