[18F]mFBG PET-CT for detection and localisation of neuroblastoma: a prospective pilot study,European Journal of Nuclear Medicine and Molecular Imaging

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[18F]mFBG PET-CT for detection and localisation of neuroblastoma: a prospective pilot study
European Journal of Nuclear Medicine and Molecular Imaging ( IF 8.6 ) Pub Date : 2022-12-12 , DOI: 10.1007/s00259-022-06063-6
Atia Samim _{1,

2} , Thomas Blom _{1,

2} , Alex J Poot _{1,

2} , Albert D Windhorst ₃ , Marta Fiocco _{1,

4} , Nelleke Tolboom _{1,

2} , Arthur J A T Braat _{1,

2} , Sebastiaan L Meyer Viol _{1,

2} , Rob van Rooij _{1,

2} , Max M van Noesel _{1,

2} , Marnix G E H Lam _{1,

2} , Godelieve A M Tytgat _{1,

2} , Bart de Keizer _{1,

2}

Affiliation

Purpose

Meta-[¹⁸F]fluorobenzylguanidine ([¹⁸F]mFBG) is a positron emission tomography (PET) radiotracer that allows for fast and high-resolution imaging of tumours expressing the norepinephrine transporter. This pilot study investigates the feasibility of [¹⁸F]mFBG PET-CT for imaging in neuroblastoma.

Methods

In a prospective, single-centre study, we recruited children with neuroblastoma, referred for meta-[¹²³I]iodobenzylguanidine ([¹²³I]mIBG) scanning, consisting of total body planar scintigraphy in combination with single-photon emission computed tomography-CT (SPECT-CT). Within two weeks of [¹²³I]mIBG scanning, total body PET-CTs were performed at 1 h and 2 h after injection of [¹⁸F]mFBG (2 MBq/kg). Detected tumour localisations on scan pairs were compared. Soft tissue disease was quantified by number of lesions and skeletal disease by SIOPEN score.

Results

Twenty paired [¹²³I]mIBG and [¹⁸F]mFBG scans were performed in 14 patients (median age 4.9 years, n = 13 stage 4 disease and n = 1 stage 4S). [¹⁸F]mFBG injection was well tolerated and no related adverse events occurred in any of the patients. Mean scan time for [¹⁸F]mFBG PET-CT (9.0 min, SD 1.9) was significantly shorter than for [¹²³I]mIBG scanning (84.5 min, SD 10.5), p < 0.01. Most tumour localisations were detected on the 1 h versus 2 h post-injection [¹⁸F]mFBG PET-CT. Compared to [¹²³I]mIBG scanning, [¹⁸F]mFBG PET-CT detected a higher, equal, and lower number of soft tissue lesions in 40%, 55%, and 5% of scan pairs, respectively, and a higher, equal, and lower SIOPEN score in 55%, 30%, and 15% of scan pairs, respectively. On average, two more soft tissue lesions and a 6-point higher SIOPEN score were detected per patient on [¹⁸F]mFBG PET-CT compared to [¹²³I]mIBG scanning.

Conclusion

Results of this study demonstrate feasibility of [¹⁸F]mFBG PET-CT for neuroblastoma imaging. More neuroblastoma localisations were detected on [¹⁸F]mFBG PET-CT compared to [¹²³I]mIBG scanning. [¹⁸F]mFBG PET-CT shows promise for future staging and response assessment in neuroblastoma.

Trial registration

Dutch Trial Register NL8152.

中文翻译：

[18F]mFBG PET-CT 用于检测和定位神经母细胞瘤：一项前瞻性试点研究

目的

间位-[ ¹⁸ F] 氟苄基胍 ([ ¹⁸ F]mFBG) 是一种正电子发射断层扫描 (PET) 放射性示踪剂，可对表达去甲肾上腺素转运蛋白的肿瘤进行快速高分辨率成像。^{该初步研究调查了 [ 18} F]mFBG PET-CT 在神经母细胞瘤中成像的可行性。

方法

在一项前瞻性单中心研究中，我们招募了患有神经母细胞瘤的儿童，转诊进行间[ 123 ^I ] 碘代苄基胍 ([ ¹²³ I]mIBG) 扫描，包括全身平面闪烁扫描结合单光子发射计算机断层扫描-CT （SPECT-CT）。^{在 [ 123} I]mIBG 扫描的两周内，在注射 [ ¹⁸ F]mFBG (2 MBq/kg)后 1 小时和 2 小时进行全身 PET-CT 。比较扫描对上检测到的肿瘤定位。软组织疾病通过 SIOPEN 评分的病变数量和骨骼疾病进行量化。

结果

对 14 名患者（中位年龄 4.9 岁， n = 13 名 4 期疾病和n = 1 名 4S 期）进行了20 对 [ ¹²³ I]mIBG 和 [ ^{18 F]mFBG 扫描。}[ ¹⁸ F]mFBG 注射耐受性良好，所有患者均未发生相关不良事件。^{[ 18} F]mFBG PET-CT的平均扫描时间（9.0 分钟，SD 1.9）明显短于 [ ¹²³ I]mIBG 扫描（84.5 分钟，SD 10.5），p < 0.01。大多数肿瘤定位是在注射后 1 小时和注射后 2 小时检测到的 [ ¹⁸ F]mFBG PET-CT。与 [ ¹²³ I]mIBG 扫描相比，[ ¹⁸F]mFBG PET-CT 分别在 40%、55% 和 5% 的扫描对中检测到较高、相等和较低数量的软组织病变，在 55%、30% 的扫描对中检测到较高、相等和较低的 SIOPEN 评分％和 15％的扫描对，分别。^{与 [ 123} I]mIBG 扫描相比，[ ¹⁸ F]mFBG PET-CT平均每名患者多检测到两个软组织病变和高 6 分的 SIOPEN 评分。