[¹⁸F]mFBG PET/CT surpasses [¹⁸F]FDG PET/CT for evaluation of pediatric neuroblastoma

[¹⁸F]FDG PET/CT serves as an alternative imaging modality for neuroblastoma in cases where [¹²³I]MIBG yields negative results or is unavailable. [¹⁸F]mFBG, a novel PET tracer for neuroblastoma imaging, requires further clinical validation. This preliminary study aims to evaluate the efficacy of [¹⁸F]mFBG PET/CT compared to [¹⁸F]FDG PET/CT in detecting neuroblastoma.

In this retrospective investigation, 56 pediatric patients were enrolled. Each patient underwent both [¹⁸F]mFBG PET/CT and [¹⁸F]FDG PET/CT within one week. Two children underwent a second paired [¹⁸F]FDG-[¹⁸F]mFBG PET/CT scan. In total, 58 paired scans (mean age 47.6 ± 38.0 months, range 6-108 months) were performed. Two experienced readers measured normal organ uptake (SUV_mean), lesion uptake (SUV_max), and tumor-to-background ratio (TBR). A lesion-by-lesion analysis was conducted to compare detection rates between [¹⁸F]mFBG and [¹⁸F]FDG.

Twenty paired scans exhibited negative findings on both [¹⁸F]mFBG and [¹⁸F]FDG studies. Among the remaining 38 scans, 8 (21.05%) were [¹⁸F]mFBG-positive/[¹⁸F]FDG-negative, 1 (2.63%) was [¹⁸F]FDG-positive/[¹⁸F]mFBG-negative, and 29 (76.32%) were positive on both tracers. In these 38 scans, [¹⁸F]mFBG PET/CT identified 431 lesions, whereas [¹⁸F]FDG PET/CT detected only 162 lesions (p<0.001). Six of eight [¹⁸F]mFBG-positive/[¹⁸F]FDG-negative cases were histopathologically confirmed as neuroblastoma. The mean TBR of [¹⁸F]mFBG PET/CT(6.68 ± 5.76) was significantly higher (p<0.001) than that of [¹⁸F]FDG PET/CT (4.49 ± 2.88).

[¹⁸F]mFBG PET/CT detected more neuroblastoma lesions than [¹⁸F]FDG PET/CT, suggesting it may be a more viable alternative when standard [¹²³I]MIBG scanning is not feasible.