The evidence-based role of catecholaminergic PET tracers in Neuroblastoma. A systematic review and a head-to-head comparison with mIBG scintigraphy

• Published in: European journal of nuclear medicine and molecular imaging Vol. 51; no. 3; pp. 756 - 767
• Main Authors: Piccardo, Arnoldo, Treglia, Giorgio, Fiz, Francesco, Bar-Sever, Zvi, Bottoni, Gianluca, Biassoni, Lorenzo, Borgwardt, Lise, de Keizer, Bart, Jehanno, Nina, Lopci, Egesta, Kurch, Lars, Massollo, Michela, Nadel, Helen, Roca Bielsa, Isabel, Shulkin, Barry, Vali, Reza, De Palma, Diego, Cecchin, Diego, Santos, Ana Isabel, Zucchetta, Pietro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2024; Springer Nature B.V
• Subjects: 3-Iodobenzylguanidine; Cardiology; Case reports; Child; Clinical medicine; Decision making; Dihydroxyphenylalanine; Fluorine isotopes; Humans; Image acquisition; Imaging; Lesions; Literature reviews; Medical imaging; Medicine; Medicine & Public Health; Neuroblastoma; Neuroblastoma - diagnostic imaging; Neuroblastoma - pathology; Nuclear Medicine; Oncology; Orthopedics; Parameter sensitivity; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography - methods; Positron-Emission Tomography - methods; Radioactive tracers; Radiology; Radiopharmaceuticals; Review Article; Scintigraphy; Spatial discrimination; Spatial resolution; Paediatric PET; I]MIBG, 18F-MFBG, 11C-HED; Guideline; PET-CT; F]F-DOPA; Neuroblastoma; [; Catecholamine; [18F]F-DOPA; [124I]MIBG, 18F-MFBG, 11C-HED
• DOI: 10.1007/s00259-023-06486-9
• ISSN: 1619-7070

Background Molecular imaging is pivotal in staging and response assessment of children with neuroblastoma (NB). [ 123 I]-metaiodobenzylguanidine (mIBG) is the standard imaging method; however, it is characterised by low spatial resolution, time-consuming acquisition procedures and difficult interpretation. Many PET catecholaminergic radiotracers have been proposed as a replacement for [ 123 I]-mIBG, however they have not yet made it into clinical practice. We aimed to review the available literature comparing head-to-head [ 123 I]-mIBG with the most common PET catecholaminergic radiopharmaceuticals. Methods We searched the PubMed database for studies performing a head-to-head comparison between [ 123 I]-mIBG and PET radiopharmaceuticals including meta-hydroxyephedrine ([ 11 C]C-HED), 18 F-18F-3,4-dihydroxyphenylalanine ([ 18 F]DOPA) [ 124 I]mIBG and Meta -[18F]fluorobenzylguanidine ([ 18 F]mFBG). Review articles, preclinical studies, small case series (< 5 subjects), case reports, and articles not in English were excluded. From each study, the following characteristics were extracted: bibliographic information, technical parameters, and the sensitivity of the procedure according to a patient-based analysis (PBA) and a lesion-based analysis (LBA). Results Ten studies were selected: two regarding [ 11 C]C-HED, four [ 18 F]DOPA, one [ 124 I]mIBG, and three [ 18 F]mFBG. These studies included 181 patients (range 5–46). For the PBA, the superiority of the PET method was reported in two out of ten studies (both using [ 18 F]DOPA). For LBA, PET detected significantly more lesions than scintigraphy in seven out of ten studies. Conclusions PET/CT using catecholaminergic tracers shows superior diagnostic performance than mIBG scintigraphy. However, it is still unknown if such superiority can influence clinical decision-making. Nonetheless, the PET examination appears promising for clinical practice as it offers faster image acquisition, less need for sedation, and a single-day examination.