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18F-DOPA PET/CT in Neuroblastoma: Comparison of Conventional Imaging With CT/MR

Lopci, Egesta MD*,†; Piccardo, Arnoldo MD; Nanni, Cristina MD*; Altrinetti, Vania MD; Garaventa, Alberto MD§; Pession, Andrea Prof; Cistaro, Angelina MD; Chiti, Arturo MD, FEBNM; Villavecchia, Giampiero MD; Fanti, Stefano Prof*

doi: 10.1097/RLU.0b013e3182485172
Original Articles

Aim: Role of 18F-DOPA PET/CT in neuroblastoma (NB) compared with CT/MR.

Materials and Methods: In all, 21 patients (M:F = 14:7; mean age, 7.4 years) affected by advanced stage NB (III-IV) were prospectively enrolled. Overall, 37 paired 18F-DOPA PET and CT/MR scans were performed, and for each, we identified site and number of lesions. Standard of reference was based on a multidisciplinary assessment, including 123I-MIBG, selective biopsy, and clinical-instrumental monitoring. Both scan-based and a lesion-based analysis was performed, and for each modality, we calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy.

Results: On the scan-based analysis, 18F-DOPA PET and CT/MR showed the following rates: sensitivity, specificity, NPV, PPV, and accuracy were 100%, 92.3%, 100%, 96%, and 97.3% versus 91.7%, 61.5%, 80%, 81.5%, and 81.1%, respectively (P = 0.014). Overall 179 findings were reported at imaging, of which 139 (77.7%) resulted true sites of disease at final outcome. On the lesion-based analysis, the 2 imaging modalities showed the following sensitivity, specificity, NPV, PPV, and accuracy rates: 90.6%, 90%, 73.5%, 96.9%, and 90.5% versus 47.5%, 27.5%, 13.1%, 69.5%, and 43% (P < 0.00001).

Conclusions: In our study, 18F-DOPA PET/CT results more accurate than CT/MR in advanced stage NB therefore should be taken into consideration for the diagnostic workup of these patients.

From the *PET Unit, Nuclear Medicine Department, University Hospital S. Orsola-Malpighi, Bologna, Italy; †Nuclear Medicine Department, IRCCS Humanitas, Rozzano (MI), Italy; ‡Nuclear Medicine Department, Galliera Hospital, Genova, Italy; §Medical and Pediatric Oncology Division, Hospital G. Gaslini, Genova, Italy; ¶Department of Pediatric Onco-hematology, University Hospital S. Orsola-Malpighi, Bologna, Italy; and ‖PET Unit, IRMET, Torino, Italy.

Received for publication August 8, 2011; revision accepted December 20, 2011.

E.L. and A.P. equally contributed to the paper.

Conflicts of interest and sources of funding: none declared.

Reprints: Egesta Lopci, MD, Nuclear Medicine Department, University Hospital S. Orsola-Malpighi, Via Massarenti, 9 CAP 40138, Bologna, Italy, or Nuclear Medicine Department, IRCCS Humanitas, Via Manzoni, 56 CAP 20089, Rozzano (MI), Italy. E-mail: egesta.lopci@gmail.com or egesta.lopci@cancercenter.humanitas.it.

© 2012 Lippincott Williams & Wilkins, Inc.