Risk Stratification of Pediatric Patients with Neuroblastoma Using Volumetric Parameters of 18F-FDG and 18F-DOPA PET/CT

Chia Ju Liu, Meng Yao Lu, Yen Lin Liu, Chi Lun Ko, Kuan Yin Ko, Kai Yuan Tzen, Hsiu Hao Chang, Yung Li Yang, Shiann Tarng Jou, Wen Ming Hsu, Ruoh Fang Yen

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Abstract

Purpose This study determined the prognostic value of volumetric parameters derived from pretreatment 18F-FDG and 18F-DOPA PET/CT of neuroblastoma and their correlation with clinical and histopathologic features. Patients and Methods A total of 25 children with neuroblastoma underwent pretreatment 18F-FDG and 18F-DOPA PET/CT within 4 weeks. The SUVmax of primary tumors on 18F-FDG and 18F-DOPA PET were recorded as SUVFDG and SUVDOPA, respectively. For volumetric parameters of primary tumors, 40% of SUVmax was used to generate volume of interest. If the 40% of SUVmax was below 2.5, an SUV threshold of 2.5 was used instead. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), dopaminergic tumor volume (DTV), and total lesion 18F-DOPA activity (TLDA) were recorded as 18F-FDG and 18F-DOPA volumetric parameters. All indices were compared between groups distinguished by survival status and clinical features, including bone marrow involvement, lymph node metastasis, amplification of the MYCN oncogene, invasive features on anatomic images, and risk categories. The Kaplan-Meier method and log-rank test were used to compare the survival curves between groups. Results The median follow-up period was 28.2 months. Nonsurvivors (20%) tended to have lower SUVDOPA, DTV, and TLDA (P ≤ 0.05), and higher SUVFDG, MTV, and TLG (all P < 0.05). Lower 18F-DOPA uptake is associated with bone marrow and lymph node metastases (all P < 0.05). Higher 18F-FDG uptake is associated with MYCN amplification (all P < 0.05) and anatomic invasive features of tumors such as vascular encasement or adjacent organ invasion (TLG, P = 0.05). Only volumetric indices (DTV, TLDA, MTV, and TLG) significantly differed among risk groups (all P < 0.05). Conclusions Pretherapeutic 18F-DOPA and 18F-FDG PET provided complementary information, and both can be served for risk stratification. Volumetric indices of 18F-DOPA and 18F-FDG PET correlate more highly with risk grouping.

Original languageEnglish
Pages (from-to)e142-e148
JournalClinical Nuclear Medicine
Volume42
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Fluorodeoxyglucose F18
Neuroblastoma
Tumor Burden
Pediatrics
Glycolysis
Lymph Nodes
Bone Marrow
Neoplasm Metastasis
Neoplasms
Survival
Oncogenes
Blood Vessels

Keywords

  • F-DOPA
  • F-FDG
  • neuroblastoma
  • risk stratification
  • volumetric parameters

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Risk Stratification of Pediatric Patients with Neuroblastoma Using Volumetric Parameters of 18F-FDG and 18F-DOPA PET/CT. / Liu, Chia Ju; Lu, Meng Yao; Liu, Yen Lin; Ko, Chi Lun; Ko, Kuan Yin; Tzen, Kai Yuan; Chang, Hsiu Hao; Yang, Yung Li; Jou, Shiann Tarng; Hsu, Wen Ming; Yen, Ruoh Fang.

In: Clinical Nuclear Medicine, Vol. 42, No. 3, 01.03.2017, p. e142-e148.

Research output: Contribution to journalArticle

Liu, Chia Ju ; Lu, Meng Yao ; Liu, Yen Lin ; Ko, Chi Lun ; Ko, Kuan Yin ; Tzen, Kai Yuan ; Chang, Hsiu Hao ; Yang, Yung Li ; Jou, Shiann Tarng ; Hsu, Wen Ming ; Yen, Ruoh Fang. / Risk Stratification of Pediatric Patients with Neuroblastoma Using Volumetric Parameters of 18F-FDG and 18F-DOPA PET/CT. In: Clinical Nuclear Medicine. 2017 ; Vol. 42, No. 3. pp. e142-e148.
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abstract = "Purpose This study determined the prognostic value of volumetric parameters derived from pretreatment 18F-FDG and 18F-DOPA PET/CT of neuroblastoma and their correlation with clinical and histopathologic features. Patients and Methods A total of 25 children with neuroblastoma underwent pretreatment 18F-FDG and 18F-DOPA PET/CT within 4 weeks. The SUVmax of primary tumors on 18F-FDG and 18F-DOPA PET were recorded as SUVFDG and SUVDOPA, respectively. For volumetric parameters of primary tumors, 40{\%} of SUVmax was used to generate volume of interest. If the 40{\%} of SUVmax was below 2.5, an SUV threshold of 2.5 was used instead. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), dopaminergic tumor volume (DTV), and total lesion 18F-DOPA activity (TLDA) were recorded as 18F-FDG and 18F-DOPA volumetric parameters. All indices were compared between groups distinguished by survival status and clinical features, including bone marrow involvement, lymph node metastasis, amplification of the MYCN oncogene, invasive features on anatomic images, and risk categories. The Kaplan-Meier method and log-rank test were used to compare the survival curves between groups. Results The median follow-up period was 28.2 months. Nonsurvivors (20{\%}) tended to have lower SUVDOPA, DTV, and TLDA (P ≤ 0.05), and higher SUVFDG, MTV, and TLG (all P < 0.05). Lower 18F-DOPA uptake is associated with bone marrow and lymph node metastases (all P < 0.05). Higher 18F-FDG uptake is associated with MYCN amplification (all P < 0.05) and anatomic invasive features of tumors such as vascular encasement or adjacent organ invasion (TLG, P = 0.05). Only volumetric indices (DTV, TLDA, MTV, and TLG) significantly differed among risk groups (all P < 0.05). Conclusions Pretherapeutic 18F-DOPA and 18F-FDG PET provided complementary information, and both can be served for risk stratification. Volumetric indices of 18F-DOPA and 18F-FDG PET correlate more highly with risk grouping.",
keywords = "F-DOPA, F-FDG, neuroblastoma, risk stratification, volumetric parameters",
author = "Liu, {Chia Ju} and Lu, {Meng Yao} and Liu, {Yen Lin} and Ko, {Chi Lun} and Ko, {Kuan Yin} and Tzen, {Kai Yuan} and Chang, {Hsiu Hao} and Yang, {Yung Li} and Jou, {Shiann Tarng} and Hsu, {Wen Ming} and Yen, {Ruoh Fang}",
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T1 - Risk Stratification of Pediatric Patients with Neuroblastoma Using Volumetric Parameters of 18F-FDG and 18F-DOPA PET/CT

AU - Liu, Chia Ju

AU - Lu, Meng Yao

AU - Liu, Yen Lin

AU - Ko, Chi Lun

AU - Ko, Kuan Yin

AU - Tzen, Kai Yuan

AU - Chang, Hsiu Hao

AU - Yang, Yung Li

AU - Jou, Shiann Tarng

AU - Hsu, Wen Ming

AU - Yen, Ruoh Fang

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Purpose This study determined the prognostic value of volumetric parameters derived from pretreatment 18F-FDG and 18F-DOPA PET/CT of neuroblastoma and their correlation with clinical and histopathologic features. Patients and Methods A total of 25 children with neuroblastoma underwent pretreatment 18F-FDG and 18F-DOPA PET/CT within 4 weeks. The SUVmax of primary tumors on 18F-FDG and 18F-DOPA PET were recorded as SUVFDG and SUVDOPA, respectively. For volumetric parameters of primary tumors, 40% of SUVmax was used to generate volume of interest. If the 40% of SUVmax was below 2.5, an SUV threshold of 2.5 was used instead. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), dopaminergic tumor volume (DTV), and total lesion 18F-DOPA activity (TLDA) were recorded as 18F-FDG and 18F-DOPA volumetric parameters. All indices were compared between groups distinguished by survival status and clinical features, including bone marrow involvement, lymph node metastasis, amplification of the MYCN oncogene, invasive features on anatomic images, and risk categories. The Kaplan-Meier method and log-rank test were used to compare the survival curves between groups. Results The median follow-up period was 28.2 months. Nonsurvivors (20%) tended to have lower SUVDOPA, DTV, and TLDA (P ≤ 0.05), and higher SUVFDG, MTV, and TLG (all P < 0.05). Lower 18F-DOPA uptake is associated with bone marrow and lymph node metastases (all P < 0.05). Higher 18F-FDG uptake is associated with MYCN amplification (all P < 0.05) and anatomic invasive features of tumors such as vascular encasement or adjacent organ invasion (TLG, P = 0.05). Only volumetric indices (DTV, TLDA, MTV, and TLG) significantly differed among risk groups (all P < 0.05). Conclusions Pretherapeutic 18F-DOPA and 18F-FDG PET provided complementary information, and both can be served for risk stratification. Volumetric indices of 18F-DOPA and 18F-FDG PET correlate more highly with risk grouping.

AB - Purpose This study determined the prognostic value of volumetric parameters derived from pretreatment 18F-FDG and 18F-DOPA PET/CT of neuroblastoma and their correlation with clinical and histopathologic features. Patients and Methods A total of 25 children with neuroblastoma underwent pretreatment 18F-FDG and 18F-DOPA PET/CT within 4 weeks. The SUVmax of primary tumors on 18F-FDG and 18F-DOPA PET were recorded as SUVFDG and SUVDOPA, respectively. For volumetric parameters of primary tumors, 40% of SUVmax was used to generate volume of interest. If the 40% of SUVmax was below 2.5, an SUV threshold of 2.5 was used instead. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), dopaminergic tumor volume (DTV), and total lesion 18F-DOPA activity (TLDA) were recorded as 18F-FDG and 18F-DOPA volumetric parameters. All indices were compared between groups distinguished by survival status and clinical features, including bone marrow involvement, lymph node metastasis, amplification of the MYCN oncogene, invasive features on anatomic images, and risk categories. The Kaplan-Meier method and log-rank test were used to compare the survival curves between groups. Results The median follow-up period was 28.2 months. Nonsurvivors (20%) tended to have lower SUVDOPA, DTV, and TLDA (P ≤ 0.05), and higher SUVFDG, MTV, and TLG (all P < 0.05). Lower 18F-DOPA uptake is associated with bone marrow and lymph node metastases (all P < 0.05). Higher 18F-FDG uptake is associated with MYCN amplification (all P < 0.05) and anatomic invasive features of tumors such as vascular encasement or adjacent organ invasion (TLG, P = 0.05). Only volumetric indices (DTV, TLDA, MTV, and TLG) significantly differed among risk groups (all P < 0.05). Conclusions Pretherapeutic 18F-DOPA and 18F-FDG PET provided complementary information, and both can be served for risk stratification. Volumetric indices of 18F-DOPA and 18F-FDG PET correlate more highly with risk grouping.

KW - F-DOPA

KW - F-FDG

KW - neuroblastoma

KW - risk stratification

KW - volumetric parameters

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