Predictive value of FDG PET/CT in pediatric Neuroblastoma patients | ||
| Egyptian Journal Nuclear Medicine | ||
| Article 5, Volume 10, Issue 10 - Serial Number 2, June 2014, Pages 46-59 PDF (527.39 K) | ||
| Document Type: Original Paper, Oncology | ||
| DOI: 10.21608/egyjnm.2014.5452 | ||
| Author | ||
| Mai Amr* | ||
| Lecturer Of nuclear medicine, National Cancer Institute, Cairo University. | ||
| Abstract | ||
| Purpose: To explore the prognostic value of F-18 FDG PET/CT in neuroblastoma patients. Materials and method: comparative study with 63 pathologically proved NB patients with dominating high risk category (~65.1 %) who underwent F- 18 FDG PET/CT using standard technique for purpose of initial, posttherapy or follow up assessment. Clinico-pathological, radiological and follow up data were also collected.Results:FDG uptake level was expressed in terms of maximum standardized uptake of the primary lesion against the maximum standardized uptake of the reference liver activity and maximum standardized uptake of the primary lesion stands alone where ROC curves marked cut off values of 1.95 & 2.05 respectively (both are almost double the reference hepatic activity). The marked cut-off values were tested in respect to the established clinicopathological features and the disease outcome. we found significant relationship between the Shimada classification and FDG uptake level ,using 2.05 (cut-off value of the max SUV of the primary lesion), where 88.9% of those with favorable histology exhibit low FDG tumor uptake , while on the contrary 51.9 % of those with unfavorable histology showed high FDG uptake level exceeding the cut-off value 2.05.The rest of correlation of both cut-off values with the other clinicopathological features showed prevalence of increased primary tumor uptake of FDG (almost equal to or above double the reference hepatic activity) among those with less favorable clinico-pathological features yet was not statistically significant.As a trial to quantitatively evaluate the impact of variable patterns of tracer accumulation on overall survival using the suggested cut off values. Our results revealed higher risk for lower 2 years overall survival with increased tumor accumulation of FDG which was statistically significant when using max SUV of the primary/ max SUV of the hepatic activity cutoff value (1.95) (p-value=0.05) and a trend was seen with max SUV of the primary(p-alue=0.07). CONCLUSION: PET-CT seems a valuable prognostic indicator where higher tracer accumulation of F-18 FDG seems to be linked to unfavorable histology and lower survival. | ||
| Keywords | ||
| FDG PET/CT; neuroblastoma | ||
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