Feasibility of 18 F-DOPA and 18 F-FDG PET/CT for guiding decision-making for localized incidental neuroblastoma in infants under 18 months of age.

Autor: Hung WT; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan., Liu CJ; Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan., Liu YL; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University and Taipei Medical University Hospital, Taipei, Taiwan.; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan., Ko KY; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.; Department of Nuclear Medicine, National Taiwan University Cancer Center, Taipei, Taiwan., Chou SW; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan., Chang HH; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan., Yang YL; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan., Lu MY; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan., Hsu WM; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2024 Jul; Vol. 71 (7), pp. e30983. Date of Electronic Publication: 2024 Apr 11.
DOI: 10.1002/pbc.30983
Abstrakt: Background: Neuroblastoma varies widely in risk. Risk indicators in infants with incidental neuroblastoma refine treatment confidence for observation or intervention. The potential of functional imaging, particularly PET/CT, remains to be defined.
Procedure: A retrospective review of infants under 18 months diagnosed with incidental neuroblastoma from 2008 to May 2022 in our institute was conducted. Before October 2015, incidental patients were treated similarly to symptomatic cases, undergoing biopsy or surgical excision upon diagnosis (early cohort). Post October 2015 (late cohort), treatment decisions were guided by PET/CT findings, with 18 F-DOPA PET/CT confirming diagnosis and staging. For tumors with low 18 F-FDG uptake, an expectant observation approach was considered. Patient characteristics, diagnostic methods, image findings at diagnosis, treatment courses, and responses were compared between cohorts.
Results: Thirty infants less than 18 months were identified with incidental neuroblastoma and completed PET/CT at diagnosis. The early and late cohorts each comprised 15 patients. In the late cohort, nine out of 15 patients (60%) presented with localized FDG non-avid tumors were offered the option of expectant observation. Of these, seven patients opted for observation, thereby avoiding surgery. Treatment outcomes were comparable between early and late cohorts, except for one mortality of a patient who, despite showing 18 F-FDG activity, declined treatment.
Conclusions: This study demonstrates the potential utility of 18 F-DOPA and 18 F-FDG PET/CT scans in aiding clinical decision-making for infants with localized, incidental neuroblastoma. Given the concerns regarding radiation exposure, such imaging may be valuable for cases with suspected metastasis, initial large tumor size, or growth during follow-up.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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