背景:分子成像在神经母细胞瘤(NB)患儿的分期和反应评估中至关重要。[123I]-间碘苄基胍(mIBG)是标准的成像方法;然而,它的特点是空间分辨率低,耗时的收购程序和困难的解释。已经提出了许多PET儿茶酚胺能放射性示踪剂作为[123I]-mIBG的替代品,然而,他们还没有进入临床实践。我们旨在回顾现有文献,比较头对头[123I]-mIBG与最常见的PET儿茶酚胺能放射性药物。
方法:我们在PubMed数据库中搜索了在[123I]-mIBG和PET放射性药物(包括间羟基麻黄碱([11C]C-HED))之间进行头对头比较的研究,18F-18F-3,4-二羟基苯丙氨酸([18F]DOPA)[124I]mIBG和间-[18F]氟苄基胍([18F]mFBG)。评论文章,临床前研究,小案例系列(<5个科目),病例报告,非英文文章被排除在外。从每一项研究中,提取了以下特征:书目信息,技术参数,以及根据基于患者的分析(PBA)和基于病变的分析(LBA)的程序的敏感性。
结果:选择了十项研究:两项关于[11C]C-HED,四个[18F]DOPA,一[124I]mIBG,和三[18F]mFBG。这些研究包括181名患者(范围5-46)。对于PBA来说,PET方法的优越性在10项研究中有2项报道(均使用[18F]DOPA).对于LBA,在十分之七的研究中,PET检测到的病变明显多于闪烁显像。
结论:使用儿茶酚胺能示踪剂的PET/CT显示出比mIBG闪烁显像更好的诊断性能。然而,尚不清楚这种优势是否会影响临床决策.尽管如此,PET检查在临床实践中似乎很有希望,因为它提供了更快的图像采集,更少的镇静需要,和一天的检查。
BACKGROUND: Molecular imaging is pivotal in staging and response assessment of children with neuroblastoma (NB). [123I]-metaiodobenzylguanidine (mIBG) is the standard imaging method; however, it is characterised by low spatial resolution, time-consuming acquisition procedures and difficult interpretation. Many PET catecholaminergic radiotracers have been proposed as a replacement for [123I]-mIBG, however they have not yet made it into clinical practice. We aimed to
review the available literature comparing head-to-head [123I]-mIBG with the most common PET catecholaminergic radiopharmaceuticals.
METHODS: We searched the PubMed database for studies performing a head-to-head comparison between [123I]-mIBG and PET radiopharmaceuticals including meta-hydroxyephedrine ([11C]C-HED), 18F-18F-3,4-dihydroxyphenylalanine ([18F]DOPA) [124I]mIBG and Meta-[18F]fluorobenzylguanidine ([18F]mFBG).
Review articles, preclinical studies, small case series (< 5 subjects), case reports, and articles not in English were excluded. From each study, the following characteristics were extracted: bibliographic information, technical parameters, and the sensitivity of the procedure according to a patient-based analysis (PBA) and a lesion-based analysis (LBA).
RESULTS: Ten studies were selected: two regarding [11C]C-HED, four [18F]DOPA, one [124I]mIBG, and three [18F]mFBG. These studies included 181 patients (range 5-46). For the PBA, the superiority of the PET method was reported in two out of ten studies (both using [18F]DOPA). For LBA, PET detected significantly more lesions than scintigraphy in seven out of ten studies.
CONCLUSIONS: PET/CT using catecholaminergic tracers shows superior diagnostic performance than mIBG scintigraphy. However, it is still unknown if such superiority can influence clinical decision-making. Nonetheless, the PET examination appears promising for clinical practice as it offers faster image acquisition, less need for sedation, and a single-day examination.