W. Wang1,2, P. Shi3, X. Zhang2, Z. Fu4,5, K. Cheng6,7, Z. Liu4, J. Wang8, and J. Yue2,9; 1School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong,China, Weifang, China, 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 3Shandong Cancer Hospital affiliated to Shandong First Medical University, Jinan, Shandong, China, 4Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 5PET/CT center, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, Jinan, China, 6Department of PET/CT Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 7Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 8Department of Pediatric Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 9Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
Purpose/Objective(s):Currently, 68Ga-NOTA TATE is the most studied somatostatin receptor (SSR)- targeted PET imaging agent in neuroblastoma (NB). However, the value of 18F-labeled NOTA TATE remains unclear in children with neuroblastoma. We compared two groups of neuroblastoma patients, one group undergoing 18F-NOTA TATE PET/CT and the other undergoing 18F-FDG PET/CT, to explore the value of predicting short-term outcomes in children. Materials/
Methods: We collected 46 children diagnosed with NB between 2022 and 2023 who underwent 18F-NOTA TATE PET/CT (23 cases) or 18F-FDG PET/CT (23 cases) before receiving treatment at our hospital. The metabolic tumour volume (MTV) was derived from these ROIs using a fixed SUV threshold of =40% of SUVmax. The software MIM automatically generated variables including SUVmax, SUVmean, MTV, total lesion SSR (TL-SSR). STL-SSR represents the sum of all soft tissue TL-SSRs. We performed immunohistochemical staining, including NSE, LDH, SSTR2 on the tumor tissue and then performed a semi-quantitative pathological scoring. Imaging evaluation was performed according to the International Neuroblastoma Response Criteria after 4-5 cycles of chemotherapy. Patients with CR or PR were classified as good responders and patients with SD or PD were classified as poor responders. Receiver operating characteristic curve analysis was used to assess the relationships between disease response and PET/CT variables. Correlations between PET variables and associated immunohistochemical markers were assessed using Spearmans rank test. Results: The median age of patients of TATE was 3(2,4 years and FDG groups was (1,3 years). Out of the TATE patients, 9 were classified as good responders and 14 as poor responders. In contrast, in the FDG group, 14 patients were classified as good responders and 9 as poor responders. Immunohistochemical staining was performed in a total of 15 patients with pathological tissue. In the TATE group, SSTR2 staining was positively correlated with PET/CT uptake variables (SUVmean and SUVmax; both p<0.05). In the FDG group, all variables showed no significant difference with the immunohistochemical staining values (all p <0.05). There were differences in SUVmean and SUVmax between the two groups (p=0.029, p=0.003, respectively). In our cohort, SUVmean of 18F-NOTA TATE PET/CT can predict NB short-term outcome, (area=0.792, p=0.018, 95%CI:0.582~1.000). All variables of 18F-FDG PET/CT showed no significance in predicting. Conclusion: 18F-NOTA TATE PET/CT could visualize SSTR2 expression in NB compared to18F-FDG PET/CT. Our results suggest that SUVmean of baseline 18F-NOTA TATE PET/CT could predict short-term outcome in children with NB, superior to 18F-FDG PET/CT.
