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: email@example.com or firstname.lastname@example.org.