Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2018; 17: 27-34
Показания для сцинтиграфии костей скелета с 99mTc-фосфатными комплексами после сцинтиграфии с 123I-метайодбензилгуанидином у пациентов с нейробластомой
https://doi.org/10.24287/1726-1708-2018-17-4-27-34Аннотация
Сцинтиграфия с метайодбензилгуанидином, меченным 123I (123I-МЙБГ), и сцинтиграфия костей скелета с 99mTc-фосфатными комплексами широко используются для оценки распространенности процесса у пациентов с нейробластомой (НБ). Применение обоих методов приводит к повышению общей лучевой нагрузки на пациента, увеличению занятости оборудования, нагрузки на медперсонал отделения и увеличению расходов, в том числе связанных с проведением анесте- зиологического пособия для большей части пациентов. Целью работы было определение показаний для сцинтиграфии с 99mTc-фосфатными комплексами после сцинтиграфии с 123I-МЙБГ у пациентов с НБ. В ретроспективный анализ были включены 129 пациентов с диагнозом НБ, которым на диагностическом этапе выполняли сцинтиграфию с 123I-МЙБГ и сцинтиграфию костей скелета с 99mTc-фосфатными комплексами. Только у 48 из 83 МЙБГ-позитивных пациентов результаты сцинтиграфии костей скелета были положительными и не имели дополнительного диагностического значения. Однако у 3 из 14 МЙБГ-негативных пациентов с НБ сцинтиграфия костей скелета позволила выявить метастатическое поражение костной ткани. Показания для сцинтиграфии костей скелета с 99mTc-фосфатными комплексами: только для оценки костной ткани у пациентов с первично МЙБГ-негативной НБ, а также те случаи, когда статус накопления МЙБГ
невозможно определить (группа пациентов, у которых сцинтиграфию с МЙБГ выполняют после операции/начала химиотерапии).
Список литературы
1. Louis C.U., Shohet J.M. Neuroblastoma: molecular pathogenesis and therapy. Annu Rev Med 2015; 66: 49–63.
2. Lonergan G.J., Schwab C.M., Suarez E.S., Carlson C.L. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics 2002; 22 (4): 911–34.
3. Park J.R., Eggert A., Caron H. Neuroblastoma: biology, prognosis, and treatment. Hematol Oncol Clin North Am 2010; 24 (1): 65–86.
4. Kaatsch P. Epidemiology of childhood cancer. Cancer Treat Rev 2010; 36 (4): 277–85.
5. DuBois S.G., Kalika Y., Lukens J.N., Brodeur G.M., Seeger R.C., Atkinson J.B., et al. Metastatic sites in stage IV and IVS neuroblastoma correlate with age, tumor biology, and survival. J Pediatr Hematol Oncol 1999; 21 (3): 181–9.
6. Monclair T., Brodeur G.M., Ambros P.F., Brisse H.J., Cecchetto G., Holmes K., et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol 2009; 27 (2): 298–303.
7. Simon T., Hero B., Benz-Bohm G., von Schweinitz D., Berthold F. Review of image defined risk factors in localized neuroblastoma patients: Results of the GPOH NB97 trial. Pediatr Blood Cancer 2008; 50 (5): 965–9.
8. Sharp S.E., Shulkin B.L., Gelfand M.J., Salisbury S., Furman W.L. 123I-MIBG scintigraphy and 18F-FDG PET in neuroblastoma. J Nucl Med 2009; 50 (8): 1237–43.
9. Brisse H.J., McCarville M.B., Granata C., Krug K.B., Wootton-Gorges S.L., Kanegawa K., et al. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International Neuroblastoma Risk Group Project. Radiology 2011; 261 (1): 243–57.
10. Mueller W.P., Coppenrath E., Pfluger T. Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol 2013; 43 (4): 418–27.
11. Mehta K., Haller J.O., Legasto A.C. Imaging neuroblastoma in children. Crit Rev Comput Tomogr 2003; 44 (1): 47– 61.
12. Pfluger T., Schmied C., Porn U., Leinsinger G., Vollmar C., Dresel S., et al. Integrated imaging using MRI and 123I metaiodobenzylguanidine scintigraphy to improve sensitivity and specificity in the diagnosis of pediatric neuroblastoma. AJR Am J Roentgenol 2003; 181 (4): 1115–24.
13. Shulkin B.L., Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.
14. Dumba M., Jawad N., McHugh K. Neuroblastoma and nephroblastoma: a radiological review. Cancer Imaging 2015; 15 (1): 5.
15. Sharp S.E., Trout A.T., Weiss B.D., Gelfand M.J. MIBG in Neuroblastoma Diagnostic Imaging and Therapy. Radiographics 2016; 36 (1): 258–78.
16. Jacobson A.F., Deng H., Lombard J., Lessig H.J., Black R.R. 123I-metaiodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab 2010; 95 (6): 2596–606.
17. Vik T.A., Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C., et al. (123) I-mIBG scintigraphy in patients with known or suspected neuroblastoma: Results from a prospective multicenter trial. Pediatr Blood Cancer 2009; 52 (7): 784–90.
18. Biasotti S., Garaventa A., Villavecchia G.P., Cabria M., Nantron M., De Bernardi B. False-negative metaiodobenzylguanidine scintigraphy at diagnosis of neuroblastoma. Med Pediatr Oncol 2000; 35 (2): 153–5.
19. Gordon I., Peters A.M., Gutman A., Morony S., Dicks-Mireaux C., Pritchard J. Skeletal assessment in neuroblastoma-the pitfalls of iodine-123-MIBG scans. J Nucl Med 1990; 31 (2): 129–34.
20. Turba E., Fagioli G., Mancini A.F., Rosito P., Galli A., Alvisi P. Evaluation of stage 4 neuroblastoma patients by means of MIBG and 99mTc-MDP scintigraphy. J Nucl Biol Med 1993; 37 (3): 107–14.
21. Ladenstein R., Pötschger U., Pearson A.D.J., Brock P., Luksch R., Castel V., et al. Busulfan and melphalan versus carboplatin, etoposide, and melphalan as high-dose chemotherapy for high-risk neuroblastoma (HR-NBL1/SIOPEN): an international, randomised, multi-arm, open-label, phase 3 trial. Lancet Oncol 2017; 18 (4): 500–14.
22. Gauguet J.M., Pace-Emerson T., Grant F.D., Shusterman S., DuBois S.G., Frazier A.L., et al. Evaluation of the utility of 99mTc-MDP bone scintigraphy versus MIBG scintigraphy and cross-sectional imaging for staging patients with neuroblastoma. Pediatr Blood Cancer 2017; 864 (11): 1–7.
Pediatric Hematology/Oncology and Immunopathology. 2018; 17: 27-34
Indication of 99mTc-MDP bone scan after 123I-MIBG scintigraphy in patients with neuroblastoma
https://doi.org/10.24287/1726-1708-2018-17-4-27-34Abstract
123I-MIBG (metaiodobenzylguanidine) scintigraphy and 99mTc-MDP bone scintigraphy (bone scan) are widely used in diagnosis and staging of NB. Consecutively using both methods lead to overall radiation exposure. As most of the patients need additional anesthesia to perform these diagnostic procedures, which accordingly increase the side effect, workload and expenditure. To minimize the exposure, side effect, workload and expenditure, we set the tasks to optimize the diagnostic algorithm. Determine the indications of bone scan after 123I-MIBG scintigraphy. Materials and Methods: 129 patients with NB were included in retrospective study who underwent both diagnostic procedures at interval of less than 30 days at the stage of initial diagnostic procedure using standard protocols. Out of 83 MIBG positive patients bone scan was able to detect metastatic lesions only in 48 patients. However, bone scan had revealed metastatic lesions in 3 out of 14 MIBG-negative patients. Bone scan is indicated only in MIBG-negative neuroblastoma patients; and in cases where the MIBG uptake cannot be determined for example after operative treatment or after starting of chemotherapy.
References
1. Louis C.U., Shohet J.M. Neuroblastoma: molecular pathogenesis and therapy. Annu Rev Med 2015; 66: 49–63.
2. Lonergan G.J., Schwab C.M., Suarez E.S., Carlson C.L. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics 2002; 22 (4): 911–34.
3. Park J.R., Eggert A., Caron H. Neuroblastoma: biology, prognosis, and treatment. Hematol Oncol Clin North Am 2010; 24 (1): 65–86.
4. Kaatsch P. Epidemiology of childhood cancer. Cancer Treat Rev 2010; 36 (4): 277–85.
5. DuBois S.G., Kalika Y., Lukens J.N., Brodeur G.M., Seeger R.C., Atkinson J.B., et al. Metastatic sites in stage IV and IVS neuroblastoma correlate with age, tumor biology, and survival. J Pediatr Hematol Oncol 1999; 21 (3): 181–9.
6. Monclair T., Brodeur G.M., Ambros P.F., Brisse H.J., Cecchetto G., Holmes K., et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol 2009; 27 (2): 298–303.
7. Simon T., Hero B., Benz-Bohm G., von Schweinitz D., Berthold F. Review of image defined risk factors in localized neuroblastoma patients: Results of the GPOH NB97 trial. Pediatr Blood Cancer 2008; 50 (5): 965–9.
8. Sharp S.E., Shulkin B.L., Gelfand M.J., Salisbury S., Furman W.L. 123I-MIBG scintigraphy and 18F-FDG PET in neuroblastoma. J Nucl Med 2009; 50 (8): 1237–43.
9. Brisse H.J., McCarville M.B., Granata C., Krug K.B., Wootton-Gorges S.L., Kanegawa K., et al. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International Neuroblastoma Risk Group Project. Radiology 2011; 261 (1): 243–57.
10. Mueller W.P., Coppenrath E., Pfluger T. Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol 2013; 43 (4): 418–27.
11. Mehta K., Haller J.O., Legasto A.C. Imaging neuroblastoma in children. Crit Rev Comput Tomogr 2003; 44 (1): 47– 61.
12. Pfluger T., Schmied C., Porn U., Leinsinger G., Vollmar C., Dresel S., et al. Integrated imaging using MRI and 123I metaiodobenzylguanidine scintigraphy to improve sensitivity and specificity in the diagnosis of pediatric neuroblastoma. AJR Am J Roentgenol 2003; 181 (4): 1115–24.
13. Shulkin B.L., Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.
14. Dumba M., Jawad N., McHugh K. Neuroblastoma and nephroblastoma: a radiological review. Cancer Imaging 2015; 15 (1): 5.
15. Sharp S.E., Trout A.T., Weiss B.D., Gelfand M.J. MIBG in Neuroblastoma Diagnostic Imaging and Therapy. Radiographics 2016; 36 (1): 258–78.
16. Jacobson A.F., Deng H., Lombard J., Lessig H.J., Black R.R. 123I-metaiodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab 2010; 95 (6): 2596–606.
17. Vik T.A., Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C., et al. (123) I-mIBG scintigraphy in patients with known or suspected neuroblastoma: Results from a prospective multicenter trial. Pediatr Blood Cancer 2009; 52 (7): 784–90.
18. Biasotti S., Garaventa A., Villavecchia G.P., Cabria M., Nantron M., De Bernardi B. False-negative metaiodobenzylguanidine scintigraphy at diagnosis of neuroblastoma. Med Pediatr Oncol 2000; 35 (2): 153–5.
19. Gordon I., Peters A.M., Gutman A., Morony S., Dicks-Mireaux C., Pritchard J. Skeletal assessment in neuroblastoma-the pitfalls of iodine-123-MIBG scans. J Nucl Med 1990; 31 (2): 129–34.
20. Turba E., Fagioli G., Mancini A.F., Rosito P., Galli A., Alvisi P. Evaluation of stage 4 neuroblastoma patients by means of MIBG and 99mTc-MDP scintigraphy. J Nucl Biol Med 1993; 37 (3): 107–14.
21. Ladenstein R., Pötschger U., Pearson A.D.J., Brock P., Luksch R., Castel V., et al. Busulfan and melphalan versus carboplatin, etoposide, and melphalan as high-dose chemotherapy for high-risk neuroblastoma (HR-NBL1/SIOPEN): an international, randomised, multi-arm, open-label, phase 3 trial. Lancet Oncol 2017; 18 (4): 500–14.
22. Gauguet J.M., Pace-Emerson T., Grant F.D., Shusterman S., DuBois S.G., Frazier A.L., et al. Evaluation of the utility of 99mTc-MDP bone scintigraphy versus MIBG scintigraphy and cross-sectional imaging for staging patients with neuroblastoma. Pediatr Blood Cancer 2017; 864 (11): 1–7.
