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The prognostic significance of semi-quantitative metabolic parameters and tumoral metabolic activity based on 123I-MIBG SPECT/CT in pretreatment neuroblastoma patients.

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PMID40165328
JournalCancer imaging : the official publication of the International Cancer Imaging Society
Publication Date2025-03-31
Ingested2026-08-02 12:04 AM
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PURPOSE: To assess the prognosis predictive value of semi-quantitative metabolic parameters and tumoral metabolic activity based on 123I-meta-iodobenzylguanidine (MIBG) SPECT/CT in pretreatment neuroblastoma (NB) patients. METHODS: A total of 50 children (25 girls, 25 boys, median age 37 months, range 1-102 months) with newly diagnosed NB, consecutively examined with pretherapeutic 123I-MIBG SPECT/CT between 2018 and 2024, were included in this retrospective study. The semi-quantitative metabolic parameters and activity of primary tumor were measured, including Tmax/Lmax, Tmean/Lmean, Tmax/Lmean, Tmax/Mmax, Tmean/Mmean and asphericity (ASP). The ratio was maximum or mean count of primary tumor, liver and muscle. Clinical data and image-related factors was recorded as well. The outcome endpoint was event-free survival (EFS). Independent predictors were identified through univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) and Kaplan Meier analysis with log-rank test for EFS were performed. RESULTS: Median follow-up was 42 months (range 2.5-74 months; 4 patients showed disease progression/relapse, 7 patients died). The univariate and multivariate Cox regression analysis demonstrated that bone/bone marrow metastasis [95% confidence interval (CI): 1.051, 18.570, p = 0.043], Tmax/Lmax (95% CI: 1.074, 1.459, p = 0.004) and ASP (95% CI: 2.618, 273.477, p = 0.006) were independent predictors of EFS. The Kaplan Meier survival analyses demonstrated that Tmax/Lmax undefined[Formula: see text]]]>6 and ASP [Formula: see text]undefined]]>34% and with bone/bone marrow metastasis had worse outcomes. CONCLUSION: In this exploratory study, pretherapeutic 123I-MIBG image-derived semi-quantitative metabolic parameters and tumor asphericity provided prognostic value for EFS in NB patients. Tmax/Lmax [Formula: see text]undefined]]>6 and ASP [Formula: see text]undefined]]>34%, along with the presence of bone/bone marrow metastasis, could be considered as supplementary factors alongside existing ones.

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The prognostic significance of semi-quantitative metabolic parameters and tumoral metabolic activity based on 123I-MIBG SPECT/CT in pretreatment neuroblastoma patients.

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