title: Prognostic value of ¹⁸F-DOPA PET/CT at the time of recurrence in patients affected by neuroblastoma.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationship between (123)I-metaiodobenzylguanidine (MIBG) scan semi-quantification and a new (18)F-DOPA positron emission tomography (PET)/CT score in patients with suspected or documented neuroblastoma (NB) relapse and to assess the association between these two parameters and progression-free survival (PFS)/overall survival (OS).
  
  
  METHODS
  We analysed 24 NB patients who had undergone (123)I-MIBG and (18)F-DOPA PET/CT scans at the time of suspected relapse, after applying a proper scoring system for each scan. In time-to-event analyses, the score distributions were regarded as continuous and were categorized in tertiles and medians. We used Kaplan-Meier curves and Cox proportional hazard models for PFS and OS in order to estimate the independent prognostic impact of (123)I-MIBG and (18)F-DOPA PET/CT scans.
  
  
  RESULTS
  The (123)I-MIBG and (18)F-DOPA scores were highly and positively correlated (Spearman's rho = 0.8, p < 0.001). Over a median follow-up of 14 months (range 6-82), 12 cases of disease progression and 6 deaths occurred. Multivariate Cox models showed a higher risk of disease progression [hazard ratio (HR) 17.0, 95% confidence interval (CI) 2.7-109] in NB patients with (123)I-MIBG score > 3 (3rd tertile) and an even higher risk (HR:37.2, 95% CI 2.4-574) in those with (18)F-DOPA whole-body metabolic burden (WBMB) >7.5 (median), after adjustment for all main clinical/pathological factors considered. Kaplan-Meier analyses showed a significant association with OS (log-rank p = 0.01 and p = 0.03 for (123)I-MIBG and (18)F-DOPA WBMB, respectively).
  
  
  CONCLUSIONS
  Our results confirm the good agreement between (18)F-DOPA PET/CT and (123)I-MIBG scan in patients affected by NB relapse. In time-to-event analyses, (123)I-MIBG scan and (18)F-DOPA PET/CT scores were independently and significantly associated with disease progression.
authors.affiliation: Nuclear Medicine Unit, Galliera Hospital, Genoa, Italy, arnoldo.piccardo@galliera.it.
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Piccardo
authors.forename: Matteo
authors.initials: M
authors.lastname: Puntoni
authors.forename: Egesta
authors.initials: E
authors.lastname: Lopci
authors.forename: Massimo
authors.initials: M
authors.lastname: Conte
authors.forename: Luca
authors.initials: L
authors.lastname: Foppiani
authors.forename: Stefania
authors.initials: S
authors.lastname: Sorrentino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morana
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Naseri
authors.forename: Angelina
authors.initials: A
authors.lastname: Cistaro
authors.forename: Giampiero
authors.initials: G
authors.lastname: Villavecchia
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
mesh_terms: D019797:3-Iodobenzylguanidine; D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D009447:Neuroblastoma / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012008:Recurrence; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D019797:3-Iodobenzylguanidine; D004295:Dihydroxyphenylalanine