123 I-MIBG SPECT/CT断层显像在儿童神经母细胞瘤Curie评分中的价值分析

目的 探讨¹²³碘-间碘苄胍(¹²³I-metaiodobenzylguanidine,¹²³I-MIBG)平面显像和单光子发射型计算机断层成像(single-photon emission computed tomography,SPECT/CT)在儿童神经母细胞瘤Curie评分中的价值。方法 分析211例神经母细胞瘤患儿的¹²³I-MIBG平面显像和SPECT/CT断层显像的图像,所有患儿均属于3期或4期的高危患者。收集¹²³I-MIBG平面显像和SPECT/CT断层显像的Curie评分,以病理结果、其他相关的影像学检查及临床随访为神经母细胞瘤病灶诊断的依据,分别比较两种显像方式的差异性,以及它们与金标准的一致性和诊断准确率。结果 在211例患儿中,48.82%(103/211)的患儿基于¹²³I-MIBG平面显像和SPECT/CT断层显像的Curie评分是一致的。51.18%(108/211)的患儿¹²³I-MIBG平面显像和SPECT/CT断层显像差异有统计学意义。¹²³I-MIBG平面显像的Curie评分为0(0,1)分,SPECT/CT断层显像的Curie评分为0(0,2)分,两种显像方式的Curie评分差异有统计学意义(Z=-3.46,P<0.001)。依据Curie评分的结果,将患者分为高分组(≥2)和低分组(＜2),两种显像方式的分组差异有统计学意义(P=0.001)。¹²³I-MIBG平面显像和SPECT/CT断层显像的诊断正确率分别为51.66%和93.84%,两种显像方法的诊断准确率差异有统计学意义(P＜0.001);它们与金标准的诊断一致性分别为0.44(0.34~0.54)和0.90(0.85~0.96),相较于¹²³I-MIBG平面显像,SPECT/CT断层显像具有极好的一致性。结论 与¹²³I-MIBG平面显像相比,SPECT/CT断层显像具有更高的诊断准确率及诊断一致性;基于¹²³I-MIBG SPECT/CT断层显像的Curie评分,对患儿全身肿瘤情况的半定量评估具有非常重要的意义。

The value of ~(123)I-MIBG SPECT/CT tomography imaging in Curie score of pediatric neuroblastoma

Objective To explore the value of ¹²³I-metaiodobenzylguanidine(¹²³I-MIBG ) plane imaging and single-photon emission computed tomography (SPECT)/ computed tomography (CT) in Curie score of pediatric neuroblastoma. Methods Retrospective analysis of ¹²³I-MIBG plane imaging and SPECT/CT tomography images of 211 pediatric neuroblastoma patients was performed. All patients were ranked into high-risk patients with stage 3 or 4. All scores of ¹²³I-MIBG SPECT/CT planar and tomography imaging were collected. Pathological results, other related imaging examinations and clinical follow-up results were used as gold standard of diagnosis. The differences between two imaging methods were compared, and also the diagnostic accuracy and consistency of two imaging methods were compared with gold standard of diagnosis. Results Based on planar imaging and SPECT/CT tomography, 48.82% (103/211) patients had same Curie scores while 51.18% (108/211) patients had different scores. Curie score of planar imaging and tomography were 0 (0,1) and 0 (0,2), respectively, with significant difference (Z=-3.46, P<0.001). According to the results of Curie score, patients were divided into high score group (≥2) and low score group (<2). There was significant difference between two imaging methods in grouping (P=0.001). The diagnostic accuracy rates of planar imaging and tomographic imaging were 51.66% and 93.84%, respectively, with significant difference (P＜0.001). The diagnostic consistency of two imaging with the gold standard of diagnosis was 0.44(0.34-0.54) and 0.90 (0.85-0.96) respectively. Compared with planar imaging, tomography imaging showed excellent consistency with gold standard of diagnosis. Conclusion Compared with planar imaging, tomography imaging had better diagnostic accuracy and consistency. The Curie score based on ¹²³I-MIBG SPECT/CT tomography imaging had an important significance for semi-quantitative evaluation of pediatric neuroblastoma.