Application of modified Curie and SIOPEN skeleton scoring systems in ¹⁸F-AlF-NOTA-octreotide PET/CT for neuroblastoma

The study aimed to explore the role of fluorine-18-aluminum fluoride-1,4,7-triazacyclononane-1,4,7-triacetic acid-octreotide (¹⁸F-OC) positron emission tomography/computed tomography (PET/CT) in neuroblastoma (NB) and compared it with Iodine-123 labeled metaiodobenzylguanidine (¹²³I-MIBG) scintigraphy with single photon emission computed tomography/computed tomography (SPECT/CT), as well as to investigate the feasibility of the modified Curie scoring system and International Society of Pediatric Oncology Europe Neuroblastoma (SIOPEN) skeleton scoring system applied in ¹⁸F-OC PET/CT.

Patients with pathologically confirmed NB underwent ¹²³I-MIBG scintigraphy with SPECT/CT and ¹⁸F-OC PET/CT according the standard imaging protocols. The interval between the two imaging techniques ranged from 0 to 22 days (median interval: 9 days). The number of lesions in modified Curie scoring system and SIOPEN skeleton scoring system applied on ¹²³I-MIBG SPECT/CT and ¹⁸F-OC PET/CT was compared.

A total of 50 NB patients (male: female = 25:25) with a median age of 62-month-old were enrolled. ¹²³I-MIBG and ¹⁸F-OC imaging were positive in 22 patients and negative in 27 patients. 1 patient had positive ¹⁸F-OC but negative ¹²³I-MIBG results (p = 1.000). In lesion-based analysis, ¹⁸F-OC PET/CT revealed more positive lesions than ¹²³I-MIBG scintigraphy with SPECT/CT (57 vs. 44, p < 0.001), regardless of bone/bone marrow lesions (43 vs. 37, p = 0.031) or soft tissue lesions (14 vs. 7, p = 0.016). The Curie scores of the two imaging techniques showed a significant difference (p = 0.047), whereas no statistic difference for SIOPEN scores (p = 0.688). The Curie and SIOPEN scores were significantly higher in patients with the presence of MYCN amplification or positive bone marrow puncture result (p < 0.05).

¹⁸F-OC could be used in the evaluation of NB, and the modified Curie scoring system could be used to semi-quantify the disease extent of NB in ¹⁸F-OC PET/CT.