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Purpose <p>To assess the prognosis predictive value of semi-quantitative metabolic parameters and tumoral metabolic activity based on <sup>123</sup>I-meta-iodobenzylguanidine (MIBG) SPECT/CT in pretreatment neuroblastoma (NB) patients.</p> Methods <p>A total of 50 children (25 girls, 25 boys, median age 37 months, range 1-102 months) with newly diagnosed NB, consecutively examined with pretherapeutic <sup>123</sup>I-MIBG SPECT/CT between 2018 and 2024, were included in this retrospective study. The semi-quantitative metabolic parameters and activity of primary tumor were measured, including Tmax/Lmax, Tmean/Lmean, Tmax/Lmean, Tmax/Mmax, Tmean/Mmean and asphericity (ASP). The ratio was maximum or mean count of primary tumor, liver and muscle. Clinical data and image-related factors was recorded as well. The outcome endpoint was event-free survival (EFS). Independent predictors were identified through univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) and Kaplan Meier analysis with log-rank test for EFS were performed.</p> Results <p>Median follow-up was 42 months (range 2.5–74 months; 4 patients showed disease progression/relapse, 7 patients died). The univariate and multivariate Cox regression analysis demonstrated that bone/bone marrow metastasis [95% confidence interval (CI): 1.051, 18.570, <i>p</i> = 0.043], Tmax/Lmax (95% CI: 1.074, 1.459, <i>p</i> = 0.004) and ASP (95% CI: 2.618, 273.477, <i>p</i> = 0.006) were independent predictors of EFS. The Kaplan Meier survival analyses demonstrated that Tmax/Lmax undefined<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="40644_2025_858_Article_IEq1.gif" Format="GIF" Height="11" Rendition="HTML" Resolution="72" Type="Linedraw" Width="18" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:&gt;\)</EquationSource> </InlineEquation>]]&gt;6 and ASP <InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="40644_2025_858_Article_IEq2.gif" Format="GIF" Height="11" Rendition="HTML" Resolution="72" Type="Linedraw" Width="18" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:&gt;\)</EquationSource> </InlineEquation>undefined]]&gt;34% and with bone/bone marrow metastasis had worse outcomes.</p> Conclusion <p>In this exploratory study, pretherapeutic <sup>123</sup>I-MIBG image-derived semi-quantitative metabolic parameters and tumor asphericity provided prognostic value for EFS in NB patients. Tmax/Lmax <InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="40644_2025_858_Article_IEq3.gif" Format="GIF" Height="11" Rendition="HTML" Resolution="72" Type="Linedraw" Width="18" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:&gt;\)</EquationSource> </InlineEquation>undefined]]&gt;6 and ASP <InlineEquation ID="IEq4"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="40644_2025_858_Article_IEq4.gif" Format="GIF" Height="11" Rendition="HTML" Resolution="72" Type="Linedraw" Width="18" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:&gt;\)</EquationSource> </InlineEquation>undefined]]&gt;34%, along with the presence of bone/bone marrow metastasis, could be considered as supplementary factors alongside existing ones.</p>

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The prognostic significance of semi-quantitative metabolic parameters and tumoral metabolic activity based on 123I-MIBG SPECT/CT in pretreatment neuroblastoma patients

  • 期刊论文

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  • 发表日期：

    2025年3月31日

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  • Ziang Zhou,
  • Xu Yang,
  • Guanyun Wang,
  • Xiaoya Wang,
  • Jun Liu,
  • Yanfeng Xu,
  • Kan Ying,
  • Wei Wang,
  • Jigang Yang

摘要

Purpose

To assess the prognosis predictive value of semi-quantitative metabolic parameters and tumoral metabolic activity based on 123I-meta-iodobenzylguanidine (MIBG) SPECT/CT in pretreatment neuroblastoma (NB) patients.

Methods

A total of 50 children (25 girls, 25 boys, median age 37 months, range 1-102 months) with newly diagnosed NB, consecutively examined with pretherapeutic 123I-MIBG SPECT/CT between 2018 and 2024, were included in this retrospective study. The semi-quantitative metabolic parameters and activity of primary tumor were measured, including Tmax/Lmax, Tmean/Lmean, Tmax/Lmean, Tmax/Mmax, Tmean/Mmean and asphericity (ASP). The ratio was maximum or mean count of primary tumor, liver and muscle. Clinical data and image-related factors was recorded as well. The outcome endpoint was event-free survival (EFS). Independent predictors were identified through univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) and Kaplan Meier analysis with log-rank test for EFS were performed.

Results

Median follow-up was 42 months (range 2.5–74 months; 4 patients showed disease progression/relapse, 7 patients died). The univariate and multivariate Cox regression analysis demonstrated that bone/bone marrow metastasis [95% confidence interval (CI): 1.051, 18.570, p = 0.043], Tmax/Lmax (95% CI: 1.074, 1.459, p = 0.004) and ASP (95% CI: 2.618, 273.477, p = 0.006) were independent predictors of EFS. The Kaplan Meier survival analyses demonstrated that Tmax/Lmax undefined \(\:>\) ]]>6 and ASP \(\:>\) undefined]]>34% and with bone/bone marrow metastasis had worse outcomes.

Conclusion

In this exploratory study, pretherapeutic 123I-MIBG image-derived semi-quantitative metabolic parameters and tumor asphericity provided prognostic value for EFS in NB patients. Tmax/Lmax \(\:>\) undefined]]>6 and ASP \(\:>\) undefined]]>34%, along with the presence of bone/bone marrow metastasis, could be considered as supplementary factors alongside existing ones.