Open AccessUsefulness of 18F-Fluorodeoxyglucose Positron Emission Tomography for Follow-Up of 13-cis-Retinoic Acid Treatment for Residual Neuroblastoma After Myeloablative Chemotherapy
Author(s) -
Yuya Sato,
Hidemitsu Kurosawa,
Setsu Sakamoto,
Shigeko Kuwashima,
Teisuke Hashimoto,
Kentaro Okamoto,
Takashi Terauchi,
Keitaro Fukushima,
Osamu Arisaka
Publication year - 2015
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000001290
Subject(s) - medicine , neuroblastoma , nuclear medicine , positron emission tomography , chemotherapy , scintigraphy , fluorodeoxyglucose , stage (stratigraphy) , autologous stem cell transplantation , radiology , paleontology , genetics , biology , cell culture
13- cis -retinoic acid (13- cis -RA) treatment is used as a second-line treatment for residual or recurrent neuroblastoma. However, determining the duration of 13- cis -RA treatment for residual and recurrent neuroblastoma can be a problem because it is difficult to evaluate the effectiveness of the treatment. We performed 13- cis -RA treatment to remove residual active neuroblastoma cells in an 8-year-old boy with stage 4 neuroblastoma that developed from a left sympathetic ganglion and had been treated with chemotherapy, surgery, autologous peripheral blood stem-cell transplantation, and radiotherapy. 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) and iodine-123 metaiodobenzylguanidine ( 123 I-MIBG) scintigraphy obtained immediately before 13- cis -RA treatment both showed positive findings in the area of the primary lesion. At 18 months after 13- cis -RA treatment, there was accumulation on 123 I-MIBG scintigraphy but no uptake on 18 F-FDG-PET, and 13- cis -RA treatment was suspended. The patient has been in complete remission for 3 years. In comparing the effectiveness of the 2 imaging modalities for monitoring the response to 13- cis -RA treatment, we considered that 18 F-FDG-PET was superior to 123 I-MIBG scintigraphy because 18 F-FDG-PET images were not affected by the cell differentiation induced by 13- cis -RA treatment in our case. Thus, 18 F-FDG-PET was useful for determining the treatment response and outcomes. We have reported a case of residual neuroblastoma treated with differentiation-inducing 13- cis -RA therapy. Different results were produced with 18 F-FDG-PET and 123 I-MIBG scintigraphy. The cessation of 13- cis -RA treatment was based on 18 F-FDG-PET findings and there has been no relapse for 3 years.