Nuclear medicine review. Central & Eastern Europe · 2026
Potential usefulness of [123I]I-MIBG SPECT/CT with AC Quant protocols in diagnostics and treatment monitoring of children with neuroblastoma.
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Śliwińska Anna, Świtaj Karolina, Durma Adam Daniel
Аннотация
BACKGROUND: Neuroblastoma (NB) is the most common extracranial solid tumor in children. Metaiodobenzylguanidine (MIBG) selectively accumulates in adrenergic tissue, enabling its use for diagnostic imaging of NB. The implementation of new SPECT/CT protocols allows for the application of novel imaging parameters that may improve diagnostic accuracy and disease monitoring. This study aimed to evaluate the usefulness of AC Quant protocols and parameters in the diagnosis of NB.
MATERIAL AND METHODS: This retrospective analysis included 16 treatment-naive children with NB who underwent SPECT/CT with [¹²³I]I-MIBG. AC Quant parameters of the primary tumor and selected organs were analyzed statistically. In the study group, the following tumor parameters were assessed: volume (mL), Hounsfield units (HU), standard deviation of HU (SDHU), SUVmax, SUVpeak, and metabolic tumor volume (MTV). Additionally, SUVmax values for the pancreas, liver, aorta, spleen, and skeletal muscles were measured.
RESULTS: Eight of the sixteen patients underwent chemotherapy. Tumor SUVmax and SUVpeak did not change significantly after treatment (p = 0.068). Chemotherapy resulted in a significant increase in SDHU (p = 0.027) and a significant decrease in MTV (p = 0.043). SUV values in the pancreas, liver, aorta, and spleen increased after chemotherapy (p = 0.010; p = 0.007; p = 0.029; p = 0.050, respectively). Tumor-to-pancreas, tumor-to-liver, tumor-to-aorta, tumor-to-spleen, and tumor-to-muscle ratios did not change significantly (p = 0.326; p = 0.176; p = 0.944; p = 0.674; p = 0.484, respectively), with the smallest differences observed for the tumor-to-aorta and tumor-to-muscle ratios.
CONCLUSIONS: AC Quant parameters demonstrate potential utility in the assessment of patients with NB. Chemotherapy significantly reduces MTV and increases tumor density heterogeneity in NB. The aorta and paraspinal muscles appear to be the most suitable reference organs for quantitative assessment in NB imaging.
MATERIAL AND METHODS: This retrospective analysis included 16 treatment-naive children with NB who underwent SPECT/CT with [¹²³I]I-MIBG. AC Quant parameters of the primary tumor and selected organs were analyzed statistically. In the study group, the following tumor parameters were assessed: volume (mL), Hounsfield units (HU), standard deviation of HU (SDHU), SUVmax, SUVpeak, and metabolic tumor volume (MTV). Additionally, SUVmax values for the pancreas, liver, aorta, spleen, and skeletal muscles were measured.
RESULTS: Eight of the sixteen patients underwent chemotherapy. Tumor SUVmax and SUVpeak did not change significantly after treatment (p = 0.068). Chemotherapy resulted in a significant increase in SDHU (p = 0.027) and a significant decrease in MTV (p = 0.043). SUV values in the pancreas, liver, aorta, and spleen increased after chemotherapy (p = 0.010; p = 0.007; p = 0.029; p = 0.050, respectively). Tumor-to-pancreas, tumor-to-liver, tumor-to-aorta, tumor-to-spleen, and tumor-to-muscle ratios did not change significantly (p = 0.326; p = 0.176; p = 0.944; p = 0.674; p = 0.484, respectively), with the smallest differences observed for the tumor-to-aorta and tumor-to-muscle ratios.
CONCLUSIONS: AC Quant parameters demonstrate potential utility in the assessment of patients with NB. Chemotherapy significantly reduces MTV and increases tumor density heterogeneity in NB. The aorta and paraspinal muscles appear to be the most suitable reference organs for quantitative assessment in NB imaging.