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Application of Virtual Trials to Improve the Accuracy of Quantitative Assessments of Pathological Lesions by Single-Photon Emission Computed Tomography in Patients with Neuroblastoma

N. Denisova, M. Gurko, Y. Likar, S. A. Ryzhov

Meditsinskaya Fizika, 2026

Abstract

Purpose: The development of a simulation mathematical modeling method is an urgent task for pediatric nuclear medicine due to the ethical limitations of clinical trials. A mathematical model of a pediatric patient allows for safe testing under various irradiation conditions, while computer experiments can be conducted without restrictions under different scenarios. Thanks to realistic modeling, virtual trials offer an effective way to evaluate and optimize imaging technologies. This study is the first work aimed at developing and validating mathematical modeling software using digital twins of patients with neuroblastoma to improve the accuracy of quantitative assessments of pathological lesions.

Material and methods: A software package "Virtual Platform for Simulation Trials of the 123I MIBG SPECT/CT Method in Pediatric Oncology" has been developed, which acts as a simulator for the SPECT scanning procedure. A methodology for creating "virtual patients" – digital twins of real patients with neuroblastoma – has been established. Simulation modeling of a clinical case involving a patient with neuroblastoma examined on a Discovery NM/CT 670 scanner with the 123I-MIBG radiopharmaceutical at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology was conducted.

Results: Good agreement was obtained between the clinical "raw" data recorded from a real patient and the projection data calculated by the Monte Carlo method from their…

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