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Chest CT imaging may safely be omitted from neuroblastoma surveillance for pediatric patients
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Neuroblastoma progression or recurrence in the chest is rare among children and usually can be detected with non-CT imaging modalities or through the presentation of symptoms, according to study results.
The findings suggest chest CT imaging may safely be omitted from neuroblastoma surveillance, allowing for a 35% to 42% reduction in radiation burden among these patients, results showed.
Sara M. Federico, MD, of the department of oncology at St. Jude Children’s Research Hospital, and colleagues evaluated data from 88 patients diagnosed with high-risk neuroblastoma between 2002 and 2009. Patients underwent surveillance imaging through 2013.
Overall, the 5-year OS for the cohort was 51.9% (±6.5%) and the 5-year EFS was 42.6% (±6.5%). At the time of the analysis, 46 patients (58.9%) had progressed or recurred, and 41 patients (52.6%) had died of their disease.
Chest CT surveillance imaging identified thoracic disease progression or recurrence in 11 patients (14%). These cases of progression or recurrence included one paraspinal mass, one pulmonary nodule and nine nodals.
Researchers found that metaiodobenzylguanidine (MIBG) scans were able to detect thoracic disease in six of these patients. The other five patients had normal MIBG scans, but three also presented with symptoms. The other two patients were asymptomatic and had normal MIBG scans but had avid bone disease.
Researchers estimated that forgoing CT chest imaging from surveillance would reduce patients’ radiation burden by 42%. In analyses accounting for modern CT acquisition from 2011 to 2013, the estimated reduction in radiation burden was 34%.
“Neuroblastoma progression/recurrence in the chest is rare and often presents with symptoms or is identified using standard non-CT imaging modalities,” Federico and colleagues concluded. “For patients with non-thoracic high-risk neuroblastoma at diagnosis, omission of surveillance chest CT imaging can save 35%-42% of the radiation burden without compromising disease detection.”
Disclosure: The researchers report no relevant financial disclosures.
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