[18F]mFBG PET-CT for detection and localisation of neuroblastoma: a prospective pilot study
Atia Samim, Thomas Blom, Alex J. Poot, Albert D. Windhorst, Marta Fiocco, Nelleke Tolboom, Arthur J. A. T. Braat, Sebastiaan L. Meyer Viol, Rob van Rooij, Max M. van Noesel, Marnix G. E. H. Lam, Godelieve A.M. Tytgat, Bart de Keizer
Abstract
Abstract Purpose Meta -[ 18 F]fluorobenzylguanidine ([ 18 F]mFBG) is a positron emission tomography (PET) radiotracer that allows for fast and high-resolution imaging of tumours expressing the norepinephrine transporter. This pilot study investigates the feasibility of [ 18 F]mFBG PET-CT for imaging in neuroblastoma. Methods In a prospective, single-centre study, we recruited children with neuroblastoma, referred for meta -[ 123 I]iodobenzylguanidine ([ 123 I]mIBG) scanning, consisting of total body planar scintigraphy in combination with single-photon emission computed tomography-CT (SPECT-CT). Within two weeks of [ 123 I]mIBG scanning, total body PET-CTs were performed at 1 h and 2 h after injection of [ 18 F]mFBG (2 MBq/kg). Detected tumour localisations on scan pairs were compared. Soft tissue disease was quantified by number of lesions and skeletal disease by SIOPEN score. Results Twenty paired [ 123 I]mIBG and [ 18 F]mFBG scans were performed in 14 patients (median age 4.9 years, n = 13 stage 4 disease and n = 1 stage 4S). [ 18 F]mFBG injection was well tolerated and no related adverse events occurred in any of the patients. Mean scan time for [ 18 F]mFBG PET-CT (9.0 min, SD 1.9) was significantly shorter than for [ 123 I]mIBG scanning (84.5 min, SD 10.5), p < 0.01. Most tumour localisations were detected on the 1 h versus 2 h post-injection [ 18 F]mFBG PET-CT. Compared to [ 123 I]mIBG scanning, [ 18 F]mFBG PET-CT detected a higher, equal, and lower number of soft tissue lesions in 40%, 55%, and 5% of scan pairs, respectively, and a higher, equal, and lower SIOPEN score in 55%, 30%, and 15% of scan pairs, respectively. On average, two more soft tissue lesions and a 6-point higher SIOPEN score were detected per patient on [ 18 F]mFBG PET-CT compared to [ 123 I]mIBG scanning. Conclusion Results of this study demonstrate feasibility of [ 18 F]mFBG PET-CT for neuroblastoma imaging. More neuroblastoma localisations were detected on [ 18 F]mFBG PET-CT compared to [ 123 I]mIBG scanning. [ 18 F]mFBG PET-CT shows promise for future staging and response assessment in neuroblastoma. Trial registration Dutch Trial Register NL8152.