title: Comparison of 18F-dopa PET/CT and 123I-MIBG scintigraphy in stage 3 and 4 neuroblastoma: a pilot study.
abstract: OBJECTIVE
  (18)F-Dopa positron emission tomography (PET)/CT has proved a valuable tool for the assessment of neuroendocrine tumours. So far no data are available on (18)F-dopa utilization in neuroblastoma (NB). Our aim was to evaluate the role of (18)F-dopa PET/CT in NB and compare its diagnostic value with that of (123)I-metaiodobenzylguanidine (MIBG) scintigraphy in patients affected by stage 3-4 NB.
  
  
  METHODS
  We prospectively evaluated 28 paired (123)I-MIBG and (18)F-dopa PET/CT scans in 19 patients: 4 at the time of the NB diagnosis and 15 when NB relapse was suspected. For both imaging modalities we performed a scan-based and a lesion-based analysis and calculated sensitivity, specificity and accuracy. The standard of reference was based on clinical, imaging and histological data.
  
  
  RESULTS
  NB localizations were confirmed in 17 of 19 patients. (18)F-Dopa PET/CT and (123)I-MIBG scintigraphy properly detected disease in 16 (94%) and 11 (65%), respectively. On scan-based analysis, (18)F-dopa PET/CT showed a sensitivity and accuracy of 95 and 96%, respectively, while (123)I-MIBG scanning showed a sensitivity and accuracy of 68 and 64%, respectively (p < 0.05). No significant difference in terms of specificity was found. In 9 of 28 paired scans (32%) PET/CT results influenced the patient management. We identified 156 NB localizations, 141 of which were correctly detected by (18)F-dopa PET/CT and 88 by MIBG. On lesion-based analysis, (18)F-dopa PET/CT showed a sensitivity and accuracy of 90% whereas (123)I-MIBG scintigraphy showed a sensitivity and accuracy of 56 and 57%, respectively (p < 0.001). No significant difference in terms of specificity was found.
  
  
  CONCLUSIONS
  In our NB population (18)F-dopa PET/CT displayed higher overall accuracy than (123)I-MIBG scintigraphy. Consequently, we suggest (18)F-dopa PET/CT as a new opportunity for NB assessment.
authors.affiliation: Nuclear Medicine Unit, Galliera Hospital, Genoa, Italy, arnoldo.piccardo@galliera.it.
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Piccardo
authors.forename: Egesta
authors.initials: E
authors.lastname: Lopci
authors.forename: Massimo
authors.initials: M
authors.lastname: Conte
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.forename: Luca
authors.initials: L
authors.lastname: Foppiani
authors.forename: Vania
authors.initials: V
authors.lastname: Altrinetti
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Pietro
authors.initials: P
authors.lastname: Bianchi
authors.forename: Angela
authors.initials: A
authors.lastname: Cistaro
authors.forename: Stefania
authors.initials: S
authors.lastname: Sorrentino
authors.forename: Manlio
authors.initials: M
authors.lastname: Cabria
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.forename: Matteo
authors.initials: M
authors.lastname: Puntoni
authors.forename: Giampiero
authors.initials: G
authors.lastname: Villavecchia
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: C043437:fluorodopa F 18; D019797:3-Iodobenzylguanidine; D004295:Dihydroxyphenylalanine