Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2021; 20: 22-32
Значение протокола однофотонной эмиссионной компьютерной томографии, совмещенной с компьютерной томографией, при сцинтиграфии с ¹²³I-метайодбензилгуанидином у детей с нейробластомой
https://doi.org/10.24287/1726-1708-2021-20-4-22-32Аннотация
Сцинтиграфия с ¹²³I-метайодбензилгуанидином (¹²³I-МЙБГ) в режиме «все тело» является важнейшим методом исследования у пациентов с нейробластомой (НБ). Из-за особенных физических характеристик получения планарных сцинтиграмм с ¹²³I-МЙБГ существуют некоторые трудности при интерпретации полученных изображений. Так, низкое пространственное разрешение планарных сцинтиграмм может быть причиной ложноотрицательного результата у пациентов с образованиями малых размеров, а физиологическое накопление МЙБГ далеко не всегда легко дифференцировать от патологического, что может стать причиной ложноположительного результата. Выполнение протокола однофотонной эмиссионной компьютерной томографии, совмещенной с компьютерной томографией (ОФЭКТ/КТ), позволяет получить более точную диагностическую информацию за счет прямого совмещения морфологических и функциональных данных, но имеет и некоторые недостатки, наиболее важными из которых являются значительное увеличение времени исследования и дополнительная лучевая нагрузка от КТ. Целью работы стало определение диагностической значимости протокола ОФЭКТ/КТ после проведения планарной сцинтиграфии в режиме «все тело» у пациентов с НБ на этапе инициальной диагностики. Данное исследование одобрено независимым этическим комитетом и утверждено решением ученого совета НМИЦ ДГОИ им. Дмитрия Рогачева. В ретроспективный анализ включен 251 пациент с НБ, которым в дополнение к планарным сцинтиграммам в режиме «все тело» был выполнен протокол ОФЭКТ/КТ области интереса. В 72,1% случаев ОФЭКТ/КТ не показала какой-либо значимой дополнительной информации по сравнению с планарными изображениями в режиме «все тело». Однако в 27,9% случаев результаты ОФЭКТ/КТ имели значимую диагностическую информацию. В нашем исследовании полученные заключения на основе планарных изображений требовали пересмотра и уточнения с помощью ОФЭКТ/КТ у 70 из 251 пациента, что имело клиническое значение.
Список литературы
1. Heck J.E., Ritz B., Hung R.J., Hashibe M., Boffetta P. The epidemiology of neuroblastoma: a review. Paediatr Perinat Epidemiol 2009; 23 (2): 125–43. DOI: 10.1111/j.1365-3016.2008.00983.x
2. Cohn S.L., Pearson A.D.J., London W.B., Monclair T., Ambros P.A., Brodeur G.M., et al. The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol 2009; 27 (2): 289–97. DOI: 10.1200/JCO.2008.16.6785
3. 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. DOI: 10.1097/00043426-199905000-00005
4. 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. DOI: 10.1148/radiol.11101352
5. Mueller W.P., Coppenrath E., Pfluger T. Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol 2013; 43 (4): 418–27. DOI: 10.1007/s00247-012-2512-1
6. Jacobson A.F., Deng H., Lombard J., Lessig H.J., Black R.R. 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab 2010; 95 (6): 2596–606. DOI: 10.1210/jc.2009-2604
7. 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. DOI: 10.1148/rg.2016150099
8. Shulkin B.L., Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.
9. Vik T.A., Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C.A., 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. DOI: 10.1002/pbc.21932
10. Boubaker A., Bischof Delaloye A. MIBG scintigraphy for the diagnosis and follow-up of children with neuroblastoma. Q J Nucl Med Mol Imaging 2008; 52 (4): 388–402.
11. Decarolis B., Schneider C., Hero B., Simon T., Volland R., Roels F., et al. Iodine-123 metaiodobenzylguanidine scintigraphy scoring allows prediction of outcome in patients with stage 4 neuroblastoma: results of the Cologne interscore comparison study. J Clin Oncol 2013; 31 (7): 944–51. DOI: 10.1200/JCO.2012.45.8794
12. DuBois S.G., Mody R., Naranjo A., Van Ryn C., Russ D., Oldridge D., et al. MIBG avidity correlates with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children’s Oncology Group. Pediatr Blood Cancer 2017; 64 (11): 10.1002/pbc.26545. DOI: 10.1002/pbc.26545
13. Lewington V., Lambert B., Poetschger U., Bar Sever Z., Giammarline F., McEwan A.J.B., et al. (123)I-mIBG scintigraphy in neuroblastoma: development of a SIOPEN semi-quantitative reporting ,method by an international panel. Eur J Nucl Med Mol Imaging 2017; 44 (2): 234–41. DOI: 10.1007/s00259-016-3516-0
14. Yanik G.A., Parisi M.T., Shulkin B.L., Naranjo A., Kreissman S.G., London W.B., et al. Semiquantitative mIBG scoring as a prognostic indicator in patients with stage 4 neuroblastoma: a report from the Children’s oncology group. J Nucl Med 2013; 54 (4): 541–8. DOI: 10.2967/jnumed.112.112334
15. Pirson A.S., Krug B., Tuerlinckx D., Lacrosse M., Luyx D., Borght T.V., et al. Additional value of I-123 MIBG SPECT in neuroblastoma. Clin Nucl Med 2005; 30 (2): 100–1. DOI: 10.1097/00003072-200502000-00006
16. Fukuoka M., Taki J., Mochizuki T., Kinuya S. Comparison of diagnostic value of I-123 MIBG and high-dose I-131 MIBG scintigraphy including incremental value of SPECT/CT over planar image in patients with malignant pheochromocytoma/paraganglioma and neuroblastoma. Clin Nucl Med 2011; 36 (1): 1–7. DOI: 10.1097/RLU.0b013e3181feeb5e
17. Buck A.K., Nekolla S., Ziegler S., Beer A., Krause B.J., Herrmann K., et al. SPECT/CT. J Nucl Med 2008; 49 (8): 1305–19. DOI: 10.2967/jnumed.107.050195
18. Mariani G., Bruselli L., Kuwert T., Kim E.E., Flotats A., Israel O., et al. A review on the clinical uses of SPECT/ CT. Eur J Nucl Med Mol Imaging 2010; 37 (10): 1959–85. DOI: 10.1007/s00259-010-1390-8
19. Liu B., Servaes S., Zhuang H. SPECT/ CT MIBG Imaging Is Crucial in the Follow-up of the Patients With HighRisk Neuroblastoma. Clin Nucl Med 2018; 43 (4): 232–8. DOI: 10.1097/RLU.0000000000001984
20. Theerakulpisut D., Raruenrom Y., Wongsurawat N., Somboonporn C. Value of SPECT/CT in Diagnostic I-131 MIBG Scintigraphy in Patients with Neuroblastoma. Nucl Med Mol Imaging 2018; 52 (5): 350–8. DOI: 10.1007/s13139-018-0532-y
21. Bar-Sever Z., Biassoni L., Shulkin B., Kong G., Hofman M.S., Lopci E. Guidelines on nuclear medicine imaging in neuroblastoma. Eur J Nucl Med Mol Imaging 2018; 45 (11): 2009–24. DOI: 10.1007/s00259-018-4070-8
22. Кайлаш, Киреева Е.Д., Вдовина И.С., Ядгаров М.Я., Шаманская Т.В., Рощин В.Ю. и др. Неинвазивное определение неблагоприятного гистологического варианта у детей с нейрогенными опухолями по накоплению ¹²³I-МЙБГ с использованием полуколичественной и количественной оценок. Вопросы гематологии/ онкологии и иммунопатологии в педиатрии 2020; 19 (1): 68–78. DOI: 10.24287/1726-1708-2020-19-1-68-78
23. Matthay K.K., Shulkin B., Ladenstein R., Michon J., Giammarile F., Lewington V. Criteria for evaluation of disease extent by (123)I-metaiodobenzylguanidine scans in neuroblastoma: a report for the International Neuroblastoma Risk Group (INRG) Task Force. Br J Cancer 2010; 102 (9): 1319–26. DOI: 10.1038/sj.bjc.6605621
Pediatric Hematology/Oncology and Immunopathology. 2021; 20: 22-32
The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma
https://doi.org/10.24287/1726-1708-2021-20-4-22-32Abstract
The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma
Whole body scintigraphy with ¹²³I-Metaiodobenzylguanidine (¹²³I-MIBG) is an important imaging modality for evaluation of patients with neuroblastoma (NB). As the intrinsic nuclear scintigraphic characteristics, the assessment of conventional planar ¹²³I-MIBG images presents some difficulties. The limited resolution of planar images can induce false-negative results for small lesions, whereas the presence of physiologic MIBG uptake is not always easily differentiable from pathologic uptake and can induce false-positive results. Single-photon emission computed tomography combined with computed tomography (SPECT/ CT) hybrid imaging technique, allowing the direct fusion of morphologic and functional information, has been suggested to be more accurate. However, SPECT/CT imaging renders slightly more radiation to patients from CT portion of the study and is time consuming. The aim of our study was to investigate how much SPECT/CT can have additional diagnostic value over planar imaging in NB patients at initial staging. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. A total of 251 SPECT/CT scans following by planar ¹²³I-MIBG imaging scans performed in 251 patients with NB were retrospectively analyzed. In 72.1% of the studies, the whole-body planar images and SPECT/CT images showed the same result. In 27.9% of studies, however, SPECT/CT images provided additional very important information. In our study, the diagnosis reached by planar imaging was revised or specified by SPECT/CT in 70 of the 251 patients and was clinically significant.
References
1. Heck J.E., Ritz B., Hung R.J., Hashibe M., Boffetta P. The epidemiology of neuroblastoma: a review. Paediatr Perinat Epidemiol 2009; 23 (2): 125–43. DOI: 10.1111/j.1365-3016.2008.00983.x
2. Cohn S.L., Pearson A.D.J., London W.B., Monclair T., Ambros P.A., Brodeur G.M., et al. The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol 2009; 27 (2): 289–97. DOI: 10.1200/JCO.2008.16.6785
3. 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. DOI: 10.1097/00043426-199905000-00005
4. 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. DOI: 10.1148/radiol.11101352
5. Mueller W.P., Coppenrath E., Pfluger T. Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol 2013; 43 (4): 418–27. DOI: 10.1007/s00247-012-2512-1
6. Jacobson A.F., Deng H., Lombard J., Lessig H.J., Black R.R. 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab 2010; 95 (6): 2596–606. DOI: 10.1210/jc.2009-2604
7. 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. DOI: 10.1148/rg.2016150099
8. Shulkin B.L., Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.
9. Vik T.A., Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C.A., 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. DOI: 10.1002/pbc.21932
10. Boubaker A., Bischof Delaloye A. MIBG scintigraphy for the diagnosis and follow-up of children with neuroblastoma. Q J Nucl Med Mol Imaging 2008; 52 (4): 388–402.
11. Decarolis B., Schneider C., Hero B., Simon T., Volland R., Roels F., et al. Iodine-123 metaiodobenzylguanidine scintigraphy scoring allows prediction of outcome in patients with stage 4 neuroblastoma: results of the Cologne interscore comparison study. J Clin Oncol 2013; 31 (7): 944–51. DOI: 10.1200/JCO.2012.45.8794
12. DuBois S.G., Mody R., Naranjo A., Van Ryn C., Russ D., Oldridge D., et al. MIBG avidity correlates with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children’s Oncology Group. Pediatr Blood Cancer 2017; 64 (11): 10.1002/pbc.26545. DOI: 10.1002/pbc.26545
13. Lewington V., Lambert B., Poetschger U., Bar Sever Z., Giammarline F., McEwan A.J.B., et al. (123)I-mIBG scintigraphy in neuroblastoma: development of a SIOPEN semi-quantitative reporting ,method by an international panel. Eur J Nucl Med Mol Imaging 2017; 44 (2): 234–41. DOI: 10.1007/s00259-016-3516-0
14. Yanik G.A., Parisi M.T., Shulkin B.L., Naranjo A., Kreissman S.G., London W.B., et al. Semiquantitative mIBG scoring as a prognostic indicator in patients with stage 4 neuroblastoma: a report from the Children’s oncology group. J Nucl Med 2013; 54 (4): 541–8. DOI: 10.2967/jnumed.112.112334
15. Pirson A.S., Krug B., Tuerlinckx D., Lacrosse M., Luyx D., Borght T.V., et al. Additional value of I-123 MIBG SPECT in neuroblastoma. Clin Nucl Med 2005; 30 (2): 100–1. DOI: 10.1097/00003072-200502000-00006
16. Fukuoka M., Taki J., Mochizuki T., Kinuya S. Comparison of diagnostic value of I-123 MIBG and high-dose I-131 MIBG scintigraphy including incremental value of SPECT/CT over planar image in patients with malignant pheochromocytoma/paraganglioma and neuroblastoma. Clin Nucl Med 2011; 36 (1): 1–7. DOI: 10.1097/RLU.0b013e3181feeb5e
17. Buck A.K., Nekolla S., Ziegler S., Beer A., Krause B.J., Herrmann K., et al. SPECT/CT. J Nucl Med 2008; 49 (8): 1305–19. DOI: 10.2967/jnumed.107.050195
18. Mariani G., Bruselli L., Kuwert T., Kim E.E., Flotats A., Israel O., et al. A review on the clinical uses of SPECT/ CT. Eur J Nucl Med Mol Imaging 2010; 37 (10): 1959–85. DOI: 10.1007/s00259-010-1390-8
19. Liu B., Servaes S., Zhuang H. SPECT/ CT MIBG Imaging Is Crucial in the Follow-up of the Patients With HighRisk Neuroblastoma. Clin Nucl Med 2018; 43 (4): 232–8. DOI: 10.1097/RLU.0000000000001984
20. Theerakulpisut D., Raruenrom Y., Wongsurawat N., Somboonporn C. Value of SPECT/CT in Diagnostic I-131 MIBG Scintigraphy in Patients with Neuroblastoma. Nucl Med Mol Imaging 2018; 52 (5): 350–8. DOI: 10.1007/s13139-018-0532-y
21. Bar-Sever Z., Biassoni L., Shulkin B., Kong G., Hofman M.S., Lopci E. Guidelines on nuclear medicine imaging in neuroblastoma. Eur J Nucl Med Mol Imaging 2018; 45 (11): 2009–24. DOI: 10.1007/s00259-018-4070-8
22. Kailash, Kireeva E.D., Vdovina I.S., Yadgarov M.Ya., Shamanskaya T.V., Roshchin V.Yu. i dr. Neinvazivnoe opredelenie neblagopriyatnogo gistologicheskogo varianta u detei s neirogennymi opukholyami po nakopleniyu ¹²³I-MIBG s ispol'zovaniem polukolichestvennoi i kolichestvennoi otsenok. Voprosy gematologii/ onkologii i immunopatologii v pediatrii 2020; 19 (1): 68–78. DOI: 10.24287/1726-1708-2020-19-1-68-78
23. Matthay K.K., Shulkin B., Ladenstein R., Michon J., Giammarile F., Lewington V. Criteria for evaluation of disease extent by (123)I-metaiodobenzylguanidine scans in neuroblastoma: a report for the International Neuroblastoma Risk Group (INRG) Task Force. Br J Cancer 2010; 102 (9): 1319–26. DOI: 10.1038/sj.bjc.6605621
