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[18F]MFBG PET/CT outperforming [123I]MIBG SPECT/CT in the evaluation of neuroblastoma

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Abstract

Purpose

Iodine 123 labeled meta-iodobenzylguanidine ([123I]MIBG) scan with SPECT/CT imaging is one of the most commonly used imaging modalities in the evaluation of neuroblastoma. [18F]-meta-fluorobenzylguanidine ([18F]MFBG) is a novel positron emission tomography (PET) tracer which was reported to have a similar biodistribution to [123I]MIBG. However, the experience of using [18F]MFBG PET/CT in the evaluation of patients with neuroblastoma is limited. This preliminary investigation aims to assess the efficacy of [18F]MFBG PET/CT in the evaluation of neuroblastomas in comparison to [123I]MIBG scans with SPECT/CT.

Materials and methods

In this prospective, single-center study, 40 participants (mean age 6.0 ± 3.7 years) with history of neuroblastoma were enrolled. All children underwent both [123I]MIBG SPECT/CT and [18F]MFBG PET/CT studies. The number of lesions and the Curie scores revealed by each imaging method were recorded.

Results

Six patients had negative findings on both [123I]MIBG and [18F]MFBG studies. Four of the 34 patients (11.8%) were negative on [123I]MIBG but positive on [18F]MFBG, while 30 patients were positive on both [123I]MIBG and [18F]MFBG studies. In these 34 patients, [18F]MFBG PET/CT identified 784 lesions while [123I]MIBG SPECT/CT detected 532 lesions (p < 0.001). The Curie scores obtained from [18F]MFBG PET/CT (11.32 ± 8.18, range 1-27) were statistically higher (p < 0.001) than those from [123I]MIBG SPECT/CT (7.74 ± 7.52, range 0-26). 30 of 34 patients (88.2%) with active disease on imaging had higher Curie scores based on the [18F]MFBG study than on the [123I]MIBG imaging.

Conclusion

[18F]MFBG PET/CT shows higher lesion detection rate than [123I]MIBG SPECT/CT in the evaluation of pediatric patients with neuroblastoma.

Clinical trial registration

Clinicaltrials.gov: NCT05069220 (Registered: 25 September 2021, retrospectively registered); Institute Review Board of Peking Union Medical College Hospital: ZS-2514

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding authors on reasonable request.

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Funding

This work was supported by Chinese Academy of Medical Science (CAMS) Innovation Fund for Medical Sciences (grant number: CF-2021-12M-1-2-2022564), National High Level Hospital Clinical Research Funding (grant number: 2022-PUMCH-C-003), and National High Level Hospital Clinical Research Funding (grant number: 2022-PUMCH-B-070).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, People’s Republic of China

    Peipei Wang, Tuo Li, Hongli Jing & Fang Li

  2. Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, People’s Republic of China

    Zhikai Liu

  3. Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China

    Mei Jin & Yan Su

  4. Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Jingjing Zhang

  5. Department of Radiology, Children’s Hospital of Philadelphia University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Hongming Zhuang

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  1. Peipei Wang
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Contributions

Guarantors of the integrity of the entire study, all authors; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of the final version of the submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, P.W., Z.L., M.J., F.L.; clinical studies, P.W., T.L., Z.L., M.J., Y.S., H.J., F.L.; experimental studies, P.W., Z.L., M.J., Y.S.; data analysis, P.W., T.L., H.J., J.Z., H.Z., F.L.; and manuscript editing, P.W., T.L., J.Z., Y.S., H.J., H.Z., F.L.

Corresponding authors

Correspondence to Yan Su, Hongli Jing, Hongming Zhuang or Fang Li.

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Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Peking Union Medical College Hospital (Date: 27-Jul-2021/No: ZS-2514).

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Written informed consent was obtained from guardians of patient. In addition, when patients were over the age of 8, consent from the patients were also obtained.

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The authors affirm that human research participants provided informed consent for publication of the images in Figure(s) 2, 3, 4.

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Wang, P., Li, T., Liu, Z. et al. [18F]MFBG PET/CT outperforming [123I]MIBG SPECT/CT in the evaluation of neuroblastoma. Eur J Nucl Med Mol Imaging 50, 3097–3106 (2023). https://doi.org/10.1007/s00259-023-06221-4

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