The baseline ¹⁸F-FDG PET/CT imaging features in pediatric patients with congenital neuroblastoma

Congenital neuroblastoma represents a distinct subtype of neuroblastoma that originates during fetal and neonatal development. Limited research has been conducted on the prognostic significance of baseline Fluorine-18-Fluorodeoxyglucose positron emission tomography/computerized tomography (¹⁸F-FDG PET/CT) in pediatric patients with congenital neuroblastoma. This study aims to characterize the baseline ¹⁸F-FDG PET/CT imaging features in children with congenital neuroblastoma.

A retrospective collection was performed using imaging and clinical data from pediatric patients diagnosed with congenital neuroblastoma who underwent ¹⁸F-FDG PET/CT at the Beijing Friendship Hospital, Capital Medical University between June 2020 and June 2023. We collected clinical and ¹⁸F-FDG PET metabolic parameters, including maximum standardized uptake value, mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), total-body MTV and total-body TLG. Patients were categorized into the recurrence group and the non-recurrence group based on the follow-up outcomes.

A total of 28 pediatric patients with congenital neuroblastoma were included in the study. There are 26 patients exhibited elevated serum NSE levels, 25 patients exhibited elevated serum LDH levels. Only 3 patients had MYCN amplification. 5 patients had 11q23 aberration. Primary tumors were located in the abdomen or mediastinum in all but two patients, who had pelvic and cervical involvement. All primary tumor had high FDG uptake. 6 patients had liver metastases, and 1 patient showed normal FDG uptake. 4 patients had bone marrow metastases, all of them showed high FDG uptake. With a median follow-up of 711 days, 23 patients had progression free survival, and 5 cases of recurrence.

Our study showed that the prognosis of congenital neuroblastoma was generally favorable and ¹⁸F-FDG PET/CT is valuable for the diagnosis and staging in congenital neuroblastoma.