Comparative Role of 18F-DOPA PET/CT and 131I-MIBG Scintigraphy in Neuroblastoma and Application of Curie and SIOPEN Scoring Systems in 18F-DOPA PET/CT.

Abstract

Purpose: Neuroblastoma (NB) is childhood's most common extracranial solid malignancy. We have compared two imaging modalities, ¹³¹I-MIBG and ¹⁸F-DOPA PET/CT, to evaluate NB. Also, feasibility of the application of standardised scoring systems, SIOPEN and Curie scoring systems, in ¹⁸F-DOPA PET/CT was explored.

Methods: Patients with histopathology-proven NB underwent ¹³¹I-MIBG (planar and SPECT/CT) and ¹⁸F-DOPA PET/CT scans, as per standard imaging protocols. Duration between scans ranged from 1 to 30 days (median = 8 days). Number of lesions in Curie and SIOPEN scoring systems applied on both modalities was compared.

Results: Forty-six patients were included (M:F = 29:17) with a median age of 36 months. Both ¹³¹I-MIBG and ¹⁸F-DOPA scans were positive in 39 patients and negative in four patients. ¹⁸F-DOPA PET/CT was positive in additional three patients, in which ¹³¹I-MIBG was negative (p = 0.25). Overall, ¹⁸F-DOPA identified significantly greater number of lesions than ¹³¹I-MIBG, especially metastatic skeletal lesions (p < 0.05). Significant difference was observed between Curie scores in the two modalities, unlike SIOPEN scores. However, when the cut-off age of 18 months was taken, no significant difference was seen in either of the scoring systems in both the scans (p > 0.05). CS and SIOPEN scores were significantly higher in bone marrow-positive patients.

Conclusion: ¹⁸F-DOPA PET/CT detected more lesions than ¹³¹I-MIBG but had little impact on staging of the disease. For evaluation of NB, both scans can be used interchangeably as per the availability. Furthermore, both SIOPEN and Curie scoring systems, standardised for MIBG, can also be used to semi-quantify disease extent in ¹⁸F-DOPA PET/CT.

Supplementary information: The online version contains supplementary material available at 10.1007/s13139-022-00762-6.