@article {Yanik502, author = {Gregory A. Yanik and Marguerite T. Parisi and Arlene Naranjo and Helen Nadel and Michael J. Gelfand and Julie R. Park and Ruth L. Ladenstein and Ulrike Poetschger and Ariane Boubaker and Dominique Valteau-Couanet and Bieke Lambert and Maria-Rita Castellani and Zvi Bar-Sever and Aurore Oudoux and Anna Kaminska and Susan G. Kreissman and Barry L. Shulkin and Katherine K. Matthay}, title = {Validation of Postinduction Curie Scores in High-Risk Neuroblastoma: A Children{\textquoteright}s Oncology Group and SIOPEN Group Report on SIOPEN/HR-NBL1}, volume = {59}, number = {3}, pages = {502--508}, year = {2018}, doi = {10.2967/jnumed.117.195883}, publisher = {Society of Nuclear Medicine}, abstract = {A semiquantitative 123I-metaiodobenzylguanidine (123I-MIBG) scoring method (the Curie score, or CS) was previously examined in the Children{\textquoteright}s Oncology Group (COG) high-risk neuroblastoma trial, COG A3973, with a postinduction CS of more than 2 being associated with poor event-free survival (EFS). The validation of the CS in an independent dataset, International Society of Paediatric Oncology European Neuroblastoma/High-Risk Neuroblastoma 1 (SIOPEN/HR-NBL1), is now reported. Methods: A retrospective analysis of 123I-MIBG scans obtained from patients who had been prospectively enrolled in SIOPEN/HR-NBL1 was performed. All patients exhibited 123I-MIBG{\textendash}avid, International Neuroblastoma Staging System stage 4 neuroblastoma. 123I-MIBG scans were evaluated at 2 time points, diagnosis (n = 345) and postinduction (n = 330), before consolidation myeloablative therapy. Scans of 10 anatomic regions were evaluated, with each region being scored 0{\textendash}3 on the basis of disease extent and a cumulative CS generated. Cut points for outcome analysis were identified by Youden methodology. CSs from patients enrolled in COG A3973 were used for comparison. Results: The optimal cut point for CS at diagnosis was 12 in SIOPEN/HR-NBL1, with a significant outcome difference by CS noted (5-y EFS, 43.0\% {\textpm} 5.7\% [CS <= 12] vs. 21.4\% {\textpm} 3.6\% [CS \> 12], P \< 0.0001). The optimal CS cut point after induction was 2 in SIOPEN/HR-NBL1, with a postinduction CS of more than 2 being associated with an inferior outcome (5-y EFS, 39.2\% {\textpm} 4.7\% [CS <= 2] vs. 16.4\% {\textpm} 4.2\% [CS \> 2], P \< 0.0001). The postinduction CS maintained independent statistical significance in Cox models when adjusted for the covariates of age and MYCN gene copy number. Conclusion: The prognostic significance of postinduction CSs has now been validated in an independent cohort of patients (SIOPEN/HR-NBL1), with a postinduction CS of more than 2 being associated with an inferior outcome in 2 independent large, cooperative group trials.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/59/3/502}, eprint = {https://jnm.snmjournals.org/content/59/3/502.full.pdf}, journal = {Journal of Nuclear Medicine} }