18 F-FDG PET as a single imaging modality in pediatric neuroblastoma: comparison with abdomen CT and bone scintigraphy
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ORIGINAL ARTICLE
18
F-FDG PET as a single imaging modality in pediatric neuroblastoma: comparison with abdomen CT and bone scintigraphy
Yun Jung Choi • Hee Sung Hwang • Hyun Jeong Kim • Yong Hyu Jeong • Arthur Cho • Jae Hoon Lee • Mijin Yun Jong Doo Lee • Won Jun Kang
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Received: 7 October 2013 / Accepted: 13 January 2014 Ó The Japanese Society of Nuclear Medicine 2014
Abstract Objective The purpose of this study was to evaluate the diagnostic performance of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a single imaging agent in neuroblastoma in comparison with other imaging modalities. Methods A total of 30 patients with pathologically proven neuroblastoma who underwent FDG PET for staging were enrolled. Diagnostic performance of FDG PET and abdomen CT was compared in detecting soft tissue lesions. FDG PET and bone scintigraphy (BS) were compared in bone metastases. Maximal standardized uptake value (SUVmax) of primary or recurrent lesions was calculated for quantitative analysis. Results Tumor FDG uptake was detected in 29 of 30 patients with primary neuroblastoma. On initial FDG PET, SUVmax of primary lesions were lower in early stage (I– II) than in late stage (III–IV) (3.03 vs. 5.45, respectively, p = 0.019). FDG PET was superior to CT scan in detecting distant lymph nodes (23 vs. 18 from 23 lymph nodes). FDG PET showed higher accuracy to identify bone metastases than BS both on patient-based analyses (100 vs. 94.4 % in Y. J. Choi H. S. Hwang Department of Nuclear Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea H. J. Kim Y. H. Jeong A. Cho J. H. Lee M. Yun J. D. Lee W. J. Kang Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea W. J. Kang (&) Division of Nuclear Medicine, Department of Radiology, Yonsei University College of Medicine, Seongsanno 250, Seodaemun-gu, Seoul 120-752, Korea e-mail: [email protected]
sensitivity, 100 vs. 77.8 % in specificity), and on lesionbased analyses (FDG PET: 203 lesions, BS: 86 lesions). Sensitivity and specificity of FDG PET to detect recurrence were 87.5 % and 93.8, respectively. Conclusion FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma. BS might be eliminated in the evaluation of neuroblastoma when FDG PET is performed. Keywords Neuroblastoma 18F-fluoro-2-deoxy-Dglucose positron emission tomography (18F-FDG PET) Bone metastasis Bone scintigraphy
Introduction Neuroblastoma is the most common solid extracranial malignancy of childhood [1]. Primary neuroblastoma can arise from the pelvis to the neck [2], but adrenal medulla is the most common primary site for neuroblastoma. In approximately 70 % of patients, metastasis is present at the time of diagnosis and most commonly involves cortical bone and bone marrow (BM). Less frequently, there is involvement of liver, skin, and lung [3, 4]. Accurate staging at the time of diagnosis is the most important factor to determine treatmen
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