Innovative PET/CT technique detects childhood neuroblastoma in minutes
A novel molecular imaging technique is able to detect neuroblastoma in children with high sensitivity and short scan times, circumventing the need for anesthesia.
The technique, researched at Copenhagen University Hospital-Rigshospitalet (Denmark), is termed 18F-MFBG LAFOV PET/CT. It combines a novel tracer (meta-[18F]fluorobenzylguanidine – [18F]MFBG) with a long-axial-field-of-view (LAFOV) PET/CT scanner. Compared to the current standard of care, this new procedure minimizes radiation exposure and avoids anesthesia. Its high sensitivity means clinicians have an accurate read-out of the child’s cancer and could aid treatment decisions.
Neuroblastoma is the most prevalent solid tumor type outside of the brain in children. For decades, the standard of care has been 123I-MIBG SPECT/CT scans (Meta-[123I]iodobenzylguanidine ([123I]MIBG) scintigraphy), which is a 2-day procedure involving a 2-hour scan. Sedation or general anesthesia is often required to ensure children stay still during the lengthy scan.
In contrast, 18F-MFBG LAFOV PET/CT is a 1-day protocol with a 2-minute scan using a scanner that is 10 times more sensitive than the one used in 123I-MIBG SPECT/CT.
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The new study involved 10 children undergoing 123I-MIBG SPECT/CT followed by 18F-MFBG LAFOV PET/CT. Blinded researchers scored the two types of scans for pathologic lesions. Additionally, SIOPEN and Curie scores were calculated and intraspinal involvement, retroperitoneal lymph node involvement and bone marrow involvement were assessed.
The researchers found that 80% of the children receiving 123I-MIBG SPECT/CT required general anesthesia whereas none of the children receiving 18F-MFBG LAFOV PET/CT required it. To provide a clinically useful image, 18F-MFBG LAFOV PET/CT required only a 2-minute scan if there were no motion artefacts.
The results showcase promising sensitivity results for 18F-MFBG LAFOV PET/CT across all measures taken. Overall, 80% of 18F-MFBG LAFOV PET/CT scans revealed more lesions and 20% revealed the same amount as the current standard of care. SIOPEN scores were higher in 50% of cases and Curie scores were higher in 70% of the cases for the 18F-MFBG LAFOV PET/CT scans. 18F-MFBG LAFOV PET/CT also had a much higher precision diagnosis of intraspinal involvement, retroperitoneal lymph node involvement and bone marrow involvement.
Lise Borgwardt, first author on the study (Copenhagen University Hospital-Rigshospitalet) commented, “A scan with a much higher sensitivity can find very small lesions and the exact extension in the body and can be extremely beneficial in determining the right course of treatment. The fact that these scans can be performed without anesthesia or sedation, and at a lower radiation dose is a big step forward for the children, parents, and the healthcare system in general.”