Survival prediction of 18F-FDG PET/CT in pediatric patients with recurrent neuroblastoma

PURPOSE: Our study aims to investigate the predictive potential of FDG PET/CT in pediatric patients with NB at the time of recurrence. METHODS: Pediatric patients with suspected recurrence of NB underwent FDG PET/CT were included in this retrospective study. The clinicopathological data, PET visual analysis data and semiquantitative values (maximum standardized uptake value (SUVmax) of tumor, tumor-to-liver uptake ratio (TLR), metabolic tumor volume (MTV), total lesion glycolysis (TLG)), were analyzed. The Kaplan-Meier curves and Cox proportional hazard models were applied in the evaluation of the independent prognostic significance of FDG PET/CT. RESULTS: A total of 45 NB patients who underwent FDG PET/CT due to suspected recurrence of NB and got later confirmation of recurrence clinically or pathologically were included in this retrospective study. Among the PET/CT parameters, recurrent primary site TLR cutoff at 5.64 and SUVmax cutoff at 4.10 derived from the receiver operating characteristic curve yielded significant difference (TLR HR = 2.692, p = 0.014; SUVmax HR = 7.698, 0.045) in overall survival (OS). Besides, INSS stage 4, the time from diagnosis to first relapse (TTFR) and recurrence interval were related with shorter survival time in the four established multivariate Cox regression models. CONCLUSION: FDG PET/CT showed great survival predictable performance in recurrent NB. SUVmax, TLR, INSS stage 4, TTFR and recurrence interval were independent risk factors for overall survival.