PET Effective To Guide Treatment Decisions For A Common Pediatric Cancer

According to a study, positron emission tomography (PET) is significant tool for determining the extent of neuroblastoma in some patients, particularly for those in the early stages of the disease.

By identifying where exactly the diseases has occurred in the body and whether it is spreading helps in choosing appropriate types of treatment, which can include surgery, chemotherapy, radiation and in the most advanced cases, a combination of all of these treatments along with bone marrow transplant or investigational therapies.

The use of Fluorodeoxyglucose (FDG) PET imaging of neuroblastoma is increasing. However, it is unknown that when and in which patients FDG PET imaging is most useful.

Functional imaging plays an important role in assessing neuroblastoma, from initially diagnosing and staging the disease to determining whether patients are responding to treatment or whether the disease has recurred, said Susan E. Sharp, M.D., assistant professor of clinical radiology at Cincinnati Children’s Hospital Medical Center and lead author of the study. Our study found that while MIBG remains the front-line imaging tool for neuroblastoma, FDG-PET imaging can benefit some patients, especially those with early-stage disease.

The study also found that imaging of neuroblastoma tumors that do not readily absorb 123I-metaiodobenzylguanidine (MIBG) may also be done through FDG PET. In these cases, imaging with MIBG alone may not predict some malignant lesions in the body.

The study reviewed a total of 113 who underwent MIBG scans and FDG PET scans in 60 patients with neuroblastoma at two major pediatric cancer institutions. In the study, PET was used in conjunction with localization computerized tomography (CT) scans, and MIBG planar and SPECT imaging were combined. The study shows that for stage 1 and stage 2 neuroblastoma patients, FDG-PET depicted more primary or residual neuroblastoma, although MIBG imaging may be needed to exclude higher-stage disease that has spread to the bone or bone marrow. MIBG is superior in evaluating stage 4 neuroblastoma, primarily because it can detect and follow the response to treatment of tumor in the bone or bone marrow more accurately.