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MIBG scintigraphy and PET imaging for diagnosing neuroblastoma

  • Protocol
  • Diagnostic

Authors


Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

See Figure 1: flowchart of index tests.

Figure 1.

Figure 1.

Flow chart index tests in patients with suspected neuroblastoma.

Primary objective 

  1. To determine the diagnostic accuracy of 123I-MIBG (SPECT-CT) scintigraphy for detecting a primary or recurrent neuroblastoma tumour and its metastases in children from 0 to 18 years old.

  2. To determine the diagnostic accuracy of negative 123I-MIBG scintigraphy in combination with 18F-FDG-PET(-CT) imaging for detecting a primary or recurrent neuroblastoma tumour and its metastases in children from 0 to 18 years old. In this case 18F-FDG-PET(-CT) is an add-on test.

Secondary objectives

  1. To determine the diagnostic accuracy of 18F-FDG-PET(-CT) imaging for detecting a primary or recurrent neuroblastoma tumour and its metastases in children from 0 to 18 years old.

  2. To compare the diagnostic accuracy of 123I-MIBG (SPECT-CT) scintigraphy and of 18F-FDG-PET(-CT) imaging for detecting a primary or recurrent neuroblastoma tumour and its metastases in children from 0 to 18 years old. This will be executed within and between (objective 1.1 compared to objective 2.1) included studies. 123I-MIBG (SPECT-CT) scintigraphy is the comparator test in this case.

When assessing study results, we will consider methodological and clinical sources of heterogeneity as well as variation in the criteria used to define a positive test result.

Several factors may contribute to heterogeneity in diagnostic performance across studies. We will investigate, if possible, the potential influence of differences in the following.

Study population:

  • Primary versus recurrent neuroblastoma.

  • Stage of disease (1 to 4 and 4S).

Index test radiolabelled MIBG (SPECT-CT) scintigraphy:

  • Time span between injection and scanning (24 or 48 hours).

  • Whole-body scan versus SPECT-CT.

  • Interfering medication (Table 3).

Reference standard:

  • Type of test: histopathology (reference test 1) versus bone marrow aspirate or trephine biopsy (reference test 2) versus histopathology in combination with urinary metabolites and additional imaging modalities (reference test 3).

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