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Value of SPECT/CT in Diagnostic I-131 MIBG Scintigraphy in Patients with Neuroblastoma

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Abstract

Purpose

Diagnostic I-131 MIBG scintigraphy is an important imaging modality for evaluation of patients with neuroblastoma (NB) especially in centers where I-123 MIBG is not available. Single photon emission computed tomography/computed tomography (SPECT/CT) could potentially improve lesion detection over planar scintigraphy, but studies regarding its usefulness as an add-on to diagnostic I-131 MIBG scintigraphy are limited. This study aimed to determine the usefulness and factors related to usefulness of SPECT/CT in diagnostic I-131 MIBG scintigraphy in NB patients.

Methods

Usefulness of SPECT/CT for lesion detection, lesion localization, resolving suspicious findings, and clarifying the nature of lesions on anatomical imaging were retrospectively reviewed in 86 diagnostic planar I-131 MIBG scintigrams with add-on SPECT/CT.

Results

SPECT/CT detected additional lesions in 23.2%(20/86), helped localize lesions in 21.1%(8/38), resolved suspicious findings in 85.7%(6/7), determined functional status of lesions on anatomical imaging in 94.4%(17/18), and changed diagnosis from a negative to a positive study in 19.5%(8/41). Independent predictors of SPECT/CT being useful included presence of suspicious findings on planar imaging (OR 99.08; 95% C.I. 6.99–1404.41; p = 0.001), positive findings on planar imaging (OR 4.61; 95% C.I. 1.05, 20.28; p < 0.001), and presence of structural lesions on anatomical imaging (OR 32.54; 95% C.I. 5.37–196.96; p < 0.001).

Conclusion

SPECT/CT is a useful add-on to diagnostic planar I-131 MIBG scintigraphy. Predictors of usefulness of SPECT/CT include suspicious or positive findings on planar scintigraphy and the presence of structural lesions on anatomical imaging.

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References

  1. Heck JE, Ritz B, Hung RJ, Hashibe M, Boffetta P. The epidemiology of neuroblastoma: a review. Paediatr Perinat Epidemiol. 2009;23:125–43.

    Article  PubMed  Google Scholar 

  2. Cohn SL, Pearson ADJ, London WB, Monclair T, Ambros PF, Brodeur GM, et al. The international neuroblastoma risk group (INRG) classification system: an INRG task force report. J Clin Oncol. 2009;27:289–97.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Brisse HJ, McCarville MB, Granata C, Krug KB, Wootton-Gorges SL, Kanegawa K, et al. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the international neuroblastoma risk group project. Radiology. 2011;261:243–57.

    Article  PubMed  Google Scholar 

  4. Bombardieri E, Giammarile F, Aktolun C, Baum RP, Bischof Delaloye A, Maffioli L, et al. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37:2436–46.

    Article  PubMed  Google Scholar 

  5. Parisi MT, Eslamy H, Park JR, Shulkin BL, Yanik GA. 131I-Metaiodobenzylguanidine theranostics in neuroblastoma: historical perspectives; practical applications. Semin Nucl Med. 2016;46:184–202.

    Article  PubMed  Google Scholar 

  6. Feine U, Müller-Schauenburg W, Treuner J, Klingebiel T. Metaiodobenzylguanidine (MIBG) labeled with 123I/131I in neuroblastoma diagnosis and follow-up treatment with a review of the diagnostic results of the international workshop of pediatric oncology held in Rome, September 1986. Med Pediatr Oncol. 1987;15:181–7.

    Article  CAS  PubMed  Google Scholar 

  7. Jacobson AF, Deng H, Lombard J, Lessig HJ, Black RR. 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab. 2010;95:2596–606.

    Article  CAS  PubMed  Google Scholar 

  8. Bleeker G, Tytgat GAM, Adam JA, Caron HN, Kremer LCM, Hooft L, et al. 123I-MIBG scintigraphy and 18F-FDG-PET imaging for diagnosing neuroblastoma. Cochrane Database Syst Rev. 2015;9. https://doi.org/10.1002/14651858.CD009263.pub2.

  9. Kushner BH, Kramer K, Modak S, Cheung N-KV. Sensitivity of surveillance studies for detecting asymptomatic and unsuspected relapse of high-risk neuroblastoma. J Clin Oncol. 2009;27:1041–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Franzius C, Hermann K, Weckesser M, Kopka K, Juergens KU, Vormoor J, et al. Whole-body PET/CT with 11C-meta-hydroxyephedrine in tumors of the sympathetic nervous system: feasibility study and comparison with 123I-MIBG SPECT/CT. J Nucl Med. 2006;47:1635–42.

    PubMed  Google Scholar 

  11. Fukuoka M, Taki J, Mochizuki T, Kinuya S. Comparison of diagnostic value of I-123 MIBG and high-dose I-131 MIBG scintigraphy including incremental value of SPECT/CT over planar image in patients with malignant pheochromocytoma/paraganglioma and neuroblastoma. Clin Nucl Med. 2011;36:1–7.

    Article  PubMed  Google Scholar 

  12. Rozovsky K, Koplewitz BZ, Krausz Y, Revel-Vilk S, Weintraub M, Chisin R, et al. Added value of SPECT/CT for correlation of MIBG scintigraphy and diagnostic CT in neuroblastoma and pheochromocytoma. Am J Roentgenol. 2008;190:1085–90.

    Article  Google Scholar 

  13. Meyer-Rochow GY, Schembri GP, Benn DE, Sywak MS, Delbridge LW, Robinson BG, et al. The utility of metaiodobenzylguanidine single photon emission computed tomography/computed tomography (MIBG SPECT/CT) for the diagnosis of pheochromocytoma. Ann Surg Oncol. 2010;17(2):392–400.

    Article  PubMed  Google Scholar 

  14. Nadel HR. SPECT /CT in pediatric patient management. Eur J Nucl Med Mol Imaging. 2014;41(Suppl 1):S104–14.

    Article  PubMed  Google Scholar 

  15. Rufini V, Giordano A, Di Giuda D, Petrone A, Deb G, De Sio L, et al. [123I]MIBG scintigraphy in neuroblastoma: a comparison between planar and SPECT imaging. Q J Nucl Med. 1995;39:25–8.

    CAS  PubMed  Google Scholar 

  16. Gelfand MJ, Elgazzar AH, Kriss VM, Masters PR, Golsch GJ. Iodine-123-MIBG SPECT versus planar imaging in children with neural crest tumors. J Nucl Med. 1994;35:1753–7.

    CAS  PubMed  Google Scholar 

  17. Černý I, Prášek J, Kašpárková H. Superiority of SPECT/CT over planar 123I-mIBG images in neuroblastoma patients with impact on Curie and SIOPEN score values. Nuklearmedizin. 2016;55:151–7.

    Article  PubMed  Google Scholar 

  18. Dhull VS, Sharma P, Patel C, Kundu P, Agarwala S, Bakhshi S, et al. Diagnostic value of 18F-FDG PET/CT in paediatric neuroblastoma: comparison with 131I-MIBG scintigraphy. Nucl Med Commun. 2015;36:1007–13.

    Article  PubMed  Google Scholar 

  19. Dessner DA, DiPietro MA, Shulkin BL. MIBG detection of hepatic neuroblastoma: correlation with CT, US and surgical findings. Pediatr Radiol. 1993;23:276–80.

    Article  CAS  PubMed  Google Scholar 

  20. Rufini V, Fisher GA, Shulkin BL, Sisson JC, Shapiro B. Iodine-123-MIBG imaging of neuroblastoma: utility of SPECT and delayed imaging. J Nucl Med. 1996;37:1464–8.

    CAS  PubMed  Google Scholar 

  21. Maurea S, Fiumara G, Pellegrino T, Zampella E, Assante R, Mainenti P, et al. MIBG molecular imaging for evaluating response to chemotherapy in patients with malignant pheochromocytoma: preliminary results. Cancer Imaging. 2013;13:155–61.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Maurea S, Lastoria S, Caracò C, Indolfi P, Casale F, di Tullio MT, et al. Iodine-131-MIBG imaging to monitor chemotherapy response in advanced neuroblastoma: comparison with laboratory analysis. J Nucl Med. 1994;35:1429–35.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp highway, Muang, Khon Kaen, 40002, Thailand

    Daris Theerakulpisut, Yutapong Raruenrom, Nantaporn Wongsurawat & Charoonsak Somboonporn

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  1. Daris Theerakulpisut
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  2. Yutapong Raruenrom
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  3. Nantaporn Wongsurawat
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  4. Charoonsak Somboonporn
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Correspondence to Daris Theerakulpisut.

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Conflict of Interest

Daris Theerakulpisut, Yutapong Raruenrom, Nantaporn Wongsurawat, and Charoonsak Somboonporn declare that they have no conflict of interest. No funding was received for conduction of this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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Theerakulpisut, D., Raruenrom, Y., Wongsurawat, N. et al. Value of SPECT/CT in Diagnostic I-131 MIBG Scintigraphy in Patients with Neuroblastoma. Nucl Med Mol Imaging 52, 350–358 (2018). https://doi.org/10.1007/s13139-018-0532-y

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  • DOI: https://doi.org/10.1007/s13139-018-0532-y

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