Extending positron emission tomography scan utility to high-risk neuroblastoma: Fluorine-18 fluorodeoxyglucose positron emission tomography as sole imaging modality in follow-up of patients Journal Article


Authors: Kushner, B. H.; Yeung, H. W. D.; Larson, S. M.; Kramer, K.; Cheung, N. K. V.
Article Title: Extending positron emission tomography scan utility to high-risk neuroblastoma: Fluorine-18 fluorodeoxyglucose positron emission tomography as sole imaging modality in follow-up of patients
Abstract: Purpose: Although positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (18F-FDG) has a major impact on the treatment of adult cancer, the reported experience with extracranial tumors of childhood is limited. We describe a role for PET in patients with neuroblastoma (NB). Patients and Methods: In 51 patients with high-risk NB, 92 PET scans were part of a staging evaluation that included iodine-123 or iodine-131 metaiodobenzylguanidine (MIBG) scan, bone scan, computed tomography (and/or magnetic resonance imaging), urine catecholamine measurements, and bone marrow (BM) examinations. The minimum number of tests sufficient to detect NB was determined. Results: Of 40 patients who were not in complete remission, only 1 (2.5%) had NB that would have been missed had a staging evaluation been limited to PET and BM studies, and 13 (32.5%) had NB detected by PET but not by BM and urine tests. PET was equal or superior to MIBG scans for identifying NB in soft tissue and extracranial skeletal structures, for revealing small lesions, and for delineating the extent and localizing sites of disease. In 36 evaluations of 22 patients with NB in soft tissue, PET failed to identify only two long-standing MIBG-negative abdominal masses. PET and MIBG scans showed more skeletal lesions than bone scans, but the normally high physiologic brain uptake of FDG blocked PET visualization of cranial vault lesions. Similar to MIBG, FDG skeletal uptake was diffusely increased with extensive or progressing BM disease but faint or absent with minimal or nonprogressing BM disease. Conclusion: In the absence or after resolution of cranial vault lesions, and once the primary tumor is resected, PET and BM tests suffice for monitoring NB patients at high risk for progressive disease in soft tissue and bone/BM. © 2001 by American Society of Clinical Oncology.
Keywords: adolescent; adult; child; bone neoplasms; child, preschool; major clinical study; cancer localization; cancer growth; cancer staging; nuclear magnetic resonance imaging; positron emission tomography; follow up; magnetic resonance imaging; radiopharmaceuticals; computer assisted tomography; tomography, x-ray computed; diagnostic imaging; childhood cancer; cancer regression; iodine 131; neuroblastoma; diagnostic value; fluorodeoxyglucose f18; (3 iodobenzyl)guanidine; 3-iodobenzylguanidine; high risk population; fluorine 18; fluorodeoxyglucose; soft tissue neoplasms; bone scintiscanning; catecholamine urine level; bone marrow examination; tomography, emission-computed; iodine 123; humans; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 19
Issue: 14
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2001-07-15
Start Page: 3397
End Page: 3405
Language: English
PUBMED: 11454888
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus