Association of Image-Defined Risk Factors With 18F-FDG PET/CT Metabolic Metrics in Neuroblastoma: Location-Specific Correlations and Comparative Prognostic Significance.

Objective: Anatomic image-defined risk factors (IDRFs) and metabolic metrics from PET/CT imaging can evaluate tumor biology and guide clinical decision-making in neuroblastoma. This study explored the association between IDRFs and 18F-FDG PET/CT metabolic metrics in neuroblastoma and compared their prognostic value.

Methods: A retrospective analysis was conducted on 24 neuroblastoma patients who underwent pretreatment CECT and 18F-FDG PET/CT imaging. IDRF counts were determined from CECT, while PET/CT metabolic metrics, including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured. The Spearman correlation analysis assessed associations between IDRF counts and PET/CT metabolic metrics. Survival analysis evaluated the prognostic significance of IDRF counts and PET/CT metabolic metrics.

Results: IDRF counts were positively correlated with SUVmean (r=0.431, P=0.036), MTV (r=0.679, P<0.001), and TLG (r=0.771, P<0.001), but no significant correlation was observed with SUVmax (r=0.325, P=0.121). Subgroup analysis revealed IDRF counts correlated with MTV (r=0.718, P=0.001) and TLG (r=0.683, P=0.002) in abdominopelvic lesions, and with SUVmax (r=0.808, P=0.028), SUVmean (r=0.875, P=0.010), and TLG (r=0.788, P=0.035) in cervicothoracic lesions. Neither IDRF counts nor PET/CT metabolic metrics were significantly associated with overall survival (P>0.05).

Conclusion: IDRF counts are significantly associated with 18F-FDG PET/CT metabolic metrics in neuroblastoma, with distinct correlation patterns based on lesion location.