Predictive value of 18 F-FDG PET/CT versus bone marrow biopsy and aspiration in pediatric neuroblastoma

作者全名："Zhao, Zhenzhen; Yang, Chao"

作者地址："[Zhao, Zhenzhen; Yang, Chao] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Key Lab Child Dev & Disorders, Dept Surg Oncol,Childrens Hosp,Int Sci & Technol C, Chongqing 400014, Peoples R China; [Yang, Chao] 136 Zhongshan 2 Rd, Chongqing 400014, Peoples R China"

通信作者："Yang, C (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Key Lab Child Dev & Disorders, Dept Surg Oncol,Childrens Hosp,Int Sci & Technol C, Chongqing 400014, Peoples R China.; Yang, C (通讯作者)，136 Zhongshan 2 Rd, Chongqing 400014, Peoples R China."

来源：CLINICAL & EXPERIMENTAL METASTASIS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001201061600001

JCR分区：Q2

影响因子：4

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Neuroblastoma; Bone marrow; PET/CT; Pediatric; Overall survival

摘要："BackgroundNeuroblastoma (NB) is the most prevalent solid extracranial malignancy in children, often with bone marrow metastases (BMM) are present. The conventional approach for detecting BMM is bone marrow biopsy and aspiration (BMBA). 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (18 F-FDG PET/CT) has become a staple for staging and is also capable of evaluating marrow infiltration. The consensus on the utility of 18 F-FDG PET/CT for assessing BMM in NB patients is still under deliberation.MethodsThis retrospective study enrolled 266 pediatric patients with pathologically proven NB. All patients had pretherapy FDG PET/CT. BMBA, clinical, radiological, and follow-up data were also collected. The diagnostic accuracy of BMBA and 18 F-FDG PET/CT was assessed.ResultsBMBAs identified BMM in 96 cases (36.1%), while 18 F-FDG PET/CT detected BMI in 106 cases (39.8%) within the cohort. The initial sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) of 18 F-FDG PET/CT were 93.8%, 84.9%, 90.6%, and 96.3%, respectively. After treatment, these values were 92.3%, 70.6%, 97.3%, and 99.4%, respectively. The kappa statistic, which measures agreement between BMBA and 18 F-FDG PET/CT, was 0.825 before treatment and 0.784 after treatment, with both values indicating a substantial agreement (P = 0.000). Additionally, the amplification of MYCN and a positive initial PET/CT scan were identified as independent prognostic factors for overall survival (OS).Conclusion18 F-FDG-PET/CT is a valuable method for evaluating BMM in NB. The routine practice of performing a BMBA without discrimination may need to be reassessed. Negative result from 18 F-FDG-PET/CT could potentially spare children with invasive bone marrow biopsies."

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