Postoperative [18F]FDOPA and [18F]FDG PET Semiquantitative Scoring System for Risk Stratification in Neuroblastoma: A Three-tier Classification Approach.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42544989.
- Also identified by DOI 10.1097/RLU.0000000000006613.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Postoperative disease assessment in neuroblastoma remains challenging. We aimed to develop and validate a postoperative semiquantitative dual-tracer PET scoring system integrating [18F]FDOPA and [18F]FDG PET for outcome stratification in pediatric neuroblastoma. In this retrospective single-center study, 46 patients with histologically confirmed neuroblastoma who underwent curative-intent surgery, followed by postoperative dual-tracer PET/CT between 2014 and 2023, were included. Both PET studies were interpreted using a 3-point visual scoring system based on lesion uptake intensity (1: no abnormal uptake, 2: higher than background, and 3: intense uptake ≥3× liver SUVmean). Patients were stratified into dual PET-defined low, intermediate, and high-risk groups. Event-free survival (EFS) and overall survival (OS) were analyzed using Kaplan-Meier and multivariable Cox regression analyses. The discriminatory ability of the dual-tracer PET classification was quantified using Harrell C-index. Median patient age was 2.4 years, and 82.6% were classified as INRG high-risk. Median follow-up was 57.1 months. Patients were stratified into low risk (both scores = 1, n = 18), high risk (either score = 3, n = 9), and intermediate risk (remaining combinations, n = 19). The classification demonstrated significantly different 3-year EFS and OS rates: low-risk (94%, 100%), intermediate-risk (43%, 83%), and high-risk (11%, 42%). The dual PET model showed superior prognostic performance compared with single-tracer assessment (EFS C-index: 0.819 vs. 0.781 for FDG and 0.747 for FDOPA; OS C-index: 0.799 vs. 0.797 and 0.689, respectively). Dual PET classification remained an independent predictor after adjustment for age, MYCN amplification, and INRG classification. Postoperative dual-tracer PET provides robust prognostic stratification in pediatric neuroblastoma and may serve as a practical imaging biomarker for risk-adapted management.