Gadolinium-based contrast media does not improve the staging of neuroblastoma image-defined risk factors at diagnosis.
neuroblastoma
radiology
surgery
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
Jan 2024
Jan 2024
Historique:
revised:
23
08
2023
received:
02
06
2023
accepted:
06
10
2023
medline:
27
11
2023
pubmed:
17
10
2023
entrez:
17
10
2023
Statut:
ppublish
Résumé
Neuroblastoma risk stratification relies on prognostic risk factors and image-defined risk factors (IDRFs). Evaluating neuroblastoma typically involves magnetic resonance imaging (MRI) with gadolinium-based contrast media (GBCM, "contrast"). However, there are concerns regarding adverse effects and cost of GBCM. We aimed to assess the impact of intravenous GBCM on interobserver agreement for neuroblastoma staging on baseline MRI. We reviewed baseline MRI scans of 50 children with abdominopelvic neuroblastomas confirmed by histopathology. Duplicate sets of images were created, with post-contrast T1-weighted sequences removed from one set. Four pediatric radiologists independently analyzed the scans in a randomized manner. They recorded primary tumor size, presence of IDRFs, and metastatic lesions. Agreement among the reviewers was measured using kappa and Fleiss kappa statistics. Mean age of included children was 3.3 years (range: 0.01-14.9 years), and 20 [40%] were females. Mean tumor size was 5.7 cm in greatest axial diameter. Pre-contrast versus post-contrast MRI showed excellent agreement for tumor measurement. Overlapping confidence intervals (CIs) were seen in nearly all categories of interobserver agreement on the presence or absence of individual IDRFs, with agreement ranging from poor to substantial, regardless of the presence of contrast. The overall interobserver agreement on the presence of at least one IDRF was substantial with contrast (kappa = .63; 95% CI: .52-.75) and moderate without contrast (kappa = .5; 95% CI: .39-.61); although the overlapping CIs suggest a lack of meaningful difference. Similarly, interobserver agreement on the presence or absence of individual sites of metastatic disease ranged from poor to substantial. The interobserver agreement on the overall determination of presence of metastatic disease was fair with contrast (kappa = .49; 95% CI: .38-.61) and moderate without contrast (kappa = .71; 95% CI: .59-.826). Contrast does not improve tumor size measurement or radiologist agreement on the presence or absence of IDRFs or metastatic disease in children with newly diagnosed neuroblastoma.
Sections du résumé
BACKGROUND
BACKGROUND
Neuroblastoma risk stratification relies on prognostic risk factors and image-defined risk factors (IDRFs). Evaluating neuroblastoma typically involves magnetic resonance imaging (MRI) with gadolinium-based contrast media (GBCM, "contrast"). However, there are concerns regarding adverse effects and cost of GBCM. We aimed to assess the impact of intravenous GBCM on interobserver agreement for neuroblastoma staging on baseline MRI.
PROCEDURE
METHODS
We reviewed baseline MRI scans of 50 children with abdominopelvic neuroblastomas confirmed by histopathology. Duplicate sets of images were created, with post-contrast T1-weighted sequences removed from one set. Four pediatric radiologists independently analyzed the scans in a randomized manner. They recorded primary tumor size, presence of IDRFs, and metastatic lesions. Agreement among the reviewers was measured using kappa and Fleiss kappa statistics.
RESULTS
RESULTS
Mean age of included children was 3.3 years (range: 0.01-14.9 years), and 20 [40%] were females. Mean tumor size was 5.7 cm in greatest axial diameter. Pre-contrast versus post-contrast MRI showed excellent agreement for tumor measurement. Overlapping confidence intervals (CIs) were seen in nearly all categories of interobserver agreement on the presence or absence of individual IDRFs, with agreement ranging from poor to substantial, regardless of the presence of contrast. The overall interobserver agreement on the presence of at least one IDRF was substantial with contrast (kappa = .63; 95% CI: .52-.75) and moderate without contrast (kappa = .5; 95% CI: .39-.61); although the overlapping CIs suggest a lack of meaningful difference. Similarly, interobserver agreement on the presence or absence of individual sites of metastatic disease ranged from poor to substantial. The interobserver agreement on the overall determination of presence of metastatic disease was fair with contrast (kappa = .49; 95% CI: .38-.61) and moderate without contrast (kappa = .71; 95% CI: .59-.826).
CONCLUSIONS
CONCLUSIONS
Contrast does not improve tumor size measurement or radiologist agreement on the presence or absence of IDRFs or metastatic disease in children with newly diagnosed neuroblastoma.
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e30724Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014;64:83-103.
London WB, Castleberry RP, Matthay KK, et al. Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children's Oncology Group. J Clin Oncol. 2005;23:6459-6465.
Pinto NR, Applebaum MA, Volchenboum SL, et al. Advances in risk classification and treatment strategies for neuroblastoma. J Clin Oncol. 2015;33:3008-3017.
Cohn SL, Pearson ADJ, London WB, et al. The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol. 2009;27:289-297.
Sarioglu FC, Salman M, Guleryuz H, et al. Radiological staging in neuroblastoma: computed tomography or magnetic resonance imaging? Pol J Radiol. 2019;84:e46-e53.
Maris JM, Hogarty MD, Bagatell R, Cohn SL. Neuroblastoma. Lancet. 2007;369:2106-2120.
Tanabe M, Ohnuma N, Iwai J, et al. Bone marrow metastasis of neuroblastoma analyzed by MRI and its influence on prognosis. Med Pediatr Oncol. 1995;24:292-299.
Sofka CM, Semelka RC, Kelekis NL, et al. Magnetic resonance imaging of neuroblastoma using current techniques. Magn Reson Imaging. 1999;17:193-198.
Mehta K, Haller JO, Legasto AC. Imaging neuroblastoma in children. Crit Rev Comput Tomogr. 2003;44:47-61.
Siegel MJ, Ishwaran H, Fletcher BD, et al. Staging of neuroblastoma at imaging: report of the radiology diagnostic oncology group. Radiology. 2002;223:168-175.
Lai HA, Sharp SE, Bhatia A, et al. Imaging of pediatric neuroblastoma: a COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer. 2022;70(4):e29974.
Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D. High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology. 2014;270:834-841.
Anderson MA, Harrington SG, Kozak BM, Gee MS. Strategies to reduce the use of gadolinium-based contrast agents for abdominal MRI in children. AJR Am J Roentgenol. 2020;214:1054-1064.
Blumfield E, Swenson DW, Iyer RS, Stanescu AL. Gadolinium-based contrast agents-review of recent literature on magnetic resonance imaging signal intensity changes and tissue deposits, with emphasis on pediatric patients. Pediatr Radiol. 2019;49:448-457.
Arendt CT, Beeres M, Leithner D, et al. Gadolinium-enhanced imaging of pediatric thoracic lymphoma: is intravenous contrast really necessary? Eur Radiol. 2019;29:2553-2559.
Marsault P, Ducassou S, Menut F, Bessou P, Havez-Enjolras M, Chateil J-F. Correction to: diagnostic performance of an unenhanced MRI exam for tumor follow-up of the optic pathway gliomas in children. Neuroradiology. 2019;61:721.
Alsharief AN, Martinez-Rios C, Hopyan S, Amirabadi A, Doria AS, Greer M-LC. Usefulness of diffusion-weighted MRI in the initial assessment of osseous sarcomas in children and adolescents. Pediatr Radiol. 2019;49:1201-1208.
Behr GG, Zheng J, Capanu M, Price AP. Is IV contrast necessary for MRI follow-up in children with abdominal neuroblastoma? Clin Imaging. 2021;79:259-264.
Meyer JS, Siegel MJ, Farooqui SO, Jaramillo D, Fletcher BD, Hoffer FA. Which MRI sequence of the spine best reveals bone-marrow metastases of neuroblastoma? Pediatr Radiol. 2005;35:778-785.
Chen AM, Trout AT, Towbin AJ. A review of neuroblastoma image-defined risk factors on magnetic resonance imaging. Pediatr Radiol. 2018;48:1337-1347.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-174.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15:155-163.
Neubauer H, Li M, Müller VR, Pabst T, Beer M. Diagnostic value of diffusion-weighted MRI for tumor characterization, differentiation and monitoring in pediatric patients with neuroblastic tumors. Rofo. 2017;189:640-650.
Mohd ZF, Moineddin R, Grant R, Chavhan GB. Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients. Pediatr Radiol. 2016;46:1684-1693.
Monclair T, Brodeur GM, Ambros PF, et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009;27:298-303.
Parhar D, Joharifard S, Lo AC, Schlosser M-P, Daodu OO. How well do image-defined risk factors (IDRFs) predict surgical outcomes and survival in patients with neuroblastoma? A systematic review and meta-analysis. Pediatr Surg Int. 2020;36:897-907.
Simon T, Hero B, Benz-Bohm G, von Schweinitz D, Berthold F. Review of image defined risk factors in localized neuroblastoma patients: results of the GPOH NB97 trial. Pediatr Blood Cancer. 2008;50:965-969.
Günther P, Holland-Cunz S, Schupp CJ, Stockklausner C, Hinz U, Schenk J-P. Significance of image-defined risk factors for surgical complications in patients with abdominal neuroblastoma. Eur J Pediatr Surg. 2011;21:314-317.
Simon T, Häberle B, Hero B, von Schweinitz D, Berthold F. Role of surgery in the treatment of patients with stage 4 neuroblastoma age 18 months or older at diagnosis. J Clin Oncol. 2013;31:752-758.
Koivusalo AI, Pakarinen MP, Rintala RJ, Saarinen-Pihkala UM. Surgical treatment of neuroblastoma: twenty-three years of experience at a single institution. Surg Today. 2014;44:517-525.
Fumino S, Kimura K, Iehara T, et al. Validity of image-defined risk factors in localized neuroblastoma: a report from two centers in Western Japan. J Pediatr Surg. 2015;50:2102-2106.
Irtan S, Brisse HJ, Minard-Colin V, et al. Image-defined risk factor assessment of neurogenic tumors after neoadjuvant chemotherapy is useful for predicting intra-operative risk factors and the completeness of resection. Pediatr Blood Cancer. 2015;62:1543-1549.
Monclair T, Mosseri V, Cecchetto G, De Bernardi B, Michon J, Holmes K. Influence of image-defined risk factors on the outcome of patients with localised neuroblastoma. A report from the LNESG1 study of the European International Society of Paediatric Oncology Neuroblastoma Group. Pediatr Blood Cancer. 2015;62:1536-1542.
Yeung F, Chung PHY, Tam PKH, Wong KKY. Is complete resection of high-risk stage IV neuroblastoma associated with better survival? J Pediatr Surg. 2015;50:2107-2111.
Yoneda A, Nishikawa M, Uehara S, et al. Can image-defined risk factors predict surgical complications in localized neuroblastoma. Eur J Pediatr Surg. 2016;26:117-122.
Yoneda A, Nishikawa M, Uehara S, et al. Can neoadjuvant chemotherapy reduce the surgical risks for localized neuroblastoma patients with image-defined risk factors at the time of diagnosis? Pediatr Surg Int. 2016;32:209-214.
Rossa A, Cacciavillano W, Rose A, Flores P, Chantada G, Zubizarreta P. Neuroblastoma in patients under 18 months. Single institution experience in Argentina. Medicina (Mex). 2019;79:280-283.
Tanaka Y, Kawashima H, Mori M, et al. Contraindications and image-defined risk factors in laparoscopic resection of abdominal neuroblastoma. Pediatr Surg Int. 2016;32:845-850.
Avanzini S, Pio L, Erminio G, et al. Image-defined risk factors in unresectable neuroblastoma: SIOPEN study on incidence, chemotherapy-induced variation, and impact on surgical outcomes. Pediatr Blood Cancer. 2017;64:e26605. 10.1002/pbc.26605
Penazzi ACS, Tostes VS, Duarte AAB, Lederman HM, Caran EMM, Abib SCV. Do the radiological criteria with the use of risk factors impact the forecasting of abdominal neuroblastic tumor resection in children? Arq Bras Cir Dig. 2017;30:88-92.
Shirota C, Tainaka T, Uchida H, Hinoki A, Chiba K, Tanaka Y. Laparoscopic resection of neuroblastomas in low- to high-risk patients without image-defined risk factors is safe and feasible. BMC Pediatr. 2017;17:71.