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

  • Arnoldo Piccardo
  • Matteo Puntoni
  • Egesta Lopci
  • Massimo Conte
  • Luca Foppiani
  • Stefania Sorrentino
  • Giovanni Morana
  • Mehrdad Naseri
  • Angelina Cistaro
  • Giampiero Villavecchia
  • Stefano Fanti
  • Alberto Garaventa
Original Article
First Online:
Received:
Accepted:

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.

Keywords

Neuroblastoma 123I-MIBG score 18F-DOPA PET Prognostic value 
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Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Arnoldo Piccardo
    • 1
    • 8
  • Matteo Puntoni
    • 2
  • Egesta Lopci
    • 3
  • Massimo Conte
    • 4
  • Luca Foppiani
    • 5
  • Stefania Sorrentino
    • 4
  • Giovanni Morana
    • 6
  • Mehrdad Naseri
    • 1
  • Angelina Cistaro
    • 7
  • Giampiero Villavecchia
    • 1
  • Stefano Fanti
    • 3
  • Alberto Garaventa
    • 4
  1. 1.Nuclear Medicine UnitGalliera HospitalGenoaItaly
  2. 2.Clinical Trial Research UnitGalliera HospitalGenoaItaly
  3. 3.Nuclear Medicine UnitSant’Orsola-Malpighi HospitalBolognaItaly
  4. 4.Department of Hematology-OncologyG. Gaslini Children’s HospitalGenoaItaly
  5. 5.Internal MedicineGalliera HospitalGenoaItaly
  6. 6.Department of Pathology and RadiologyG. Gaslini Children’s HospitalGenoaItaly
  7. 7.PET CentreIRMETTurinItaly
  8. 8.Department of Nuclear MedicineE.O. Ospedali GallieraGenoaItaly

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