Our purpose was to evaluate the diagnostic role of ¹⁸F-3,4-dihydroxyphenylalanine (DOPA) PET/CT at the time of staging in children with neuroblastoma and to investigate its ability to assess treatment response. We also investigated the prognostic value of ¹⁸F-DOPA PET/CT at the same time points. Methods: We enrolled children with neuroblastoma at onset. Before and after induction chemotherapy, all patients underwent ¹⁸F-DOPA PET/CT and ¹²³I-metaiodobenzylguanidine (MIBG) scanning plus SPECT/CT. ¹⁸F-DOPA PET/CT results were compared with those of ¹²³I-MIBG whole-body scanning (WBS). For each modality, patient-based analysis and lesion-based analysis were performed and sensitivity was calculated. We applied scoring systems to ¹²³I-MIBG scanning and ¹⁸F-DOPA PET/CT (i.e.,¹²³I-MIBG WBS score and whole-body metabolic burden [WBMB], respectively) and evaluated the association between these parameters, the principal neuroblastoma risk factors, and outcome. Results: We enrolled 16 high-risk and 2 intermediate-risk neuroblastoma patients. On patient-based analysis, sensitivity in detecting primary tumors, soft-tissue metastases, and bone or bone-marrow metastases was 83%, 50%, and 92%, respectively, for ¹²³I-MIBG WBS versus 94%, 92%, and 100%, respectively, for ¹⁸F-DOPA PET/CT. On lesion-based analysis, the sensitivity of ¹⁸F-DOPA PET/CT in detecting soft-tissue and bone or bone-marrow metastases was 86% and 99%, respectively—significantly higher than that of ¹²³I-MIBG WBS, at 41% and 93%, respectively. After therapy, on patient-based analysis, the sensitivity in detecting primary tumors, soft-tissue metastases, and bone or bone-marrow metastases was 72%, 33%, and 38%, respectively, for ¹²³I-MIBG WBS versus 83%, 75% and 54%, respectively, for ¹⁸F-DOPA PET/CT. On lesion-based analysis, the sensitivity of ¹⁸F-DOPA PET/CT in detecting soft-tissue and bone or bone-marrow metastases was 77% and 86%, respectively—significantly higher than that of ¹²³I-MIBG WBS, at 28% and 69%, respectively. During follow-up, 8 cases of disease progression and 5 deaths occurred. On multivariate analysis, only posttherapeutic ¹⁸F-DOPA WBMB (>7.5) was associated with progression-free survival. Conclusion: ¹⁸F-DOPA PET/CT is more sensitive than ¹²³I-MIBG WBS in staging neuroblastoma patients and evaluating disease persistence after chemotherapy. In a time-to-event analysis, posttherapeutic ¹⁸F-DOPA WBMB remained the only risk factor associated with disease progression.

我们的目的是评估¹⁸ F-3,4-二羟基苯丙氨酸（DOPA）PET / CT在神经母细胞瘤患儿分期时的诊断作用，并研究其评估治疗反应的能力。我们还调查了¹⁸ F-DOPA PET / CT在同一时间点的预后价值。方法：我们招募了患有神经母细胞瘤的儿童。诱导化疗前后，所有患者均接受¹⁸ F-DOPA PET / CT和¹²³ I-甲氧苄基胍（MIBG）扫描以及SPECT / CT扫描。^将18个F-DOPA PET / CT结果与^123个结果进行了比较I-MIBG全身扫描（WBS）。对于每种方式，均进行了基于患者的分析和基于病变的分析，并计算了敏感性。我们将评分系统应用于¹²³ I-MIBG扫描和¹⁸ F-DOPA PET / CT（即¹²³ I-MIBG WBS评分和全身代谢负荷[WBMB]），并评估了这些参数与主要神经母细胞瘤之间的关联危险因素和结果。结果：我们招募了16例高危和2例中危神经母细胞瘤患者。在基于患者的分析中，¹²³例患者检测原发性肿瘤，软组织转移以及骨或骨髓转移的敏感性分别为83％，50％和92％。I-MIBG WBS与¹⁸ F-DOPA PET / CT分别为94％，92％和100％。在基于病变的分析中，¹⁸ F-DOPA PET / CT在检测软组织和骨或骨髓转移中的敏感性分别为86％和99％，显着高于¹²³ I-MIBG WBS的41岁％和93％。治疗后，基于患者的分析，对于¹²³ I-MIBG WBS ，检测原发肿瘤，软组织转移以及骨或骨髓转移的敏感性分别为72％，33％和38％，而83％¹⁸ F-DOPA PET / CT分别为75％和54％。在基于病变的分析中，敏感性为¹⁸F-DOPA PET / CT检测软组织和骨或骨髓转移的比例分别为77％和86％，显着高于¹²³ I-MIBG WBS的28％和69％。在随访期间，发生了8例疾病进展和5例死亡。在多变量分析中，只有治疗后¹⁸ F-DOPA WBMB（> 7.5）与无进展生存期相关。结论： ¹⁸ F-DOPA PET / CT在分期神经母细胞瘤患者和评估化疗后疾病持续性方面比¹²³ I-MIBG WBS敏感。在事件分析中，治疗后¹⁸ F-DOPA WBMB仍然是与疾病进展相关的唯一危险因素。