Neuroblastoma Research and Treatments
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Abstract
Abstract
The prognosis of high-risk neuroblastoma (NB) is highly heterogeneous, underscoring the necessity of refining risk stratification to guide precision treatment and improve outcomes. The aim of this study was to construct an 18 F-FDG PET/CT-based Metabolic-clinical prognostic model to refine risk stratification in high-risk NB. This retrospective study enrolled 72 (41 boys and 31 girls) patients with newly diagnosed high-risk NB. The median age was 4.03 years (interquartile range 2.52–4.95 years). Patients underwent baseline 18 F-FDG PET/CT before receiving any therapy. Two experienced nuclear medicine physicians reviewed the PET/CT images to identify and delineate tumor lesions. Semi-quantitative PET/CT parameters were extracted from lesions, including the maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and intra-tumoral metabolic heterogeneity (IMH), et al. Univariate and multivariate Cox proportional hazards regression analyses were used to identify independent prognostic risk factors and construct the Metabolic-clinical model. The optimal cut-off score for Metabolic-clinical model was determined by receiver operating characteristic curve (ROC). 27 (37.5%) patients remained event-free, while 45 (62.5%) patients experienced relapse or death. Multivariate Cox regression analysis revealed that chromosome 11q deletion ( P = 0.016), NSE ( P = 0.003) and IMH ( P = 0.030) were independent prognostic factors for event-free survival. The chromosome 11q, NSE, and IMH were incorporated into Metabolic-clinical scoring system. Based on the Metabolic-clinical scoring system, all high-risk NB patients were stratified into high- and low-score groups. A significant difference in event-free survival (EFS) was observed between the two groups ( P < 0.001). The median survival time was 39.37 months for low score group versus 15.57 months for the high score group. The 18 F-FDG PET/CT-based Metabolic-clinical prognostic model can refine the risk stratification of high-risk NB, enabling more precise risk assessment. Not applicable.
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@article{Liu2026based,
title = {18F-FDG PET/CT-based Metabolic-clinical prognostic model could refine risk stratification in high-risk neuroblastoma},
author = {Jun Liu and Qinghua Ren and Siqi Li and Lingling Zheng and Xu Yang and Xianyu Zhu and Mingyu Zhang and Jiayu Sun and Jie Liu and Huanmin Wang and Jigang Yang and Wei Wang},
journal = {BMC Medical Imaging},
year = {2026},
doi = {10.1186/s12880-026-02669-6},
url = {https://doi.org/10.1186/s12880-026-02669-6}
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