title: Usefulness of 18F-Fluorodeoxyglucose Positron Emission Tomography for Follow-Up of 13-cis-Retinoic Acid Treatment for Residual Neuroblastoma After Myeloablative Chemotherapy.
abstract: 13-cis-retinoic acid (13-cis-RA) treatment is used as a second-line treatment for residual or recurrent neuroblastoma. However, determining the duration of 13-cis-RA treatment for residual and recurrent neuroblastoma can be a problem because it is difficult to evaluate the effectiveness of the treatment.We performed 13-cis-RA treatment to remove residual active neuroblastoma cells in an 8-year-old boy with stage 4 neuroblastoma that developed from a left sympathetic ganglion and had been treated with chemotherapy, surgery, autologous peripheral blood stem-cell transplantation, and radiotherapy. F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) and iodine-123 metaiodobenzylguanidine (I-MIBG) scintigraphy obtained immediately before 13-cis-RA treatment both showed positive findings in the area of the primary lesion. At 18 months after 13-cis-RA treatment, there was accumulation on I-MIBG scintigraphy but no uptake on F-FDG-PET, and 13-cis-RA treatment was suspended. The patient has been in complete remission for 3 years. In comparing the effectiveness of the 2 imaging modalities for monitoring the response to 13-cis-RA treatment, we considered that F-FDG-PET was superior to I-MIBG scintigraphy because F-FDG-PET images were not affected by the cell differentiation induced by 13-cis-RA treatment in our case. Thus, F-FDG-PET was useful for determining the treatment response and outcomes.We have reported a case of residual neuroblastoma treated with differentiation-inducing 13-cis-RA therapy. Different results were produced with F-FDG-PET and I-MIBG scintigraphy. The cessation of 13-cis-RA treatment was based on F-FDG-PET findings and there has been no relapse for 3 years.
authors.affiliation: From the Department of Pediatrics (YS, HK, KF, OA), Dokkyo Medical University; Positron Emission Tomography Center (SS), Dokkyo Medical University Hospital; Department of Radiology (SK, TH), Dokkyo Medical University; and First Department of Surgery (KO, TT), Dokkyo Medical University, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Sato
authors.forename: Hidemitsu
authors.initials: H
authors.lastname: Kurosawa
authors.forename: Setsu
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Shigeko
authors.initials: S
authors.lastname: Kuwashima
authors.forename: Teisuke
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuchioka
authors.forename: Keitaro
authors.initials: K
authors.lastname: Fukushima
authors.forename: Osamu
authors.initials: O
authors.lastname: Arisaka
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*; D008297:Male; D018365:Neoplasm, Residual; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000628:therapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D015474:Isotretinoin