| Objective To investigate the clinical value of 18F-FDG PET/CT in the evaluation of the short-term efficacy of neuroblastoma(NB) in children.Methods Clinical data of 14 NB patients with 18F-FDG PET/CT examination were collected from April 1, 2012 to April 1, 2015 in the General Hospital of the Chinese People’s Armed Police Forces. We collected 18F-FDG PET/CT imaging, ultrasonography and NSE of the 14 children during the same period of 18F-FDG PET/CT examination(within one week of 18F-FDG PET/CT examination). The clinical curative effect evaluation was made to be the standard. According to the standard, we comparatively analysised the sensitivity and specificity of 18F-FDG PET/CT, ultrasonography and NSE for evaluating the short-term efficacy of NB patients. At the end of the follow-up, detection rate of recurrence and metastasis lesions of 18F-FDG PET/CT in recurrent patients was compared to ultrasonography, enhanced CT, enhanced MRI, bone scan, bone marrow aspiration and NSE. Meanwhile, the 2 years’ progression free survival(PFS) and overall survival(OS) of 18F-FDG PET/CT negative group and 18F-FDG PET/CT positive group were calculated and compared.Results 14 NB children totally received 18 times 18F-FDG PET/CT examinations, including 4 children inspected at the time both after three cycles chemotherapy of postoperation and after all the treatments. Among the 18 cases clinical efficacy evaluations, 9 cases were complete response(CR); 2 cases were very good partial response(VGPR); 1 cases was partial response(PR); 2 cases were stable disease(SD) and 4 cases were progressive disease(PD). The specificity of 18F-FDG PET/CT, ultrasonography and NSE for evaluating the short-term efficacy of NB children respectively were 100%, 100% and 44.4%. Comparison of each other showed that there was statistical difference between 18F-FDG PET/CT and NSE(P<0.05). The sensitivity of the three respectively were 88.9%, 55.6% and 100%.And comparison of each other showed that there was no statistical difference(P values>0.05). All children were followed up to November 30, 2015.The follow-up time ranged from 12 to 43 months with an average of 21.4 months. 10 patients survived without disease, 2 patients survived with relapse and the other 2 patients died. 4 children who suffered relapse had a total of 17 lesions. The detection rate of 18F-FDG PET/CT for recurrent and metastatic lesions was 88.2%(15/17). The detection rate of ultrasonography and enhanced CT for 4 recurrence cases at home position was respectively 50%(2/4) and 100%(4/4). The detection rate of enhanced MRI for 2 intracranial metastasis lesions and 1 masseter muscle metastasis lesion was 100%(3/3). The detection rate of bone scan for 2 bone metastasis cases was 100%(2/2), and the detection rate of bone marrow aspiration analysis for 2 bone marrow metastasis cases was 100%(2/2). The NSE of 4 recurrent patients increased more than three times abruptly and the rate of increase was 100%(4/4). There were 9 negative cases and 5 positive cases in 14 cases with 18F-FDG PET/CT after treatment. The negative group of 18F-FDG PET/CT were followed up for 14.5 to 43 months(average: 28.9 months). The positive group of 18F-FDG PET/CT were followed up for 12 to 29.5 months(average: 18.6 months). The follow-up time between the two groups had no statistical difference(P > 0.05).The 2 years PFS and OS of 18F-FDG PET/CT negative group(100% and 100%) were higher than the positive group(20% and 33.3%), and the difference was statistically significant(P values < 0.05).Conclusions18F-FDG PET/CT has an important value in the evaluation of the short-term efficacy of NB children, and is helpful for survival prediction. 18F-FDG PET/CT and the traditional examination have each advantages and disadvantages, so cannot replace each other. 18F-FDG PET/CT combined with abruptly increased NSE for the early diagnosis of the relapse and metastasis of NB children may be more accurate. |
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