Guidelines on nuclear medicine imaging in neuroblastoma

Bar-Sever, Zvi; Biassoni, Lorenzo; Shulkin, Barry L.; Kong, Grace; Hofman, Michael S; Lopci, Egesta; Manea, Irina; Koziorowski, Jacek; Castellani, Maria Rita; Boubaker, Ariane; Lambert, Bieke; Pfluger, Thomas; Nadel, Helen; Sharp, Susan E.; Giammarile, Francesco

doi:10.1007/s00259-018-4070-8

Cited by 109 publications

(138 citation statements)

References 111 publications

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“…123 I-mIBG SPECT/CT improves diagnostic accuracy (Fig. 13) and reduces the incidence of equivocal planar findings [250]. Sedation or general anaesthesia is often required for this lengthy examination in young children.…”

Section: Paediatrics Applicationsmentioning

confidence: 99%

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Two decades of SPECT/CT – the coming of age of a technology: An updated review of literature evidence

Israel

Pellet

Biassoni

et al. 2019

Eur J Nucl Med Mol Imaging

152

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Purpose Single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was introduced as a hybrid SPECT/CT imaging modality two decades ago. The main advantage of SPECT/CT is the increased specificity achieved through a more precise localization and characterization of functional findings. The improved diagnostic accuracy is also associated with greater diagnostic confidence and better inter-specialty communication. Methods This review presents a critical assessment of the relevant literature published so far on the role of SPECT/CT in a variety of clinical conditions. It also includes an update on the established evidence demonstrating both the advantages and limitations of this modality. Conclusions For the majority of applications, SPECT/CT should be a routine imaging technique, fully integrated into the clinical decision-making process, including oncology, endocrinology, orthopaedics, paediatrics, and cardiology. Large-scale prospective studies are lacking, however, on the use of SPECT/CT in certain clinical domains such as neurology and lung disorders. The review also presents data on the complementary role of SPECT/CT with other imaging modalities and a comparative analysis, where available.

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Section: Paediatrics Applicationsmentioning

confidence: 99%

“…Sedation or general anaesthesia is often required for this lengthy examination in young children. Acquisition of a fully diagnostic ceCT as part of the SPECT/CT study is an option, in order to avoid an additional examination, thus providing a "one-stop shop" evaluation with a single exposure to anaesthesia [250,251].…”

Section: Paediatrics Applicationsmentioning

confidence: 99%

Two decades of SPECT/CT – the coming of age of a technology: An updated review of literature evidence

Israel

Pellet

Biassoni

et al. 2019

Eur J Nucl Med Mol Imaging

152

View full text Add to dashboard Cite

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“…Thus, imaging is not only used for differentiation between the malignant NB, the less malignant ganglioneuroblastoma (GNB), and the benign ganglioneuroma (GN) but also for risk stratification according to the International Neuroblastoma Risk Group (INRG) classification system and staging system (INRGSS) [3][4][5][6][7][8][9]. Imaging modalities used for assessment involve ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and scintigraphy [3,10]. The evaluation of response to chemotherapy prior to surgical resection is of paramount importance [11].…”

Section: Introductionmentioning

confidence: 99%

Retrospective accuracy analysis of MRI based lesion size measurement in neuroblastic tumors: which sequence should we choose?

Gassenmaier¹,

Tsiflikas²,

Maennlin³

et al. 2020

BMC Med Imaging

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Background MR imaging of neuroblastic tumors is widely used for assessing the effect of chemotherapy on tumor size. However, there are some concerns that MRI might falsely estimate lesion diameters due to calcification and fibrosis. Therefore, the aim of our study was to compare neuroblastic tumor size based on MRI measurements to histopathology measurements of the resected specimens as standard of reference. Methods Inclusion criteria were diagnosis of a neuroblastic tumor, MR imaging within 100 days to surgery and gross total resection without fragmentation of the tumor between 2008 and 2019. Lesion diameters were measured by two radiologists according to RECIST 1.1 in axial plane in T2w turbo spin echo (TSE), diffusion-weighted imaging (DWI), and in T1w pre- and postcontrast sequences. Furthermore, the largest lesion size in three-dimensions was noted. The largest diameter of histopathology measurements of each specimen was used for comparison with MRI. Results Thirty-seven patients (mean age: 5 ± 4 years) with 38 lesions (neuroblastoma: n = 17; ganglioneuroblastoma: n = 11; ganglioneuroma: n = 10) were included in this retrospective study. There was excellent intra-class correlation coefficient between both readers for all sequences (> 0.9) Tumor dimensions of reader 1 based on axial MRI measurements were significantly smaller with the following median differences (cm): T1w precontrast − 1.4 (interquartile range (IQR): 1.8), T1w postcontrast − 1.0 (IQR: 1.9), T2w TSE: -1.0 (IQR: 1.6), and DWI -1.3 (IQR: 2.2) (p < 0.001 for all sequences). However, the evaluation revealed no significant differences between the three-dimensional measurements and histopathology measurements of the resected specimens regardless of the applied MRI sequence. Conclusions Axial MRI based lesion size measurements are significantly smaller than histopathological measurements. However, there was no significant difference between three-dimensional measurements and histopathology measurements of the resected specimens. T2w TSE and T1w postcontrast images provided the lowest deviation and might consequently be preferred for measurements.

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“…In the largest international trials by the SIOPEN group (clinicaltrials.gov identi er NCT01704716) and the Children's Oncology Group (e.g., NCT03794349, NCT02176967), [ 123 I]metaiodobenzylguanidine (mIBG) scintigraphy remains the essential diagnostic tool besides magnetic resonance imaging (MRI) for initial tumor staging and restaging. Recent guidelines on [ 123 I]mIBG scintigraphy recommend single photon emission computed tomography / computed tomography (SPECT/CT) in addition to planar images to improve lesion detection (1,2). However, while treatment options in NB multiplied with the aim of individualized therapy (3)(4)(5), image assessment in clinical routine and trials remains visual (6,7) and thus subjective and poorly differentiated.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of iodine-123-mIBG SPECT/CT quantification in neuroblastoma using CZT and NaI detectors

Rogasch¹,

Bluemel²,

Großer³

et al. 2020

Preprint

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Background In [ 123 I]mIBG SPECT/CT for neuroblastoma, lesion uptake quantification could improve therapy monitoring. This study compared quantitative accuracy of a CZT (WEHR45) and NaI (LEHR) system (GE Discovery 670). Methods Volume sensitivity VS hom was estimated from a homogenous cylindrical phantom (811 ml) acquired with body contour or fixed 27 cm detector radius. Relative accuracy of VS hom to retrieve true background activity concentration (AC) in an IEC body phantom was calculated. Maximum/peak contrast recovery (CR) of the sphere inserts used VS IEC estimated from the IEC phantom. In 16 children with 37 [ 123 I]mIBG SPECT/CTs (range, 1-6 per patient; CZT, 12; NaI, 25), normal organ SUVmean (liver r/l, spleen, myocardium, blood pool, spine, muscles) were calculated using VS hom and VS IEC . Iterative reconstruction (Q.Metrix) used resolution recovery with/without scatter correction (SC) by dual energy window (DEW; 159 ± 10% and 130 ± 10% keV). In 20 exams, metabolic tumor volume (MTV)*SUVmax changes of primary tumors were correlated with changes of MRI tumor volume in serial scans (Pearson). Results VS hom (cts * MBq -1 * s -1 ) using SC was slightly lower for 27 cm radius vs. body contour with CZT (48 vs. 50, p<0.001) but comparable with NaI (59 vs. 61, p=0.18). Relative error in IEC phantom AC based on VS hom for CZT vs. NaI was -1.3% vs. +4.1% with SC (p=0.22). Acquisition time reduction by 50% (CZT) showed similar VS hom and relative error. CRmax/peak overestimated true AC in largest spheres (diameter, 22-37 mm) with SC and underestimated it without SC. Average SUVmean in liver and myocardium of CZT vs. NaI patients were similar. In the remaining organs (high estimated scatter proportions of >60% [CZT] or >40% [NaI]), average SUVmean differed between CZT and NaI, and coefficient of variation was significantly higher in SC vs. non-SC with CZT. MTV*SUVmax changes correlated with MRI volume changes with r=0.62 (non-SC) or r=0.59 (SC). Conclusions In principle, both CZT and NaI allow quantification in [ 123 I]mIBG SPECT/CT, but quantitative accuracy remains limited if using DEW for SC due to effects from source geometry (e.g. phantoms and organs) on scatter. Detector radius and acquisition time showed minor effects. MTV*SUVmax changes might be surrogate of response to therapy.

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Guidelines on nuclear medicine imaging in neuroblastoma

Cited by 109 publications

References 111 publications

Two decades of SPECT/CT – the coming of age of a technology: An updated review of literature evidence

Two decades of SPECT/CT – the coming of age of a technology: An updated review of literature evidence

Retrospective accuracy analysis of MRI based lesion size measurement in neuroblastic tumors: which sequence should we choose?

Feasibility of iodine-123-mIBG SPECT/CT quantification in neuroblastoma using CZT and NaI detectors

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