방사선의학 웹진

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Abstract

PURPOSE:

This study aimed to evaluate the prognostic value of pretreatment (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in pediatric neuroblastoma patients.

METHODS:

The study included 50 pediatric neuroblastoma patients who underwent diagnostic work-up FDG PET before any treatment. The maximum standardized uptake value (SUVmax) of the primary tumor lesion (Pmax), the SUVmax of all the tumor lesions, including the primary tumor lesion and metastatic lesions (Tmax), and the uptake ratio of Tmax to mean SUV of normal liver tissue (Tmax/Lmean) were calculated and tested as prognostic factors.

RESULTS:

Of the 50 patients, 15 (30.0%) experienced disease progression and 21 (42.0%) died during the follow-up period. On univariate analysis, the histopathology, tumor stage, bone marrow involvement, serum levels of lactate dehydrogenase (LDH), neuron-specific enolase, and ferritin, primary tumor size, Pmax, Tmax, and Tmax/Lmean were significant prognostic factors for disease progression-free survival (PFS), whereas the tumor stage, serum level of LDH, Tmax, and Tmax/Lmean were determined to be significant for predicting overall survival (OS). On multivariate analysis, the histopathology and serum level of LDH were independent prognostic factors for PFS, and only the Tmax/Lmean was an independent prognostic factor for OS. The 2-year PFS and OS rates were over 80.0% in patients with low FDG uptake, meanwhile, patients with high FDG uptake showed the 2-year PFS of less than 30.0% and OS of less than 55.0%.

CONCLUSION:

FDG PET was an independent prognostic factor for OS in neuroblastoma patients. FDG PET can provide effective information on the prognosis for neuroblastoma patients.

Author information

Lee JW1, Cho A2, Yun M2, Lee JD3, Lyu CJ4, Kang WJ5.​

1 Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro 100 beon-gil, Seo-gu, Incheon 404-834, South Korea.

2 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul 120-752, South Korea.

3 Department of Radiology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro 100 beon-gil, Seo-gu, 404-834, South Korea.

4 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul 120-752, South Korea. Electronic address: cj@yuhs.ac.

5 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul 120-752, South Korea. Electronic address: mdkwj@yuhs.ac.