背景:全身间碘苄基胍(131I-MIBG)闪烁显像是检测神经母细胞瘤的金标准方法;然而,它依赖于放射性物质,而且价格昂贵。相比之下,全身磁共振成像(WB-MRI)在发展中国家是负担得起的,并已被证明是有效的评估实体瘤。本研究旨在比较WB-MRI与MIBG检测原发肿瘤和神经母细胞瘤转移的敏感性和特异性。
方法:这项回顾性研究纳入了2013年至2020年的神经母细胞瘤患者。所有患者以长达15天的间隔进行WB-MRI和MIBG。结果标记在区分每个患者的解剖区域的表格中。两位专家进行了评估,独立和匿名,WB-MRI图像,另外两个人评估了MIBG。结果在敏感性和特异性方面进行了比较,每个病人,将MIBG视为黄金标准。这项研究得到了UNIFESP伦理委员会的批准。
结果:本研究纳入了30例神经母细胞瘤患者。年龄从1岁到15岁,平均5.7年。检查间隔时间(WB-MRI和MIBG)为1-13天,平均为6.67天。与MIBG相比,WB-MRI对检测骨骼和淋巴结中的原发性神经母细胞瘤的敏感性和特异性均大于或等于90%。当我们考虑病人而不个性化解剖区域时,WB-MRI的敏感性为90%,特异性为73.33%。
结论:结论:WB-MRI是检测骨和淋巴结中神经母细胞瘤的一种敏感而特异的方法,对原发性肿瘤的诊断非常敏感。表明该测试在MIBG难以获得的地方是可行的替代方案。有必要对大量病例进行研究,才能得出明确的结论。
BACKGROUND: Whole-body metaiodobenzylguanidine (131 I-
MIBG) scintigraphy is the gold standard method to detect neuroblastoma; however, it depends on radioactive material and is expensive. In contrast, whole-body magnetic resonance imaging (WB-MRI) is affordable in developing countries and has been shown to be effective in the evaluation of solid tumors. This study aimed to compare the sensitivity and specificity of WB-MRI with MIBG in the detection of primary tumors and neuroblastoma metastases.
METHODS: This retrospective study enrolled patients with neuroblastoma between 2013 and 2020. All patients underwent WB-MRI and
MIBG at intervals of up to 15 days. The results were marked in a table that discriminated anatomical regions for each patient. Two experts evaluated, independently and in anonymity, the WB-MRI images, and two others evaluated MIBG. The results were compared in terms of sensitivity and specificity, for each patient, considering
MIBG as the gold standard. This study was approved by the UNIFESP Ethics Committee.
RESULTS: Thirty patients with neuroblastoma were enrolled in this study. The age ranged from 1 to 15 years, with a mean of 5.7 years. The interval between exams (WB-MRI and
MIBG) ranged from 1 to 13 days, with an average of 6.67 days. Compared to
MIBG, WB-MRI presented a sensitivity and specificity greater than or equal to 90% for the detection of primary neuroblastoma in bones and lymph nodes. When we consider the patient without individualizing the anatomical regions, WB-MRI presented sensitivity of 90% and specificity of 73.33%.
CONCLUSIONS: In conclusion, WB-MRI is a sensitive and specific method to detect neuroblastoma in bone and lymph nodes and highly sensible to primary tumor diagnosis, suggesting that this test is a viable alternative in places where MIBG is difficult to access. Studies with a larger number of cases are necessary for definitive conclusions.